巡回診療事業의 問題點과 改善方向 : 一部 無醫地域에 對한 地域社會診斷을 中心으로 = A Study on the Mobile Medical Service Program-Based on the Community Diagnosis of a Remote Farm Area
저자
발행기관
학술지명
권호사항
발행연도
1979
작성언어
Korean
KDC
040.000
자료형태
학술저널
수록면
367-382(16쪽)
제공처
소장기관
The mobile medical service has been operated for many years by a number of medical schools and hospitals as a most convenient means of medical service delivery to the people residing in such area where the geographical and socioeconomic conditions are not good enough to enjoy modern medical care. Despite of official appraisal showing off simply with numbers of outpatients treated and medical persons participated, however, as well recognized, the capability (in respect of budget, equipment and time) of those mobile medical teams is so limitted that it often discourages the recipients as well as medical participants themselves.
In the midst of rising need to secure medical service of good quality to all parts of the country, and of developing concept of primary health care system, authors evaluated the effectiveness of and problems associated with mobile medical aerivice program through the community diagnosis of a village (Opo-myun, Kwangju-gun) to obtain the information which may be helpful for future improvement.
1. Owing to the nationwide Sae-Maul movement powerfully practiced during last several years, living environment of farm villages generally and remarkably improved including houses, water supply and wastes disposal etc. Neverthless, due to limitations in budget, tome and lack of knowledge (probably the most important), these improvements tend to keep up appearances only and are far from the goal which may bring practical benefit in promoting the health of the community.
2. As a result of intensive population policy led by the government since 1962, there has been considerable advances in understanding and the rate of practicing family planning through out the villages and yet, one should see many things, especially education, to be done. Fifty eight per cent of mothers have not received prenatal check and the care for most (72%) delivery was offered by laymen at home.
3. Approximately seven per cent of the population was reported to have chronic illness but since only a few (practically none) of the people has had physical check up by doctors, the actual prevalence of chronic diseases may reach many times of the reported. The same fact was observed also in prevalence of tuberculosis; the patients registered at local health center totaled 31 comprising only 0.51% while the numbers in two neighboring villages (desganated as demonstration area of tuberculosis control and mass examination was done recently) were 3.5 and 4.0% respectively.
Prevalence rate of all diseases and injuries experienced during one month (July, 1977) was 15.8%. Only one tenth of those patients received treatment by physicians and one fifth was not treated at all. The situation was worse as for the chronic patient; 84% of all cases have never been treated or discontinued therapy, and the main reasons were known to be financial difficulty and ignorance or indifference.
4. Among the patients treated by our mobile clinic, one third was chronic cases and 45% of all patients, by the opinion of doctors attended, were those who may be treated by specially trained nurses or other paramedidcs (objects of primary care). Besides, 20 % of the cases required professional managements of level beyond the mobile team's capability and in this sense one may couclude that the effectiveness (performance) of present mobile medical team is quite limitted.
According to above findings, the authors would like to suggest followings for mobile medical service and overall medicare program for the people living in remote country side.
1. Establishment of primary health care system secured with effective communication and evacuation (between villages and local medical center) measures.
2. Nationwide enforcement of medical insurance system.
3. Simple outpatient care which now constitutes the main part of the most mobile medical services should largely be yieled up to primary health care unit of the village and the mobile services should largely be yieled up to primary health care unit of the village and the mobile team itself should be assigned on new and more urgent missions such as mass screening health examination of .the villagers, health education with modern and effective audiovisual aids, professional training and consultant services for the primary health care organization.
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