• Journal of Preventive Medicine and Public Health
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• v.7 no.1
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• pp.29-94
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• 1974

Today most developed countries provide modern medical care for most of the population. The rural area is the more neglected area in the medical and health field. In public health, the philosophy is that medical care for in maintenance of health is a basic right of man; it should not be discriminated against racial, environmental or financial situations. The deficiency of the medical care system, cultural bias, economic development, and ignorance of the residents about health care brought about the shortage of medical personnel and facilities on the rural areas. Moreover, medical students and physicians have been taught less about rural health care than about urban health care. Medical care, therefore, is insufficient in terms of health care personnel/and facilities in rural areas. Under such a situation, there is growing concern about the health problems among the rural population. The findings presented in this report are useful measures of the major health problems and even more important, as a guide to planning for improved medical care systems. It is hoped that findings from this study will be useful to those responsible for improving the delivery of health service for the rural population. Objectives: -to determine the health status of the residents in the rural areas. -to assess the rural population's needs in terms of health and medical care. -to make recommendations concerning improvement in the delivery of health and medical care for the rural population. Procedures: For the sampling design, the ideal would be to sample according to the proportion of the composition age-groups. As the health problems would be different by group, the sample was divided into 10 different age-groups. If the sample were allocated by proportion of composition of each age group, some age groups would be too small to estimate the health problem. The sample size of each age-group population was 100 people/age-groups. Personal interviews were conducted by specially trained medical students. The interviews dealt at length with current health status, medical care problems, utilization of medical services, medical cost paid for medical care and attitudes toward health. In addition, more information was gained from the public health field, including environmental sanitation, maternal and child health, family planning, tuberculosis control, and dental health. The sample Sample size was one fourth of total population: 1,438 The aged 10-14 years showed the largest number of 254 and the aged under one year was the smallest number of 81. Participation in examination Examination sessions usually were held in the morning every Tuesday, Wenesday, and Thursday for 3 hours at each session at the Namchun Health station. In general, the rate of participation in medical examination was low especially in ages between 10-19 years old. The highest rate of participation among are groups was the under one year age-group by 100 percent. The lowest use rate as low as 3% of those in the age-groups 10-19 years who are attending junior and senior high school in Taegu city so the time was not convenient for them to recieve examinations. Among the over 20 years old group, the rate of participation of female was higher than that of males. The results are as follows: A. Publie health problems Population: The number of pre-school age group who required child health was 724, among them infants numbered 96. Number of eligible women aged 15-44 years was 1,279, and women with husband who need maternal health numbered 700. The age-group of 65 years or older was 201 needed more health care and 65 of them had disabilities. (Table 2). Environmental sanitation: Seventy-nine percent of the residents relied upon well water as a primary source of dringking water. Ninety-three percent of the drinking water supply was rated as unfited quality for drinking. More than 90% of latrines were unhygienic, in structure design and sanitation (Table 15). Maternal and child health: Maternal health Average number of pregnancies of eligible women was 4 times. There was almost no pre- and post-natal care. Pregnancy wastage Still births was 33 per 1,000 live births. Spontaneous abortion was 156 per 1,000 live births. Induced abortion was 137 per 1,000 live births. Delivery condition More than 90 percent of deliveries were conducted at home. Attendants at last delivery were laymen by 76% and delivery without attendants was 14%. The rate of non-sterilized scissors as an instrument used to cut the umbilical cord was as high as 54% and of sickles was 14%. The rate of difficult delivery counted for 3%. Maternal death rate estimates about 35 per 10,000 live births. Child health Consultation rate for child health was almost non existant. In general, vaccination rate of children was low; vaccination rates for children aged 0-5 years with BCG and small pox were 34 and 28 percent respectively. The rate of vaccination with DPT and Polio were 23 and 25% respectively but the rate of the complete three injections were as low as 5 and 3% respectively. The number of dead children was 280 per 1,000 living children. Infants death rate was 45 per 1,000 live births (Table 16), Family planning: Approval rate of married women for family planning was as high as 86%. The rate of experiences of contraception in the past was 51%. The current rate of contraception was 37%. Willingness to use contraception in the future was as high as 86% (Table 17). Tuberculosis control: Number of registration patients at the health center currently was 25. The number indicates one eighth of estimate number of tuberculosis in the area. Number of discharged cases in the past accounted for 79 which showed 50% of active cases when discharged time. Rate of complete treatment among reasons of discharge in the past as low as 28%. There needs to be a follow up observation of the discharged cases (Table 18). Dental problems: More than 50% of the total population have at least one or more dental problems. (Table 19) B. Medical care problems Incidence rate: 1. In one month Incidence rate of medical care problems during one month was 19.6 percent. Among these health problems which required rest at home were 11.8 percent. The estimated number of patients in the total population is 1,206. The health problems reported most frequently in interviews during one month are: GI trouble, respiratory disease, neuralgia, skin disease, and communicable disease-in that order, The rate of health problems by age groups was highest in the 1-4 age group and in the 60 years or over age group, the lowest rate was the 10-14 year age group. In general, 0-29 year age group except the 1-4 year age group was low incidence rate. After 30 years old the rate of health problems increases gradually with aging. Eighty-three percent of health problems that occured during one month were solved by primary medical care procedures. Seventeen percent of health problems needed secondary care. Days rested at home because of illness during one month were 0.7 days per interviewee and 8days per patient and it accounts