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A survey on the perception of the role of public health doctors of Korean medicine due to regional health care gaps

Article information

J Korean Med. 2024;45(3):168-180
Publication date (electronic) : 2024 September 1
doi : https://doi.org/10.13048/jkm.24047
Eunyoung Choi1orcid_icon, Hyein Jeong2orcid_icon, Harin Kwon3orcid_icon, Soobo Shim4orcid_icon, Hyelim Lee1orcid_icon, Kyeong Han Kim5,orcid_icon
1Department of Pediatrics, College of Korean Medicine, Daejeon University
2Department of Preventive Medicine, School of Korean Medicine, Kyunghee University
3Department of Gynecology and Obstetrics, College of Korean Medicine, Wonkwang University
4Association of Public Health Doctors of Korean Medicine
5Department of Preventive Medicine, School of Korean Medicine, Woosuk University
Correspondence to: Kyeong Han Kim, College of Korean Medicine, Woosuk University, 61 seonneomeo 3-gil, wansan-gu, Jeonju 54986, Republic of Korea, Tel: +82-63-290-9031, E-mail: solip922@hanmail.net
Received 2024 July 26; Revised 2024 August 3; Accepted 2024 August 19.

Abstract

Objectives

This study aims to understand the current state of regional healthcare services and explore the role of public health doctors of Korean medicine (PHDKMs) in addressing healthcare disparities.

Methods

An online survey was conducted among 951 PHDKMs registered with the Korean Public Health Korean Medicine Doctors Association from July 15 to July 19, 2024. A total of 266 responses were collected, and after removing 2 insincere responses, 264 responses were used for analysis. The survey included questions on the provision of healthcare services and the role of PHDKMs in local healthcare crisis.

Results

Out of 264 responses, 85 community health centers and branches (32.2%) lacked public health doctors (PHDs). The traveling clinics were the most common alternative in these cases. Centers without PHDs received 46 complaints (54.1%) about healthcare gaps, while centers with PHDs received 70 complaints (39.1%), showing statistically significant differences. The most common complaints involved consultation and management of chronic elderly diseases. PHDKMs reported being capable of providing musculoskeletal and internal medicine treatments, but identified a need for improvement in emergency response, basic and inflammatory treatments, consultation and management of chronic elderly diseases, administration of medications, and vaccinations. They expressed a high willingness and perceived capability to perform minor medical tasks.

Conclusion

The decline in PHDs is adversely affecting regional healthcare. PHDKMs can help address these gaps through expanded roles and additional training. Policymakers should consider better integrating PHDKMs into the public healthcare system to ensure continuous and comprehensive healthcare services in underserved areas.

Keywords: Public health doctors; Korean medicine; Regional healthcare gap

Current Status of Healthcare Services in Community Health Centers and Branches

Complaint of patients based on Placement of Public Health Doctors

Types of Complaints

Perceptions of the Role of Public Health Doctors of Korean Medicine

Perceptions of the Minor Medical Service of Public Health Doctors of Korean Medicine

Willingness to Perform Minor Medical Service based on Placement of Public Health Doctors

References

1. Ministry of Health and Welfare. 2024. 2024 Guidelines for the Public Health Doctor System Sejong, Korea: Ministry of Health and Welfare.
2.

Act on Special Measures for Health and Medical Services in Agricultural and Fishing Villages 1980 [Enforcement on December 31, 1980] [Law No. 3335, December 31, 1980, enacted]

3. Ministry of Health and Welfare. 2005. Central Job Training Manual for New Public Health Doctors Seoul, Korea: Ministry of Health and Welfare.
4. Ministry of Health and Welfare. 2006. 2006 Plan for Promoting Oriental Public Health Projects Seoul, Korea: Ministry of Health and Welfare.
5.

Act on Special Measures for Health and Medical Services in Agricultural and Fishing Villages

