A Study on Affecting Factors to Utilization of a Rural Health Subcenter for Primary Health Care

In order to find out affecting factors to utilization of a rural health subcenter for primary health care, a study was carried out, through analyzing the specific survey data of 284 out of 1,151 total householders in a rural community, Su Dong-Myun, Nam Yang Ju-Gun, Kyung Gi-Do, Korea, and the medical records of total outpatients of the health subcenter in the district during 1976-1987. The following results were obtained: 1) Since 1977, the annual utilization rate showed decreasing tendency such as 900 per 1,000 inhabitants in 1977, 846 in 1979, 708 in 1981, 618 in 1985, 594 in 1983 and 341 in 1987. 2) The age specific utilization rate showed the highest in the group of age of 0-4 with 2,067.4 per 1,000 inhabitants in 1976, 2,402.7 in 1981 and 2,308.2 in 1986, respectively. In the other age groups, no any significant difference was found in the specific rate. 3) In the choice rate of medical facillities for primary health care, health subcenter was the highest(43.3%), and hospital (29.6%), generalist clinic (15.5%) and specialist clinic (11.6%) were in decreasing order. 4) Among the householders surveyed, 92.6% experienced to visit the rural health subcenter more than once. However, 21.1% of them said that the health subcenter is not proper medical facillitics for their situation. 5) In choice reasons of the health subcenter for primary health care, dominent priority factors were sincerity and kindness of health personnels containing staffs(57.8%), near distance from living place (24.6%), proper medical facillities(9.2%) and lower medical cost(8.4%) 6) The utilization rate of health subcenter in the district, revealed a tendency that the nearer distance from the health subcenter, the more patients visit health subcenter. 7) More than half (59.8%) of the householders surveyed, answered that primary health care was interfered mainly with the daily farm work in the district. 8) For the enhancement of utilization rate, the householders surveyed demanded the health subcenter to have good attitude of health subcenter personnel (28.5%), to observe the time and/or extend the duty hours(10.9%), to provide proper medical facillicies (9.5%) and the others(7.1%).