An Exploratory Study on Rural Home Visit Medical Services by Public Health Doctors of Korean Medicine: A Survey of Current Status and Potential Improvements

Donghwan Kim; Hyein Jeong; Soobo Shim; Dohun Hyun; Kyeong Han Kim; Kim, Donghwan; Jeong, Hyein; Shim, Soobo; Hyun, Dohun; Kim, Kyeong Han

doi:10.13048/jkm.25025

JKM > Volume 46(2); 2025 > Article

Kim, Jeong, Shim, Hyun, and Kim: An Exploratory Study on Rural Home Visit Medical Services by Public Health Doctors of Korean Medicine: A Survey of Current Status and Potential Improvements

Original Article

The Journal of Korean Medicine 2025; 46(2): 153-169.

Published online: June 1, 2025

DOI: https://doi.org/10.13048/jkm.25025

An Exploratory Study on Rural Home Visit Medical Services by Public Health Doctors of Korean Medicine: A Survey of Current Status and Potential Improvements

Donghwan Kim¹^{, §}

, Hyein Jeong²^{, §}

, Soobo Shim³

, Dohun Hyun¹

, Kyeong Han Kim⁴^{, *}

¹Association of Public Health Doctors of Korean Medicine

²Department of Preventive Medicine, School of Korean Medicine, Kyunghee University

³Department of Pediatrics, College of Korean Medicine, Daejeon University

⁴Department 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

§ These authors contributed equally to this work.

Received April 21, 2025 Revised May 15, 2025 Accepted May 22, 2025

Abstract

Objectives

This study explores the current status of rural home visit medical services provided by public health doctors of Korean medicine (PHDKMs) and evaluates the feasibility of expanding their roles to include slight medical practice, aiming to enhance healthcare access in underserved areas.

Methods

An online survey was conducted from March 10–16, 2025, targeting 951 PHDKMs. A total of 204 responses were received (response rate: 27.97%), and 150 were analyzed after excluding those not currently engaged in home visits. The questionnaire covered service provision, unmet patient needs, and perceptions regarding slight medical practice.

Results

Among respondents, 75.3% regularly conducted home visits, compared to 16.7% of medical doctors. Common services included musculoskeletal care, chronic disease counseling, and internal medicine. However, unmet needs remained high in rehabilitation, wound care, vaccinations, and IV therapy. The need and willingness to perform slight medical practice scored highly (mean 4.47/5). Prescription of medications for chronic diseases showed the highest perceived utility (4.46), followed by vaccinations and wound care. Respondents agreed that expanding their practice scope could improve care quality, increase access, and reduce urban-rural disparities.

Conclusions

PHDKMs contribute significantly to rural healthcare but face limitations due to current legal and institutional constraints. Allowing slight medical practice, especially in the management of chronic diseases, could help strengthen service delivery and enhance the rural public health system.

Keywords: Public Health Doctors of Korean Medicine, Home Visit Medical Care, Rural Healthcare, slight medical practice, Chronic Disease Management

Table 1

Current Type of Workplace and Work Region

	Classification	N(%)
Type of Workplace	Public Health Subcenter	100(66.7%)
	Public Health Center	37(24.7%)
	Public Healthcare Center	9(6.0%)
	Others (Hospital Ship, Long-Term Care Hospital, Regional Medical Center)	4(2.7%)
Work Region	Capital Region (Gyeonggi, Incheon)	22(14.7%)
	Gangwon Province	6(4.0%)
	Chungcheong Region (Chungbuk, Chungnam, Sejong)	24(16.0%)
	Honam Region (Jeonbuk, Jeonnam)	52(34.7%)
	Yeongnam Region (Gyeongbuk, Gyeongnam, Daegu, Busan, Ulsan)	39(26.0%)
	Jeju Province	7(4.7%)

Table 2

Status of Home Visit Medical Services by Western and Korean Medicine Doctors (Frequency, Patients per Visit, and Location)

	Classification	Korean medicine	Western medicine
Frequency of Home Visits by Public Health Doctors	Conducted regularly	113(75.3%)	25(16.7%)
	Conducted occasionally as needed	32(21.3%)	20(13.3%)
	Rarely conducted	5(3.3%)	78(52.0%)
Frequency of Visits (for those providing regular services)	Less than once a month	3(2.6%)	-
	1–2 times a month	34(30.1%)	11(44.0%)
	3–4 times a month	33(29.2%)	7(28.0%)
	More than 5 times a month	38(33.6%)	5(20.0%)
	Other (5 times/week, every week for 2 months/year, 2 times/week, daily, 4+ times/week)	5(4.4%)	-
	Don’t know	-	2(8.0%)
Number of Patients per Visit	1–3 patients	8(7.1%)	4(16.0%)
	4–6 patients	22(19.5%)	3(12.0%)
	7–9 patients	25(22.1%)	2(8.0%)
	10 or more patients	58(51.3%)	11(44.0%)
Place of Home Visit (multiple responses allowed)	Patient’s home	52(32.1%)	13(31.0%)
	Village hall or senior center	87(53.7%)	19(45.2%)
	Welfare facility (nursing home, disability center, etc.)	16(9.9%)	7(16.7%)
	Public health post	6(3.7%)	-
	Hospital ship	1(0.6%)	1(0.2%)
	Uncertainty	-	2(0.5%)

Table 3

Perceived Necessity of and Reasons for Providing Home Visit Services in the Current Work Region (Multiple Responses Allowed)

