Review of Chungcheong Region’s Community-based Mid-to-long-term Plans for Chronic Disease: Focusing on the 8th Regional Health Care Plan

Abstract

Long-term strategies are necessary to address the prevention and management of chronic diseases due to the aging population in the Chungcheong region. Upon reviewing the Regional Healthcare Plan by municipality, major chronic diseases were categorized into hypertension, diabetes, cerebrovascular diseases, infectious diseases, mental illnesses, and cancer. It was noted that most of these are interconnected with regional projects. To achieve sustainable operations for public health centers, systematic standardization of regional projects that are feasible for the public health center’s operation, efficient streamlining of overlapping initiatives, and integration of existing programs need to be pursued.

Key messages

① What is known previously?

As per Article 7 of the Regional Public Health Act, local governments, including both basic and metropolitan levels, craft regional healthcare plans every four years tailored to local community traits, aiming to enhance the well-being of residents.

② What new information is presented?

An evaluation focused on chronic disease management within Chungcheong’s healthcare plans highlighted primary efforts targeting hypertension, diabetes, cerebrovascular diseases, infectious diseases, mental health issues, and preventive measures against cancer.

③ What are implications?

These initiatives are supported through collaboration with entities such as public health policy institute, management center for healthpromotion, regional cardiocerebrovascular centers, cardiocerebrovascular disease preventive management centers, regional trauma & emergency medical centers, regional cancer center.

Introduction

In 2019, 14.9% of the total Korean population were aged 65 years or older, and this percentage is projected to increase to 20.3% by 2025 and 46.5% by 2067 [1]. Particularly, the Chungcheong Province, excluding Sejong, is expected to become a super-aged society in 2025 [2]. The rate of population aging in the Chungcheong Province is much higher than in other metropolitan cities and provinces, and the proportion of the older adult population in this province is markedly high as well [3]. Managing chronic diseases in an aging society is a pressing policy issue that needs to be addressed. However, the treatment rate for chronic diseases in the Chungcheong Province, specifically in Chungnam, Chungbuk, and Daejeon, excluding Sejong, is very low, contributing to an increasing disparity in chronic disease treatment within the province [4-6].

As of 2021, 79.6% of deaths in the Republic of Korea (ROK) were caused by chronic diseases, and healthcare expenditure due to chronic diseases in the country accounted for 85.0% (71 trillion KRW) of all healthcare expenditure in 2020 [7]. Managing chronic diseases should focus on a continuous control and management approach, as opposed to a purely treatment-oriented one. The high prevalence, low control rates, and poor treatment continuation of chronic diseases could severely undermine health recovery during an epidemic, as chronic diseases act as determinants of complications and death [8]. In particular, the regulation of blood pressure or blood glucose requires continued contact with a healthcare provider [9].

In 2019, the Ministry of Health and Welfare launched the Chronic Disease Management in Primary Care Pilot Project, a comprehensive chronic disease management model that features the strengths of a chronic disease management fee project and a community-based primary care pilot project. However, the Chronic Disease Management in Primary Care Pilot Project was designed so that healthcare providers can be reimbursed only when they comply with specific criteria, such as the number of services provided. Thus, certain issues have emerged, including patients who fail to adapt to or have resistance to it being lost to follow-up and a low guidance compliance rate, highlighting the need for evidence-based strategies for patient management [10].

A major reason for poor chronic disease management in primary care in the ROK is the lack of self-care or little to no support for the utilization of community resources. Furthermore, the fees designated for counseling and education essential for chronic disease management are extremely low, while the fees for tests and treatment are relatively higher, leading to a neglect of self-care [11]. Currently, there is no comprehensive chronic disease management strategy in the Chungcheong Province. Therefore, given the high disease burden and mortality associated with chronic diseases, it is crucial to assess the current status of chronic disease management and develop strategies to promote it in the Chungcheong Province.

Methods

To identify strategies to promote chronic disease management in the ROK, the agency reviewed the eighth community healthcare plan, including the Hypertension and Diabetes Registry Project, Clinic-level Chronic Disease Management System, Community Primary Care Pilot Project, and Chronic Disease Management in Primary Care Project, in the following 35 si‧gun, and gu regions: Daejeon Metropolitan City, five regional gu regions (Dong-gu, Jung-gu, Seo-gu, Yuseong-gu, and Daedeok-gu), Sejong Special Self-Governing City, 15 si and gun areas in Chungcheongnam-do (Cheonan-si, Gongju-si, Boryeong-si, Asan-si, Seosan-si, Nonsan-si, Gyeryong-si, Dangjin-si, Geumsan-gun, Buyeo-gun, Seocheon-gun, Cheongyang-gun, Hongseong-gun, Yesan-gun, and Taean-gun), and 11 si and gun areas in Chungcheongbuk-do (Cheongju-si, Chungju-si, Jecheon-si, Boeun-gun, Okcheon-gun, Yeongdong-gun, Jincheon-gun, Goesan-gun, Eumseong-gun, Danyang-gun, and Jeungpyeong-gun).

