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KMID : 0384320090300020091
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Korean Journal of Family Medicine
2009 Volume.30 No. 2 p.91 ~ p.97
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Primary health care for vulnerable population
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Park Sang-Min
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Abstract
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Although vulnerable population such as cancer survivors, terminal patients, caregivers and immigrants have greater health needs, they don’t receive enough health care services in our health care system. Continuous advances in cancer treatment have led to a marked improvement in cure rates and thus, an increased population of long-term cancer survivors. Due to both original and treatment-related risk factors, survivors are at increased risk for second primary cancers. In addition, pre-diagnosis smoking, alcohol, obesity and insulin resistance, which are well-known risk factors for cancer development, also appear to affect cancer outcome. To improve the health promotion of cancer survivors, developing shared care model between oncologist and primary care physician is needed. Chronic disease has not only a great effect on the affected patients but also on their caregivers. Caregiving burden was associated with impaired physical function and increased emotional distress. Caregiving burden also increase the risk of cardiovascular disease incidence among caregivers. More attention should be focused on these caregivers to improve their health. Recently, as increasing social needs to develop the health care system for terminal patients, Korean Government began to support palliative care units with implementing the National Cancer Control Program for Terminal Cancer Care. With these social movements, the needs for human resources in the area of palliative care are continuosly increasing, and active participation of primary care physician is needed. Due to rapid changes of population structure in South Korea, the number of multi-cultures family has continuously increased. Especially, more than 15,000 North Korean defectors settled in South Korea in 2008. North Korean defectors are more likely to have unhealthy behaviors, poor quality of life and comorbidities, while they have poor primary care accessibility. Good primary health requires a population perspective, and there has been great change of population structure in South Korea. As prevalence of vulnerable population is seemed to continuously increasing, the planning and development of tailored primary care program for this population to reflect their actual unmet needs is essentially required.
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KEYWORD
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Primary Care, Vulnerable Population, Cancer Survivor, Caregiver, Multiculture Family, North Korean Defectors, Terminal Patient
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