	Classification	Score (Mean ± SD) / N(%)
Necessity	Perceived necessity of home visit services in the current region	3.95 ± 0.98
Necessity	Overall satisfaction of patients or caregivers who received home visit services	4.47 ± 0.65
Reason	Support for patients with mobility impairments	118(31.9%)
	Alleviation of isolation and provision of psychological stability	57(15.4%)
	Support for areas with insufficient healthcare and transportation infrastructure	100(27.0%)
	Compensation for low participation in home visits by private medical institutions	45(12.2%)
	Addressing welfare blind spots through regular monitoring systems	48(13.0%)
	Other (e.g., survival checks for bedridden patients, fulfilling documentation requirements for public health centers, addressing health information gaps among patients)	2(0.5%)

Table 4

Medical Treatments and Health Management Services Currently Provided via Home Visits Services Needed by Patients (Multiple Responses Allowed)

Classification	Currently Provided Services	Services Needed
Treatment and management of musculoskeletal disorders	140	135
Internal medicine for gastrointestinal, respiratory conditions	67	81
Counseling and management of chronic diseases (e.g., hypertension, diabetes), including blood pressure and glucose monitoring	92	114
Rehabilitation support (e.g., exercise instruction, physical therapy)	27	49
Mental and psychological care (e.g., depression, cognitive decline)	26	42
Health promotion and disease prevention education or counseling	66	60
Wound care (e.g., pressure sores, lacerations, disinfection, dressing)	5	24
Tube and catheter management	1	6
Intravenous fluid therapy	2	13
Vaccination	1	19
Emergency treatment	2	14
Others (e.g., insurance-covered herbal medicine, dementia care)	2	0

Table 5

Patient Demand Fulfillment Level in Home Visits Provided by Korean Medicine Public Health Doctors

	Classification	N(%)Score (Mean ± SD)
To what extent are current home visits by Korean medicine public health doctors meeting patient demands?	Most demands are being met	38(25.3%)
	Basic medical care is possible, but additional services (e.g., medication adjustment, vaccination) are needed and not fully met	92(61.3%)
	Current home visits fail to meet most demands and remain largely formal	20(13.3%)
If there were difficulties meeting patient demands during home visits, what situations were most common? (Multiple responses allowed)	Patients needed or requested prescriptions after blood pressure/glucose checks, but prescriptions could not be issued	83(38.2%)
	Patients needed or requested vaccinations, but they could not be administered	52(24.0%)
	Patients needed or requested pressure ulcer management, or received such care, but adequate infection control and pain relief treatment could not be provided	37(17.1%)
	Patients needed or requested IV fluid therapy, but it could not be provided	37(17.1%)
	Others (one-time visit (4), performance report (1), none (2), request for medicated patch (1))	8(3.7%)
How satisfied were the patients or caregivers overall with the home visit medical services?		4.47 ± 0.65

Table 6

Perceptions and Expected Effects of Performing slight medical practice by Korean Medicine Public Health Doctors During Home Visits

Classification		Score (Mean ± SD) / N(%)
Do you think it is necessary for Korean medicine public health doctors to perform slight medical practice during home visits?		4.47 ± 0.77
If you receive training to perform slight medical practice, would you be willing to apply it in actual home visit practice?		4.47 ± 0.78
Expected effects of performing slight medical practice by Korean medicine public health doctors during home visits (multiple responses allowed)	Home visit care in rural areas would become more active than before	97(20.2%)
	Quality of medical services would improve through integrative medical approaches	111(23.1%)
	Residents’ health status could be managed more efficiently	110(22.9%)
	Access to healthcare services would improve	98(20.4%)
	Patients’ financial burden (medical costs, transportation costs, etc.) would decrease	64(13.3%)
	Others (e.g., meaningless if done frequently or for a wide population)	1(0.2%)

Table 7

Usefulness Evaluation of Each Item under slight medical practice

Classification	Patient Demand	Improvement in Patient Health and Quality of Care
Prescription of medication for chronic disease management (diabetes, hypertension, hyperlipidemia)	4.36 ± 0.83	4.46 ± 0.72
Vaccination	4.03 ± 1.0	4.21 ± 0.91
Wound care (antibiotics, painkillers, local anesthetics)	3.73 ± 1.19	4.06 ± 1.1
Intravenous fluid therapy	3.68 ± 1.18	3.93 ± 1.13

Table 8

List of Medications Prescribable at Public Health Posts (Partial List)

Category	Subcategory	English Name	Dosage Form
Cardiovascular System	Other cardiovascular drugs	Amlodipine besylate	Oral
		Atenolol	Oral
		Losartan potassium	Oral
		Telmisartan	Oral
		Atorvastatin calcium	Oral
		Atorvastatin calcium Trihydrate + ezetimibe	Oral
	Diuretics	Hydrochlorothiazide	Oral
Other metabolic agents	Diabetes medications	Metformin hydrochloride	Oral
		Sitagliptin phosphate hydrate	Oral
		Glimepiride	Oral
Antibiotics	-	Amoxicillin+clavulanate	Oral
		Doxycycline	Oral
		Gentamicin sulfate	Topical
Chemotherapeutic agents	Sulfonamides	Sulfamethoxazole, Trimethoprim (Combination)	Oral
Topical medications	Topical antibiotics	Mupirocin	Topical
Topical medications	Topical antibiotics	Fusidic acid	Topical
CNS agents	Antipyretic analgesics	Acetaminophen	Oral
		Aspirin	Oral
		Ibuprofen	Oral
		Naproxen	Oral
Peripheral nervous system	Local anesthetics	Lidocaine hydrochloride	Injection
Fluids & Electrolytes	Plasma substitutes	Dextrose/Glucose in water	Injection
		Dextrose in normal saline	Injection
		Sodium chloride	Injection
		Normal saline	Injection

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