Results

The major chronic disease management projects in each region encompass initiatives for hypertension, diabetes, cardiovascular and cerebrovascular diseases, communicable (respiratory) diseases, mental illnesses, and cancer. In Chungnam, diverse projects aim at preventing chronic diseases, including those focusing on hypertension/diabetes and cardiovascular/cerebrovascular diseases, such as individuals accruing mileage through the walking app “Geotju” and other projects to improve healthcare access among vulnerable populations, including healthy lifestyle, comprehensive health promotion, and smoking cessation projects; mobile healthcare; and patient registration and monitoring using the public health information system. Other projects and support currently underway in the region include a cardiovascular/cerebrovascular disease prevention project, support for complication screening fees, and post-discharge referral service (Table 1).

Table 1. Current status of projects related to hypertension, diabetes, and cardiovascular disease by city, county, and district in the Chungnam region.

Major category	Minor category	Sub-category (number of regions excluding Chungnam)	Chungnam (7)	Cheonan (6)	Gongju (9)	Boryeong (12)	Asan (6)	Seosan (2)	Nonsan (3)	Gyeryong (6)	Dangjin (1)	Geumsan (1)	Buyeo (2)	Seocheon (5)	Cheongyang (3)	Hongseong (1)	Yesan (1)	Taean (4)
Hypertension‧diabetes(chronic disease prevention) Integrated health promotion programa)	Health behavior	Walk APP challenge (2)	○		○	○
		Healthy living support center (3)	○	○		○				○
		Healthy life environmental design (3)				○	○			○
	Integrated health promotion program	Moderate drinking (2)			○	○
		Physical activity program (3)	○				○			○								○
		Nutrition education (2)						○		○
		Obesity prevention (6)		○	○	○	○			○								○
		Counsel (0)
	Support group for smoking cessation	Tobacco cessation service (5)	○	○	○	○	○											○
	Mobile healthcare	Monitoring (9)	○	○	○	○	○			○		○			○	○		○
	Public health information system (PHIS)	Vulnerable (0)	○
		Monitoring (3)			○	○							○
		Screening financial support (1)				○
		ICT-based telehealth (3)	○			○		○	○
	Primary health care chronic diseases management pilot program	Follow-up management service (1)		○
		Registry program (1)															○
	Visiting health management	Mobile screening (3)				○								○	○
		Chronic disease management (7)		○	○	○			○		○		○	○
		AI‧IoT-based health care service for the pneumococcus for the elderly (3)			○				○					○
	Registration and management program for hypertension and diabetes	Medical (pharmaceutical) financial support (1)												○
		Hypertension‧diabetes health school program (1)												○
		Registration and measure (2)			○										○
	Incentives	Chronic disease health point system (1)					○

Major category	Minor category	Sub-category (number of regions excluding Chungnam)	Chungnam (3)	Cheonan (2)	Gongju (4)	Boryeong (1)	Asan (0)	Seosan (3)	Nonsan (3)	Gyeryong (3)	Dangjin (2)	Geumsan (2)	Buyeo (3)	Seocheon (3)	Cheongyang (2)	Hongseong (3)	Yesan (1)	Taean (2)
Cardio-cerebrovascular disease Regional emergency medical centerb)	Cardiocerebrovascular disease preventive management program	Education and information (8) (Red Circle, Blood Vessel Campaign)			○				○		○	○	○	○	○			○
		Device provide and blood pressure & glucoserental (3)				○		○		○
		Smart healthcare management (1)	○													○
		Registration and health counsel (8)		○	○			○		○	○		○	○		○
	Regional cardiocerebrovascular center	Follow-up management service for discharge patients (4)	○		○				○			○	○
		Complications screening financial support (10)	○	○	○			○	○	○				○	○	○	○	○

APP=application; ICT=information and communications technology; AI=artificial intelligence; IoT=internet of things. ^a)Health care service support center: practice of healthy living and prevention of chronic diseases. ^b)Regional emergency medical center, regional cardiocerebrovascular center, trauma center, etc.