6. Kim M. K.. 2024. Operation Plan for Efficient Management of Health Institutions in Rural Areas due to the Decrease in Public Health Doctors: Focusing on Goesan-gun Jungwon University.
7. Korea Development Institute. 2023. Forecast of the Impact of Population Changes on Labor, Education, and Medical Sectors Considering Future Population Projections for 2021 Sejong, Korea: Korea Development Institute.
8. Ministry of Health and Welfare. 2024. Official Document: Request for Cooperation in Dispatching Public Health Doctors for Emergency Medical Support at Medical Institutions Sejong, Korea: Ministry of Health and Welfare.
9. Kim E. Y.. Decrease of 979 Public Health Doctors in the Last 10 Years... ‘Red Light’ in Health Center Operations 2023. Available from https://www.docdocdoc.co.kr/news/articleView.html?idxno=3010088.
10. Ministry of Health and Welfare. 2024. Press Release: Placement of 716 New Public Health Doctors in 2024 Sejong, Korea: Ministry of Health and Welfare.
11. Oh S. H., Kim J. S.. 2024;Strategies to enhance public health doctor system in South Korea. J Korean Med Assoc 67(6):415–422. doi:https://doi.org/10.5124/jkma.2024.67.6.415.
12. Health and Welfare Committee. 2023. Review Report on the Partial Amendment of the Regional Health Act (Bill No. 2122429) Seoul, Korea: Health and Welfare Committee.
13. Mun O. L., Park J. S., Kim G. H., Lee J. C., Jeong B. G., Jang D. M.. 2002;Job Analysis and Strategies for Utilizing Oriental Public Health Doctors Working at Health Center. Korean Assoc Health Med Soc 11:67–84.
14. Park J. S., Jang D. M., Mun O. L.. 2002;Health Center Director’s Cognition and Attitude on the Strategies for Utilizing Oriental Public Health doctors. Kor J Orient Med Soc 6(1):1–14.
15. Korea Health Industry Development Institute. 2007. Strategies for Efficient Workforce Utilization in Public Health Programs (Study No. TRKO201500007274) Seoul, Korea: Ministry of Health and Welfare.
16. Kim H. M.. 2023. An Analysis about Organizational Socialization and Public Service Motivation(PSM), Job Satisfaction of Public Health Doctor of Korean Medicine Seoul University.
17. Jin S. M., Park S. J.. 2017;Exploring the roles of Korean public health doctors in the development of Korean medicine health promotion project. J Soc Prevent Korean Med 21(3):11–18. doi: 10.25153/spkom.2017.21.3.002.
18. Song T. J.. 2012. A Study on the Plan to improve the Traditional Korean Medicine Healthcare Program for Public Health Oriental Medical Doctors Wonkwang University.
19. Lee J. S., Lee E. K., Lee K. N., Chong M. S.. 2011;Recognition of Traditional Korean Medical Public Health Program in Public Health Oriental Medical Doctors. Korean J Oriental Prevent Med Soc 15(2):115–130.
20. Shim S. B., Lee H. H., Lee S. H., Hwang M. K., Park J. S., Park S, J., et al. 2023;A Survey on Public Health Doctor of Korean Medicine Participating in School Doctor of Korean Medicine Program. J Korean Med 44(2):60–69. doi:https://doi.org/10.13048/jkm.23017.
21. Namgung Y. S.. 2024. 67.1% of non-dispatched public health workers complain of stress. 87.8% increase in mobile medical treatment Available from http://www.doctorstimes.com/news/articleView.html?idxno=227487.
22. The Society of Stroke on Korean Medicine. 2021. Hypertension Clinical Practice Guideline of Korean Medicine. National Institute for Korean Medicine Development Seoul, Korea: National Institute for Korean Medicine Development.
23. The Society of Internal Korean Medicine. 2023. Type 2 Diabetes Mellitus Clinical Practice Guideline of Korean Medicine National Institute for Korean Medicine Development. Seoul, Korea: National Institute for Korean Medicine Development.
24. Park J. Y.. 2021. Investigation research on current status and perception of using insurance herbal medicine by public health Korean medical doctors in rural areas Wonkwang University.
25. Kim K. H., Lee J. A., Go H. Y., Choi J., Park S. J., Lee M. S., et al. 2016;A review of the development of the public health doctor system in Korea - The role of traditional Korean Medicine. European J Integr Med 8(5):841–846. doi:https://doi.org/10.1016/j.eujim.2016.05.009.
26. Daejeon University. 2016. Study on the Model of Traditional Korean Medicine Health Promotion Programs at Public Health Centers (Study No. TRKO201900000822) Sejong, Korea: Ministry of Health and Welfare.
27. Korean Consumer Agency. 2012;Problems and Improvement Plans of Emergency Room in Hospital. Korean Consumer Agency Investigation Report :1–56.
28. Seo J.H., Lee S. J., Ha J. H., Kim J. H., Lee J. H., Na B. J., et al. 2011;The Experience and Competence of Physicians Who Provide Emergency Health Care at Public Health Sub-Centers on Remote Islands in Korea. J Agric Med Community Health 35(1):36–46. doi: 10.5393/JAMCH.2011.36.1.036.
29. Choi Y. J., Yoon J. G.. 2022;Status analysis of patients on islands and seas of Jeollanam-do. The Korean Journal of Emergency Medical Services 26(2):87–96. Doi: https://doi.org/10.14408/KJEMS.2022.26.2.087.
30.

