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KMID : 0365220180550020041
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Korean Journal of Public Health
2018 Volume.55 No. 2 p.41 ~ p.53
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The attribute of multiple chronic diseases experience of frequent medical overusers in rural area
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Joo Jung-Min
You Myoung-Soon
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Abstract
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Objectives: Multiple chronic diseases are known to affect the amount of medical service use such as the number of visiting medical institutions and outpatient medical expenses. The purpose of this study was to investigate the characteristics of multiple chronic diseases experience of frequent medical service user living in the rural area which can provide basic data on the chronic disease policy
Methods: The participants of the study were multiple chronic patients with more than 4 chronic diseases among the highest 1% of all medical service users based on the National Health Insurance claims data of 2013. Patient and their doctors randomly selected, qualified researchers performed semi-structured in-depth interviews. 10 cases as ‘residents’ of the rural area and 3 cases of doctors were analyzed using the consensual qualitative research method.
Results: The subject areas of the individual cases were extracted from thematic domain: the perception of cause of the disease, the local primary medical institution, and the disease management behavior, five key concepts were extracted to explain the disease experience characteristics of the chronic disease patients in the rural area. For cross cases it has been shown that the experience of multiple chronic illnesses is a trail of a tough life, being fixed through repetitive controlling body to work. In addition, the lack of medical goals and the visit to medical institutions as a leisure activity shows that there was a need to understand the nature of the disease experience in the organizational context of the healthcare infrastructure.
Conclusion: Chronic diseases can’t be cured, and the improvement and deterioration of the condition are repeated throughout life, so a supportive primary health care is essential as well as self-management in rural area.
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KEYWORD
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Multiple Chronic Conditions, Medical Overuse, Attitude to Health, Rural Health Services
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