• Journal of Preventive Medicine and Public Health
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• 제49권6호
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• pp.386-393
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• 2016

Objectives: General practitioners (GPs) retention in rural and underserved areas highly effects on accessibility of healthcare facilities across the country. Education seems to be a critical factor that affects GPs retention. Thus, the present study aimed at inquiry into medical education challenges that limit their retention in rural and underserved areas. Methods: A qualitative approach was applied for the aim of this study. Data were gathered via 28 semi-structured interviews with experts at different levels of Iran's health system as well as GPs who retained and refused to retain working in rural settings. Interviews mainly were performed face-to-face and in some cases via telephone during 2015 and then coded and analyzed using content analysis approach. Results: Iran's medical education is faced with several challenges that were categorized in four main themes including student selection, medical students' perception about their field of study, education setting and approach, curriculum of medical education. According to experts this challenges could results in making GP graduates disinterested for practicing in rural and underserved areas. Conclusions: Challenges that were found could have negative effects on retention. Modification in student's perception about rural practice could be done via changing education setting and approach and curriculum. These modifications could improve GPs retention in rural and underserved areas.

• 보건행정학회지
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• 제2권1호
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• pp.147-166
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• 1992

The purpose of this study is to analyze the effects of the health center hospital on the health service utilization pattern of the rural population in a county. Two field studies had been conducted in Yonchon County, Kyunggi Province, on February 1989 and on August 1991 before and after the establishment of the Yonchon health center hospital. This study revealed that Yonchon health center hospital occupied 7.3% of total outpatient visits and 16.8% of hospitalization of the county population and the self-sufficient rate of the outpatient visit and hospitalization of Yonchon County between two field studies increased by 1.7% and 20.9% each. Yonchon health center hospital contributed to the growth of the public health sector but it weakened the role of health sub-centers. For the efficient health service utilization of the population in that County, more investment to health center hospital would be needed and the primary health activities of the health subcenter should be enforced.

• 농촌의학ㆍ지역보건
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• 제22권2호
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• pp.225-237
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• 1997

This study was conducted to the cognition and attitude for internal and external organizational behavior of health centers staff. An analytical model employed in this study was developed by modifying 'organizational behavior model'. Data was collected a mail survey of officers at health center, including 66 directors and 1,768 staffs of the health centers in southern region. The major findings are as follows : Among directors of the health centers 47% of them stated that legislators and chief executive officer(CEO) of local governments are highly concerned about the public health program. However only 15.2% of health center directors reported that legislators and CEO put public health high priority. For leadership type of directors 39.0% of them was classified as controller, 30.3% as participant, 22.7% entertaining and 7.6% comprehending. Regarding sociopsychological characteristics of the health center staffs, about a quarter of them had high degree of group cohesion, while 10.7% had low degree. Those staffs who are older, high educational level, or working in the rural health centers showed higher degree of cohesion than those who are young, low educational level, or working in urban health center. A third of them were less likely to be satisfied by what they are doing at the health centers. The higher educational level, the likely to be satisfied by what they are doing at the health centers. The higher educational level, the more satisfied with their job. Considering these results, policy implication was discussed and suggested. It is suggested that educational efforts be made to improve leadership of the health center directors and concern with public health program by the CEOs and legislators of local governments.

• 대한예방한의학회지
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• 제24권2호
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• pp.57-62
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• 2020

