• Journal of agricultural medicine and community health
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• v.19 no.2
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• pp.141-158
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• 1994

To provide better health care services to the rural population, the government has made the Community Health Practitioner(CHP) a regular government official from April 1, 1992. This study was carried out to study the impact of officialization of CHP on the activities and management system of Primary Health Post(PHP). Fifty PHPs were selected by two stage sampling, cluster and simple random, from 595 PHPs in Kyungnam and Kyungpook provinces. Data were collected by a personal interview with CHPs and review of records and reports kept in the PHPs. The study was done for the periods of January 1-March 31, 1992 (before officialization) and January 1-March 31, 1993 (after officialization). Ninety-six percent of the CHPs wanted to become a regular government official in the hope of better job security and higher salary. The proportion of CHPs who were proud of their iob was increased from 24% to 46% after officialization. Those CHPs who felt insecure for their job decreased from 30% to 10%. Monthly salary was increased by 34% from 802,600 Won to 1,076,000 Won and 90% of the CHPs were satisfied with their salary, also more CHPs responded that they have autonomy in their work planning, implementation of plan, management of the post, and evaluation of their activity. There were no appreciable changes in such CHPs' activities as assessment of local health resources, drawing map for the catchment area, utilization of community organization, grasping the current population structure in the catchment area, keeping the family health records, individual and group health education, and school health service. However, the number of home visits was increased from 13.6 times on the average per month per CHP to 27.5 times. More mothers and children were referred to other medical facilities for the immunization and family planning services. Average number of patients of hypertension, cancer, and diabetes in three months period was decreased from 12.7 to 11.6, from 1.5 to 1.2, and 4.3 to 3.4, respectively. Records for the patient care, drug management, and equipment were well kept but not for other records. The level of record keeping was not changed after officialization. The proportion of PHPs which had support from the health center was increased for drug supply from 14.0% to 30.0%, for consumable commodities from 22.0% to 52.0%, for maintenance of PHP from 54.0% to 68.0%, for supply of health education materials from 34.0% to 44.0%, and supply of equipment from 54.0% to 58.0%. Total monthly revenue of a PHP was increased by about 50,000 Won; increased by 22,000 Won in patient care and 34,700 Won in the government subsidy but decreased in the membership due and donation. However, there was no remarkable changes in the expenditure. The proportion of PHPs which had received official notes from the health center for the purpose of guidance and supervision of the CHPs was increased from 20% to 38% during three months period and the average number of telephone call for supervision from the health center per PHP was increased from 1.8 to 2.1 times(p<0.01). However, the proportion of PHPs that had supervisory visit and conference was reduced from 79% to 62%, and from 88% to 74%, respectively. The proportion of CHPs who maintained a cooperative relationship with Myun Health Workers was reduced from 42% to 36%, that with the director of health center from 46% to 24%, that with the chief of public health administration section from 56% to 36%, and that with the chairman of PHP management council from 62% to 38%. Most of the CHPs (92% before and 82% after officialization) stated that the PHP management council is not helpful for the PHP. CHPs who considered the PHP management council unnecessary increased from 4% to 16%(p<0.05). Suggestions made by the CHPs for the improvement of CHP program included emphasis on health education, assurance of autonomy for PHP management, increase of the kind of drugs that can be dispensed by CHPs, and appointment of an experienced CHP in the health center as the supervisor of CHPs. The results of this study revealed that the role and function of CHPs as reflected in their activities have not been changed after officialization. However, satisfaction in job security and salary was improved as well as the autonomy. Support of health center to the PHP was improved but more official notes were sent to the PHPs which required the CHPs more paper works. Number of telephone calls for supervision was increased but there was little administrative and technical guidance for the CHP activities.

• Journal of agricultural medicine and community health
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• v.25 no.2
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• pp.231-244
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• 2000

Classification and research trends were studied to analyze a total of 240 original articles that have been published in 34 volumes of The Korean Journal of Rural Medicine from 1976 to 1999. The results were as follows: 1. A total of 337 articles were published. Among them, 240(71.2%) articles were classified as original articles. This number has been increasing significantly over the years as the number of the articles was 13 in the 1970s, 73 in the 1980s, and 154 in the 1990s. 2. There were 10 authors in the original articles and 55(22.9%) of them were written by 3 of them. There were five research institutions involved in the articles, and 106(44.2%) of the articles were done by one research group. 3. In the original articles. 24(10.0%) were noted to be done using research funds, and only 6(2.5%) were written in English. 4. In the view of the research styles of the original articles, 115(47.9%) used analytical study, 92(38.3%) used technical study, 21(9.2%) used experimental study, and 6(2.5%) used case reports. In the 1970s, 13(100.0%) articles used technical study, and in the 1980s, 47(64.4%) used technical studies and 19(26.0%) used analytical studies. However, in the 1990s, 96(62.8%) articles used analytical studies and 32(20.9%) used technical studies. The statistical methods most commonly used in the articles were technical statistics, the ${\chi}^2$-test, and the t-test respectively. 5. On the classification into three different research fields, 105(43.8%) articles were classified as health management, 96(40.0%) as disease epidemiology, and 39(16.3%) as rural environment and rural occupational disorders. In the 1970s, 12 (92.3 %) of the articles were on disease epidemiology and 1(7.7%) on health management were published. In the 1980s, 33(45.2%) articles on disease epidemiology, 29(39.7%) on health control, and 11(15.1%) on rural environment and rural occupational disorders were recorded. In the 1990s, however, 75(48.7%) articles were on health control, 51(33.1%) on disease control, and 28(18.2%) on the rural environment and rural occupational disorders. 6. According to the research subjects in each research field, the 39 articles in rural environment and rural occupational disorders were composed of 8(20.5%) articles on pesticide intoxication, 7(17,9%) on farmer's diseases, 7(17.9%) on vinyl-house diseases, and 6(15.4%) on accidents. From a total of 96 articles in disease epidemiology 56(58.3%) articles were on parasites, 16(16.7%) on non-infectious diseases, 12(12.5) on infectious diseases. From 105 articles in health control 25(23.8%) articles were on medical care utilization patterns, 18(17.1%) on the health care delivery system, and 13(12.4%) on maternal and child health. In the analysis of the 10 most prevalent subjects dealt in the above articles, 6(46.2%) articles were on parasites and 4(30.8%) on non-infectious diseases were recorded in the 1970s. In the 1980s, 28(38.4%) were on parasites. 9(12.3%) on the health care system, 7(9.6%) on medical care utilization patterns, 5(6.8%) on maternal and child health, and 4(5.5%) were on pesticide intoxication. In the 1990s, 22(14.3%) articles were on parasites. 18(11.7%) on medical care utilization patterns, 16(10.4%) on senile health, 14(9.1%) on the health care system, 10(6.5%) on infectious diseases, arid 10(6.5%) were on non-infectious diseases. In conclusion, the research activity on rural health has been strengthened in this country because the original articles in The Korean Journal of Rural Medicine have significantly increased in the past 24 years. In the 1970s and 1980s, research on disease epidemiology was most prevalent, but in the 1990s papers on health care were most popular. In addition, the articles on parasites were most frequently published in the 1970s, 1980s, and 1990s, showing that parasitic problem was the main theme in those eras. However, in the 1990s, it was evident that the articles on parasites were decreasing and articles on the subject of medical care utilization patterns and senile health increased. Hereafter it was expected that research on health care would be more common in rural health in Korea.