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

Article information

J Korean Med. 2025;46(2):153-169
Publication date (electronic) : 2025 June 1
doi : https://doi.org/10.13048/jkm.25025
Donghwan Kim1,§orcid_icon, Hyein Jeong2,§orcid_icon, Soobo Shim3orcid_icon, Dohun Hyun1orcid_icon, Kyeong Han Kim4,orcid_icon
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 2025 April 21; Revised 2025 May 15; Accepted 2025 May 22.

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

Current Type of Workplace and Work Region

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

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

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

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

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

Usefulness Evaluation of Each Item under slight medical practice

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

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Article information Continued

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
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
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