Objectives : This study is retrospective chart review research on the combined-prescription of Western and Korean medicine in Public Health Center in rural area. Methods : Researchers reviewed medical records of patients who was prescribed Korean medicine and Western medicine from 1st, Jan, 2019 to 31st, Dec, 2019 in Public Health Center. 50 patients' medical records were included. Results : Total number of treatment is 3,808 cases and 1.3% of them is prescribed Korean medicine and Western medicine simultaneously. Prescription of Korean medicine is 153 cases and Western medicine is 160. Jowiseunggi-tang and Diroba tablet were the most frequently prescribed Korean medicine and Western medicine. Furthermore, Korean Medicine Doctors of Public Health Center use muscular skeletal disease system code(M code among KCD code) for prescription and Western Medicine Doctors use diseases of the circulatory system(I code among KCD code) frequently. Conclusions : We analyze 50 patients who were prescribed both Korean medicine and Western medicine. Mostly, patients were prescribed medicine for different diseases in each clinic. In western medicine clinic, drugs about circulatory or endocrine disease were prescribed frequently and in Korean Medicine clinic, drugs about muscular skeletal disease were most frequently prescribed. This result imply the real world's combination of prescription status that was different from result of National health insurance corporation database. Senior patients in rural area take medicine long period and have various underlying disease. We call for some attention about senior and rural area patients' prescription status in interaction studies of Korean medicine and Western medicine.

• 농촌의학ㆍ지역보건
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• 제18권1호
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• pp.77-91
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• 1993

농촌지역 주민들의 보건의료원에 대한 인식도 및 이용양상을 파악하여 보건의료원 제도와 관련된 연구에 기초자료를 제공하고자 1990년 9월 24일부터 90년 9월 28일 까지 5일간 정상북도 울진군 소재 국민학교 3개교와 중학교 3개교의 학부모들에게 설문지를 배부, 회수된 832가구의 가구원 754명을 대상으로 분석한 결과를 요약하면 다음과 같다. 응답자는 남자 60.3%, 여자 39.7%였고 연령은 30, 40대가 81.3%로 대부분을 차지하였으며, 교육수준은 고졸이 40.3%, 의료보장형태로는 지역의료보험이 44.1%를 차지하였다. 응답자의 58.4%가 보건의료원이라는 명칭을 알고 있었는데, 응답자의 학력과 수입이 높을 수록 그리고 거주지역이 보건의료원에 근접한 지역일수록 보건의료원에 대한 인식도가 높았다(p<0.01). 보건의료원의 진료사업 내용중에서 의료보호대 상자 진료와 치과진료를, 각각 35.1%와 31.0%가 알고 있었으며, 보건예방서비스 사업에서는 예방접종사업을 36.1%로 가장 많이 인지하고 있었는데, 학력과 지리적 근접도가 높을수록 보건의료원의 사업내용 인지도는 높게 나타났다. 보건의료원의 연간 외래이용율과 예방서비스 이용율은 대상자 100명당 11.1회 및 4.5회였으며, 입원이용율은 10,000명당 34.6회였다. 보건의료원 이용동기는 잘나아서(45.7%), 약이 좋아서 (45.2%), 거리가 가까워서(42.9%) 순이었다. 일반병의원과 비교해서 보건의료원의 진료수준이 더 좋다고 응답한 이용자는 16.3% 였고, 더 못하다는 19.0%였다. 또한 보건의료원의 진료비가 저렴하다고 한 응답자는 61.5%인데 비해 비싸다고한 경우는 3.9%였다. 보건의료원 이용시의 교통수단으로는 도보가 55.0%, 버스가 35.5%로 대부분이었다. 보건의료원 이용시 느낀 불편사항으로는 장시간 대기가 46.7%로 가장 많았고, 그 다음으로 이용시간이 제한되어 있어서가 17.8%였다. 보건의료원을 한번도 이용하지 않은 이유로는 아픈적이 없어서가 33.5%, 교통이 불편하고 거리가 멀어서가 28.0%, 장시간 대기한다고 해서가 12.8%순으로 나타났다. 이상과 같이 아직도 보건의료원에 대한 인식이 낮고, 잘못 인식하고 있는 주민이 많기 때문에 보건의료원에 대한 전반적인 홍보가 필요할 것으로 보이며, 보건의료원의 이용율을 높이기 위해서는 의료시설, 장비확충과 더불어 의료진의 보강이 필요하고 관리의 효율성도 고려해야 할 것으로 생각된다.