In Chungnam, all local governments have planned national vaccination promotion as part of their communicable or respiratory disease projects. Depending on the region, there are plans for encouraging education and screening for sexually transmitted infections (HIV infection/AIDS), support for treatment costs, mobile screening for tuberculosis and treatment fee support for close contacts, mobile clinics for Hansen’s disease, and support for medical and living expenses. For mental illnesses, early screening and prevention programs are offered at dementia support centers. For cancer, patients are referred to national cancer screening and medical treatment fee coverage through the National Cancer Center (Table 2).

Table 2. Status of projects related to infectious (respiratory) diseases, mental diseases, and cancer diseases by city, county, and district in the Chungnam region.

Major category	Minor category	Sub-category (number of regions excluding Chungnam)	Chungnam (9)	Cheonan (4)	Gongju (9)	Boryeong (13)	Asan (5)	Seosan (7)	Nonsan (2)	Gyeryong (9)	Dangjin (9)	Geumsan (6)	Buyeo (7)	Seocheon (12)	Cheongyang (5)	Hongseong (4)	Yesan (3)	Taean (3)
Transimissible (respiratory) disease Regional infectious diseases control & prevention centera)	National immunization program	Influenza (15)	○	○	○	○	○	○	○	○	○	○	○	○	○	○	○	○
		Legionellosis (0)	○
		Pneumococcus for the elderly (7)									○		○	○	○	○	○	○
	Chronic lung disease	Vibrio monitoring (1)									○
	Sexually transmitted disease	Education and management (4)	○	○						○	○							○
		Financial support (3)				○		○					○
		Anonymous testing (3)					○	○					○
		Regular testing for employees in sanitary facilities (3)					○			○			○
	Tuberculosis	Screening service (10)	○	○	○	○	○			○		○		○	○		○	○
		Mobile screening (6)						○	○	○		○	○	○
		Contact financial support (6)	○			○	○					○	○	○			○
	Hansen’s disease	Mobile diagnosis (2)				○												○
		Medical (living) fee support (1)				○

Major category	Minor category	Sub-category (number of regions excluding Chungnam)	Chungnam (9)	Cheonan (4)	Gongju (9)	Boryeong (13)	Asan (5)	Seosan (7)	Nonsan (2)	Gyeryong (9)	Dangjin (9)	Geumsan (6)	Buyeo (7)	Seocheon (12)	Cheongyang (5)	Hongseong (4)	Yesan (3)	Taean (3)
Mental disease Regional dementia centerb)	Dementia care center	Early medical checkup (13)	○		○	○	○	○	○	○	○	○	○	○	○	○	○
		Preventive management (14)	○	○	○	○	○	○	○	○		○	○	○	○	○	○	○
		Fee support (6)	○		○	○					○		○		○			○
		Cognitive rehabilitation program (2)									○						○
		Assistance goods support (7)			○	○					○	○	○	○	○
		Guardian (family) support (9)	○		○	○	○	○		○	○		○	○				○
		Public guardianship service (3)				○					○			○
		Community association (3)				○				○				○
	Facility expansion	Dementia relief village (5)			○	○				○				○		○
		Daycare center (3)	○		○									○
		Dementia ward (1)	○
		Dementia patient shelter (7)	○		○		○	○		○			○	○
		Care facility for the elderly (convalescent hospital) public project (2)	○			○
		Dementia relief center branch (5)		○	○	○							○			○
	Living environment improvement	Home environment modification program (2)	○	○								○
		Living safety support (fire, gas) (4)				○					○	○		○
	Awareness improvement	Awareness improvement project of dementia (7)		○		○	○	○		○				○	○
		Disappearance prevention program (GPS device supply) (6)				○		○		○	○	○		○
		Dementia partner (3)						○		○	○

Major category	Minor category	Sub-category (number of regions excluding Chungnam)	Chungnam (5)	Cheonan (1)	Gongju (5)	Boryeong (3)	Asan (1)	Seosan (1)	Nonsan (2)	Gyeryong (1)	Dangjin (2)	Geumsan (2)	Buyeo (5)	Seocheon (4)	Cheongyang (3)	Hongseong (2)	Yesan (4)	Taean (1)
Cancer Regional cancer centerc)	National scale support program	National cancer screening service (14)	○	○	○	○	○	○	○		○	○	○	○	○	○	○	○
		Cancer patient financial support program (8)	○		○	○				○	○	○	○	○	○
		Hospice (0)
	Regional scale support program	Home-based terminal cancer patient visiting care (3)	○		○								○		○
		Home-based terminal cancer patient goods support (3)	○										○	○			○
		Cancer survivor support (1)	○						○
		Cancer screening visit (2)			○	○
		Wig cost support (1)			○
		Cancer patient self-help group (3)											○	○			○
		Cancer screening support (2)														○	○

GPS=global positioning system. ^a)Center for infectious diseases control & prevention: prevention and management of tuberculosis, sexually transmitted infections, pneumonia, etc. ^b)Provincial dementia center, dementia care centers, mental health and welfare commission, center or mental health, etc. ^c)Regional cancer center, regional cancer survivorship center.