for 2,161 days for the total productive population in the area. (Table 20) 2. In a year The incidence rate of medical care problems during a year was 74.8%, among them health problems which required rest at home was 37 percent. Estimated number of patients in the total population during a year was 4,600. The health problems that occured most frequently among the interviewees during a year were: Cold (30%), GI trouble (18), respiratory disease (11), anemia (10), diarrhea (10), neuralgia (10), parasite disease (9), ENT (7), skin (7), headache (7), trauma (4), communicable disease (3), and circulatory disease (3) -in that order. The rate of health problems by age groups was highest in the infants group, thereafter the rate decreased gradually until the age 15-19 year age group which showed the lowest, and then the rate increased gradually with aging. Eighty-seven percent of health problems during a year were solved by primary medical care. Thirteen percent of them needed secondary medical care procedures. Days rested at home because of illness during a year were 16 days per interviewee and 44 days per patient and it accounted for 57,335 days lost among productive age group in the area (Table 21). Among those given medical examination, the conditions observed most frequently were respiratory disease, GI trouble, parasite disease, neuralgia, skin disease, trauma, tuberculosis, anemia, chronic obstructive lung disease, eye disorders-in that order (Table 22). The main health problems required secondary medical care are as fellows: (previous page). Utilization of medical care (treatment) The rate of treatment by various medical facilities for all health problems during one month was 73 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 52% while the rate of those who have health problems which did not required rest was 61 percent (Table 23). The rate of receiving of medical care for all health problems during a year was 67 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 82 percent while the rate of those who have health problems which did not required rest was as low as 53 percent (Table 24). Types of medical facilitied used were as follows: Hospital and clinics: 32-35% Herb clinics: 9-10% Drugstore: 53-58% Hospitalization Rate of hospitalization was 1.7% and the estimate number of hospitalizations among the total population during a year will be 107 persons (Table 25). Medical cost: Average medical cost per person during one month and a year were 171 and 2,800 won respectively. Average medical cost per patient during one month and a year were 1,109 and 3,740 won respectively. Average cost per household during a year was 15,800 won (Table 26, 27). Solution measures for health and medical care problems in rural area: A. Health problems which could be solved by paramedical workers such as nurses, midwives and aid nurses etc. are as follows: 1. Improvement of environmental sanitation 2. MCH except medical care problems 3. Family planning except surgical intervention 4. Tuberculosis control except diagnosis and prescription 5. Dental care except operational intervention 6. Health education for residents for improvement of utilization of medical facilities and early diagnosis etc. B. Medical care problems 1. Eighty-five percent of health problems could be solved by primary care procedures by general practitioners. 2. Fifteen percent of health problems need secondary medical procedures by a specialist. C. Medical cost Concidering the economic situation in rural area the amount of 2,062 won per residents during a year will be burdensome, so financial assistance is needed gorvernment to solve health and medical care problems for rural people.

• Journal of Global Scholars of Marketing Science
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• v.17 no.4
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• pp.141-173
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• 2007

The study examines how the environmental factors of store influence service brand personality and repurchase intention in the service environment. The service industry has been experiencing the intensified competition with the industry's continuous growth and the influence from rapid technological advancement. Under the circumstances, it has become ever more important for the brand competitiveness to be distinctively recognized against competition. A brand needs to be distinguished and differentiated from competing companies because they are all engaged in the similar environment of the service industry. The differentiation of brand achievement has become increasingly important to highlight certain brand functions to include emotional, self-expressive, and symbolic functions since the importance of such functions has been further emphasized in promoting consumption activities. That is the recent role of brand personality that has been emphasized in the service industry. In other words, customers now freely and actively express their personalities or egos in consumption activities, taking an important role in construction of a brand asset. Hence, the study suggests that it is necessary to disperse the recognition and acknowledgement that the maintenance of the existing customers contributes more to boost repurchase intention when it is compared to the efforts to create new customers, particularly in the service industry. Meanwhile, the store itself can offer a unique environment that may influence the consumer's purchase decision. Consumers interact with store environments in the process of,virtually, all household purchase they make (Sarel 1981). Thus, store environments may encourage customers to purchase. The roles that store environments play are to provide informational cues to customers about the store and goods and communicate messages to stimulate consumers' emotions. The store environments differentiate the store from competing stores and build a unique service brand personality. However, the existing studies related to brand in the service industry mostly concentrated on the relationship between the quality of service and customer satisfaction, and they are mostly generalized while the connective studies focused on brand personality. Such approaches show limitations and are insufficient to investigate on the relationship between store environment and brand personality in the service industry. Accordingly, the study intends to identify the level of contribution to the establishment of brand personality made by the store's physical environments that influence on the specific brand characteristics depending on the type of service. The study also intends to identify what kind of relationships with brand personality exists with brand personality while being influenced by store environments. In addition, the study intends to make meaningful suggestions to better direct marketing efforts by identifying whether a brand personality makes a positive influence to induce an intention for repurchase. For this study, the service industry is classified into four categories based on to the characteristics of service: experimental-emotional service, emotional -credible service, credible-functional service, and functional-experimental service. The type of business with the most frequent customer contact is determined