• 한국보건간호학회지
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• 제17권1호
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• pp.47-57
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• 2003

The purpose of this study was to investigate health status and health promoting behaviors of female elderly, and their needs for health-related services in an urban-rural combined city. The data were collected from the subjects registered in senior welfare center and senior citizens' clubs. A total of 119 women were participated in the survey. The results of the study are as follows; 1. The subjects perceived their health status relatively unhealthy. Their health promotion behavior score was 10.82 (range 0-17), and more than $60\%$ of them performed well in smoking and drinking control, regular meal. taking breakfast, and maintaining good relationship with others. 2. The most needed service was health screening followed by health risk assessment, disease diagnosis and treatment. 3. The most demanded education was on dementia prevention, followed by exercise, balanced diet, and maintenance of memorial and mental capability. 4. As the health interest and the health responsibility increased, the need for health service increased as well. Likewise, the health education needs increased as the health interest, health responsibility, and health promotion behavior increased. The results show that the health promotion programs for female elderly need to be focused, primarily, on health screening, health risk assessment, medical services for disease diagnosis and treatment, and health consulting and education. And health consulting and education programs should be designed to promote health interest and health responsibility of female elderly, change positively their attitude to aging, and include education on dementia prevention, exercise and nutrition management. Recommendations are discussed.

• 기본간호학회지
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• 제11권1호
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• pp.82-91
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• 2004

Purpose: The purpose of this study was to identify health promoting behavior and life satisfaction in rural elderly people. Method: The data were collected from October 1st 2002 to October 31th, 2003. The participants were 142 elderly people living in Hong Cheon, Korea. Data were collected using structured questionnaires and analyzed using the SPSS program. Result: The average score for the health promoting behavior was 2.64 (${\pm}0.34$), with a minimum of 1.48 and maximum of 3.80. The average scores for each subscale were, nutrition, 2.98, interpersonal support, 2.78, health responsibility, 2.67, self-actualization, 2.66, stress management, 2.58, and exercise, 1.93. Signifiant differences in health promoting behavior were found according to the following general characteristics: education level, religion, senior citizens center usage and allowance. The average score for life satisfaction was 2.68 (${\pm}0.42$), with a minimum of 1.38 and a maximum of 3.85. Senior citizens center usage was the only general characteristics that showed a significant difference for life satisfaction. There was a significant positive correlation between health promoting behavior and life satisfaction (r= 0.5783, p=0.001). Self-actualization and stress management had statistically significant casual effects on life satisfaction ($R^2$=0.3961). Conclusion: Effective methods to enhance life satisfaction of rural elderly should emphasize self-actualization and stress management.

• 한국환경보건학회:학술대회논문집
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• 한국환경보건학회 2004년도 International Conference Current Challenges and Advances in Environmental Health
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• pp.8-11
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• 2004

Objective To know about hygienic condition of drinking water in rural area of Kunming. Methods Selected 4 counties with different economy to investigate. In every county, according to the proportion, 10 drinking water spots were selected by randomization of lift drinking water'. Results In 4 areas, surface water for drinking is 82.41%, under water is 17.59%. And concentrated supply is 83.02% by populated proportion, others are 16.98%. 40 specimens qualification rate is 47.50%, and in it concentrated supply is 87.50%, others are 19.05%. Conclusion Unhealthy drinking water exist in most testing counties. Mainly microorganism isn't qualified. Concentrated management in drinking water is batter than other ways.