In Chungbuk, chronic disease prevention and hypertension/diabetes management projects include comprehensive health promotion and home health management projects to promote a healthy lifestyle as well as a hypertension/diabetes registry. Furthermore, the cardiovascular/cerebrovascular prevention and management project involves the provision of consultations to high-risk groups and registered patients, the launch of the Red Circle Campaign in communities, and education promotion projects such as Knowing My Blood Vessel Numbers (Table 3).

Table 3. Current status of projects related to hypertension, diabetes, and cardiovascular disease by city, county, and district in the Chungbuk region.

Major category	Minor category	Sub-category (number of regions excluding Chungbuk)	Chungbuk (13)	Cheongju (5)	Chungju (5)	Jecheon (2)	Boeun (2)	Okcheon (6)	Yeongdong (6)	Jincheon (2)	Goesan (6)	Eumseong (6)	Danyang (3)	Jeungpyeong (4)
Hypertension‧diabetes(chronic disease prevention) Integrated health promotion programa)	Health behavior	Walk APP challenge (2)	○								○			○
		Healthy living support center (4)	○			○			○			○		○
		Healthy life environmental design (0)	○
	Integrated health promotion program	Moderate drinking (3)	○		○			○				○
		Physical activity program (2)	○						○				○
		Nutrition education (3)	○						○		○		○
		Obesity prevention (3)	○					○	○			○
		Counsel (4)		○	○				○		○
	Support group for smoking cessation	Tobacco cessation service (4)	○		○			○				○	○
	Mobile healthcare	Monitoring (4)		○	○			○						○
	Public health information system (PHIS)	Vulnerable (0)
		Monitoring (0)
		Screening financial support (1)		○
		ICT-based telehealth (0)
	Primary health care chronic diseases management pilot program	Follow-up management service (0)
		Registry program (0)
	Visiting health management	Mobile screening (1)	○								○
		Chronic disease management (4)	○		○						○			○
		AI‧IoT-based health care service for the pneumococcus for the elderly (3)	○			○	○		○			○
	Registration and management program for hypertension and diabetes	Medical (pharmaceutical) financial support (0)
		Hypertension·diabetes health school program (4)	○	○			○	○		○
		Registration and measure (4)	○	○						○	○	○
	Incentives	Chronic disease health point system (1)						○

Major category	Minor category	Sub-category (number of regions excluding Chungbuk)	Chungbuk (4)	Cheongju (1)	Chungju (2)	Jecheon (1)	Boeun (1)	Okcheon (3)	Yeongdong (3)	Jincheon (2)	Goesan (2)	Eumseong (3)	Danyang (3)	Jeungpyeong (2)
Cardio-cerebrovascular disease Regional emergency medical centerb) Metabolic syndrome management center	Cardiocerebrovascular disease preventive management program	Education and Information (Red Circle Campaign, Blood Vessel Campaign) (10)	○	○	○	○	○	○	○		○	○	○	○
		Device provide and blood pressure & glucose rental (2)						○					○
		Smart healthcare management (0)
		Registration and health counsel (5)	○					○	○	○		○		○
	Regional cardiocerebrovascular center	Follow-up management service for discharge patients (1)			○
		Complications screening financial support (5)	○						○	○	○	○	○
	Regional trauma center	(Stroke, cardiac arrest) emergency room connection (0)	○

PHIS=public health information system; APP=application; ICT=information and communications technology; AI=artificial intelligence; IoT=internet of things. ^a)Health care service support center: practice of healthy living and prevention of chronic diseases. ^b)Regional emergency medical center, regional cardiocerebrovascular center, trauma center, etc.

In terms of communicable (respiratory) diseases in Chungbuk, a national vaccination campaign and monitoring program as well as tuberculosis screening have been planned in all regions, and there are other projects planned in certain regions, including sexually transmitted disease management and education; early screening, prevention, and management at dementia support centers; the Dementia Awareness Project, national cancer screening at the National Cancer Center; and referral to the cancer treatment fee support project (Table 4).

Table 4. Status of projects related to infectious (respiratory) diseases, mental diseases, and cancer diseases by city, county, and district in the Chungbuk region.