for each service type and the enterprise with the highest brand value in each service sector based on the report made by the Korea Management Association. They are designated as the representative of each category. The selected representatives are a fast-food store (experimental-emotional service), a cinema house (emotional-credible service), a bank (credible-functional service), and discount store (functional-experimental service). The survey was conducted for the four selected brands to represent each service category among consumers who are experienced users of the designated stores in Seoul Metropolitan City and Gyeonggi province via written questionnaires in order to verify the suggested assumptions in the study. In particular, the survey adopted 15 scales, which represent each characteristic factor, among the 42 unique characteristics developed by Jennifer Aaker(1997) to assess the brand personality of each service brand. SPSS for Windows Release 12.0 and LISREL were used in the analysis of data verification. The methodology of the structural equation model was used for the study and the pivotal findings are as follows. 1) The environmental factors ware classified as design factors, ambient factors, and social factors. Therefore, the validity of measurement scale of Baker et al. (1994) was proved. 2) The service brand personalities were subdivided as sincerity, excitement, competence, sophistication, and ruggedness, which makes the use of the brand personality scales by Jennifer Aaker(1997) appropriate in the service industry as well. 3) One-way ANOVA analysis on the scales of store environment and service brand personality showed that there exist statistically significant differences in each service category. For example, the social factors were highest in discount stores, while the ambient factors and design factors were highest in fast-food stores. The discount stores were highest in the sincerity and excitement, while the highest point for banks was in the competence and ruggedness, and the highest point for fast-food stores was in the sophistication, The consumers will make a different respond to the physical environment of stores and service brand personality that are inherent to the corresponding service interface. Hence, the customers will make a different decision-making when dealing with different service categories. In this aspect, the relationships of variables in the proposed hypothesis appear to work in a different way depending on the exposed service category. 4) The store environment factors influenced on service brand personalities differently by category of service. The factors of store's physical environment are transferred to a brand and were verified to strengthen service brand personalities. In particular, the level of influence on the service brand personality by physical environment differs depending on service category or dimension, which indicates that there is a need to apply a different style of management to a different service category or dimension. It signifies that there needs to be a brand strategy established in order to positively influence the relationship with consumers by utilizing an appropriate brand personality factor depending on different characteristics by service category or dimension. 5) The service brand personalities influenced on the repurchase intention. Especially, the largest influence was made in the sophistication dimension of service brand personality scale; the unique and characteristically appropriate arrangement of physical environment will make customers stay in the service environment for a long time and will lead to give a positive influence on the repurchase intention. 6) The store environment factors influenced on the repurchase intention. Particularly, the largest influence was made on the social factors of store environment. The most intriguing finding is that the service factor among all other environment factors gives the biggest influence to the repurchase intention in most of all service types except fast-food stores. Such result indicates that the customers pay attention to how much the employees try to provide a quality service when they make an evaluation on the service brand. At the same time, it also indicates that the personal factor is directly transmitted to the construction of brand personality. The employees' attitude and behavior are the determinants to establish a service brand personality in the process of enhancing service interface. Hence, there should be a reinforced search for a method to efficiently manage the service staff who has a direct contact with customers in order to make an affirmative improvement of the customers' brand evaluation at the service interface. The findings suggest several managerial implications. 1) Results from the empirical study indicated that store environment factors have a strong positive impact on a service brand personality. To increase customers' repurchase intention of a service brand, the management is required to effectively manage store environment factors and create a friendly brand personality based on the corresponding service environment. 2) Mangers and researchers must understand and recognize that the store environment elements are important marketing tools, and that brand personality influences on consumers' repurchase intention. Based on such result of the study, a service brand could be utilized as an efficient measure to achieve a differentiation by enforcing the elements that are most influential among all other store environments for each service category. Therefore, brand personality established involving various store environments will further reinforce the relationship with customers through the elevated brand identification of which utilization to induce repurchase decision can be used as an entry barrier. 3) The study identified the store environment as a component of service brand personality for the store's effective communication with consumers. For this, all communication channels should be maintained with consistency and an integrated marketing communication should be executed to efficiently approach to a larger number of customers. Mangers and researchers must find strategies for aligning decisions about store environment elements with the retailers' marketing and store personality objectives. All ambient, design, and social factors need to be orchestrated so that consumers can take an appropriate store personality. In this study, the induced results from the previous studies were extended to the service industry so as to identify the customers' decision making process that leads to repurchase intention and a result similar to those of the previous studies. The findings suggested several theoretical and managerial implications. However, the situation that only one service brand served as the subject of analysis for each service category, and the situation that correlations among store environment elements were not identified, as well as the problem of representation in selection of samples should be considered and supplemented in the future when further studies are conducted. In addition, various antecedents and consequences of brand personality must be looked at in the aspect of the service environment for further research.