Infectious Disease Control and Prevention Act.

31. European Observatory on Health Systems and Policies. 2021. The organization and delivery of vaccination services in the European Union Copenhagen, Denmark: WHO Health Organization.
32.

Medical Service Act.

Article information Continued

Table 1

Current Status of Healthcare Services in Community Health Centers and Branches

Classification N(%)
Placement Status of Public Health Doctors (n=264) Public Health Doctors of Korean Medicine 67(25.4)
Public Health Doctors of Korean Medicine and Public Health Doctors 98(37.1)
Public Health Doctors of Korean Medicine, Public Health Doctors and Public Health Dentists 81(30.7)
Public Health Doctors of Korean Medicine and Public Health Dentists 18(6.8)
Current Status of Medical Services of Public Health Doctors (n=85) Rotating medical services from another branch (once a week) 32(37.7)
Rotating medical services from another branch (2 times a week) 21(24.7)
Rotating medical services from another branch (3 times a week) 3(3.5)
Referred to nearby contracted hospitals 2(2.4)
No medical services provided 13(15.3)
Other 14(16.5)
Current position as Head of Community Health Center Branches (n=85) Yes 46(54.1)
No 36(42.4)
No response 3(3.5)

Table 2

Complaint of patients based on Placement of Public Health Doctors

Placement Status of Public Health Doctors Complaint due to absence of Public Health Doctor Total
n(%)		 x2(p)
Yes
n(%)		 No
n(%)
Not Assigned (n=85) 46(54.1) 39(45.9) 85(100) 5.272 (0.022)
Assigned (n=179) 70(39.1) 110(60.9) 179(100)
Total 116(43.9) 148(56.1) 244(100)

Table 3

Types of Complaints

Classification N(%)
Consultation and Management of Chronic Elderly Diseases (Hypertension, Diabetes, etc.) 84(72.4)
Administration of Medications 51(44.0)
Internal Medicine Treatments (Gastrointestinal, Respiratory, etc.) 46(39.7)
Vaccinations 26(22.4)
Basic and inflammatory Treatments (Dressing) 18(15.5)
Emergency Responses (Amputation, CPR, Anaphylaxis, etc.) 13(11.2)
Musculoskeletal Treatments 12(10.3)
Consultation and Management of Dementia 7(6.0)
Others 2(1.7)

Table 4

Perceptions of the Role of Public Health Doctors of Korean Medicine

Classification N, % (Rank)
Areas of Excellence Areas Needing improvement Areas Needing
Advanced Training
Musculoskeletal Treatments 241, 45.4% (1) 14, 2.6% (7) 75, 9.4% (6)
Internal Medicine Treatments (Gastrointestinal, Respiratory, etc.) 175, 33.0% (2) 36, 6.8% (6) 62, 7.8% (7)
Consultation and Management of Chronic Elderly Diseases (Hypertension, Diabetes, etc.) 62, 11.7% (3) 81, 15.3% (3) 151, 19.0% (2)
Vaccinations 22, 4.1% (4) 66, 12.4% (5) 79, 9.9% (5)
Basic and inflammatory Treatments (Dressing) 11, 2.1% (5) 95, 17.9% (2) 122, 15.3% (3)
Administration of Medications 9, 1.7% (6) 75, 14.1% (4) 111, 13.9% (4)
Consultation and Management of Dementia 7, 1.3% (7) 14, 2.6% (7) 9, 1.1% (8)
Emergency Responses (Amputation, CPR, Anaphylaxis, etc.) 4, 0.8% (8) 150, 28.2% (1) 187, 23.5% (1)

Table 5

Perceptions of the Minor Medical Service of Public Health Doctors of Korean Medicine

Placement Status of Public Health Doctors Mean±SD t P-value
Not Assigned (n=85) 4.08 ± 1.14 −.489 0.626
Assigned (n=179) 4.16 ± 1.18

Table 6

Willingness to Perform Minor Medical Service based on Placement of Public Health Doctors

Classification Score (Mean ± SD)
Do you think that Public Health Doctors of Korean Medicine should perform ‘minor medical service’ as Community Health Practitioners in charge of health services to address healthcare gaps and improve public health? 4.14 ± 1.16
How do you perceive the competency (e.g., level of education) of Public Health Doctors of Korean Medicine in performing ‘minor medical service’ compared to that of Community Health Practitioners? 3.83 ± 1.19
If additional job education training is required for Public Health Doctors of Korean Medicine to perform ‘minor medical service’, would you be willing to undergo such training? 4.18 ± 1.11