• 농촌지도와개발
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• 제18권3호
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• pp.591-629
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• 2011

The purpose of this research is to examine how the village community centers are being used and find how to improve leisure activities of elders in rural areas by using them. In order to achieve the purpose of this research, we did convenience sampling from elders using 92 village community centers in one of the counties in Gyeong-gi province, and did field survey to 343 persons. The collected data was analyzed by SPSS 18 program, and the results are as follows: The survey on population sociological peculiarity of elders using village community centers shows that most of elders are over 70 years old. As for health conditions, there are more elders who are physically weaker than healthy elders. And the survey shows that most of the elders are suffering from illness such as hypertension, arthritis, neuralgia, and indigestion so such programs related to health are critically required. First, the survey on using village community centers by elders in rural areas shows that they think the village community centers are important for them and use them often. Most of respondents said that they use the village community center so as to meet friends, to enjoy leisure, and to spend time in rural areas where they have difficulty enjoying cultural facilities. Meanwhile, some people dislike to use the village community centers mainly because there is few programs for leisure or each one has a different personality or they don't have enough money to pay for the membership fee. Second, according to the survey on leisure for the elders in village community centers, there are few leisure programs. For men, they spend time by playing Baduk, Janggi, Hwatu and drinking. Meanwhile, women spend time by meeting with friends, listening to radio and TV watching. There are almost nothing to improve leisure activities such as hobby, recreation and health etc. Male elders using centers are suffering from health problems, economic difficulty, and lack of leisure activities, meanwhile, female elders are suffering from loneliness, health problems, and economic difficulty. Third, according to the survey on improving the leisure program of village community center, elders preferred health related programs to improve leisure activities. The most necessary leisure activities in village community center are hobby classrooms, health programs and group travelling. They preferred health related programs for leisure in village community center. Based upon the reality described above, improving the village community centers as leisure facilities is considered to be important for the welfare well of elders in rural areas.

• 농촌의학ㆍ지역보건
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• 제24권1호
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• pp.49-63
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• 1999

1. 건강증진을 위한 농촌형과 도시형을 특성을 고려한 다양한 시설 및 프로그램의 개발이 필요하다. 순천시 주민의 건강실천행위는 미흡하다고 할 수 있으며 특히 농촌지역은 기본적인 의료시설 뿐만 아니라 건강증진을 위한 체육시설도 갖추고 있지 않다. 건강 행태를 실천하도록 유도하기 위한 다양한 시설과 교육프로그램을 개발하여 올바른 생활습관이 되도록 유도해야 할 것이다. 2. 건강증진을 위하여 지역사회와의 제휴를 형성하여 지역 구성원들이 적극 참여하도록 해야 한다. 좋은 보건교육프로그램이 있다 하더라도 지역 주민의 참여와 지원 없이는 성공할 수 없다. 그러므로 사기관, 자선기관, 공공보건조직을 프로그램에 따라 연계하여 실질적으로 전 주민의 참여를 유도할 수 있어야 한다. 3. 보건소의 역할에 대한 중요성을 재인식하고 지역의료체계의 핵심적인 중추기관으로서의 기능을 재정립해야 한다. 의료시설이 미비한 농촌지역의 경우는 보건지소와 보건진료소가 의료시설의 역할을 대행할 수 있는 수준으로 준비가 되어 접근성이 부족한 주민들의 불편함을 보완할 수 있다. 보건소가 지금까지 수행해온 기능을 재정리하고 지역주민이 무엇을 원하고 있는가를 파악하여 지역보건의료에 관련된 전체적인 계획을 수립하는데 기초로 삼아야 할 것이다. 이제까지의 사업실적위주의 업무에서 탈피하여 구체적인 기획을 수행하는 의사결정기구로서의 역할에 그 중요성을 두어야 할 것이다. 4. 지역주민의 요구사항을 적극 수용할 수 있는 정보시스템의 구축이 필요하다. 현대는 정보화 시대이기 때문에 빠른 업무 수행이 그 성과의 승패를 좌우할 수 있을 것이다. 현장에서 직접 주민의 요구를 수용하여 정책으로 처리하기 위해서는 정보화가 필수적이다. 순천시인 경우 그 특성상 농촌형과 도시형이 함께 존재하는데, 현재와 같이 일일이 개별 방문만을 통한 관리는 시간적으로나 경제적으로 효율적이지 않으므로 주민들의 요구를 정확히 파악하여 필요한 정보관리를 위해서는 보건의료 정보화의 구축이 시급하다.