Major category	Minor category	Sub-category (number of regions excluding Chungbuk)	Chungbuk (3)	Cheongju (4)	Chungju (3)	Jecheon (4)	Boeun (2)	Okcheon (2)	Yeongdong (7)	Jincheon (3)	Goesan (4)	Eumseong (3)	Danyang (3)	Jeungpyeong (2)
Transimissible (respiratory) disease Regional infectious diseases control & prevention centera)	National immunization program	Influenza (10)	○	○	○	○	○	○	○		○	○	○	○
		Legionellosis (0)
		Pneumococcus for the elderly (4)		○					○	○	○
	Chronic lung disease	Vibrio monitoring (0)
	Sexually transmitted disease	Education and management (5)		○					○	○	○	○
		Financial support (2)	○						○
		Anonymous testing (0)
		Regular testing for employees in sanitary facilities (0)
	Tuberculosis	Screening service (11)	○	○	○	○	○	○	○	○	○	○	○	○
		Mobile screening (3)			○	○			○
		Contact financial support (2)				○							○
	Hansen’s disease	Mobile diagnosis (0)
		Medical (living) fee support (1)							○

Major category	Minor category	Sub-category (number of regions excluding Chungbuk)	Chungbuk (9)	Cheongju (7)	Chungju (9)	Jecheon (7)	Boeun (4)	Okcheon (6)	Yeongdong (7)	Jincheon (3)	Goesan (4)	Eumseong (4)	Danyang (7)	Jeungpyeong (2)
Mental disease Regional dementia centerb)	Dementia care center	Early medical checkup (11)	○	○	○	○	○	○	○	○	○	○	○	○
		Preventive management (11)	○	○	○	○	○	○	○	○	○	○	○	○
		Fee support (2)	○		○	○
		Cognitive rehabilitation program (4)	○		○	○		○		○
		Assistance goods support (2)			○	○
		Guardian (family) support (5)	○	○		○			○		○		○
		Public guardianship service (2)	○	○									○
		Community association (0)
		AI-based and web_IoT operation (3)			○	○	○
	Facility expansion	Dementia relief village (4)		○	○				○			○
		Daycare center (0)
		Dementia ward (1)											○
		Dementia patient shelter (3)	○	○	○								○
		Care facility for the elderly (convalescent hospital) public project (2)						○	○
		Dementia relief center branch (1)	○				○
	Living environment improvement	Home environment modification program (0)
		Living safety support (fire, gas) (0)
	Awareness improvement	Awareness improvement project of dementia (6)	○	○	○				○		○	○	○
		Disappearance prevention program (GPS device supply) (2)						○	○
		Dementia partner (supporters) (1)						○

Major category	Minor category	Sub-category (number of regions excluding Chungbuk)	Chungbuk (1)	Cheongju (5)	Chungju (1)	Jecheon (6)	Boeun (1)	Okcheon (6)	Yeongdong (1)	Jincheon (2)	Goesan (1)	Eumseong (2)	Danyang (4)	Jeungpyeong (3)
Cancer Regional cancer centerc)	National scale support program	National cancer screening service (11)	○	○	○	○	○	○	○	○	○	○	○	○
		Cancer patient financial support program (7)		○		○		○		○		○	○	○
		Hospice (1)				○
	Regional scale support program	Home-based terminal cancer patient visiting care (5)		○		○		○					○	○
		Home-based terminal cancer patient goods support (3)		○		○		○
		Cancer survivor support (0)
		Cancer screening visit (0)
		Wig cost support (0)
		Cancer patient self-help group (4)		○		○		○					○
		Cancer screening support (0)

AI=artificial intelligence; GPS=global positioning system; IoT=internet of things. ^a)Center for infectious diseases control & prevention: prevention and management of tuberculosis, sexually transmitted infections, pneumonia, etc. ^b)Provincial dementia center, dementia care centers, mental health and welfare commission, center or mental health, etc. ^c)Regional cancer center, regional cancer survivorship center.

In Daejeon Metropolitan City and Sejong Special Self- Governing City, chronic disease prevention and hypertension/diabetes projects primarily include a healthy lifestyle, comprehensive health promotion, and smoking cessation projects, and the cities have launched or are planning to implement a hypertension/diabetes registry project. Furthermore, the cities are focusing on the education (e.g., the Red Circle Campaign and Knowing My Blood Vessel Numbers) and promotion of cardiovascular/cerebrovascular disease prevention and management (Table 5). Additionally, the local governments in these cities plan to implement the national vaccination campaign. In particular, most local governments in Daejeon plan to implement a tuberculosis-related project; projects for early screening, prevention, and management of dementia and the Dementia Awareness Project through dementia support centers; and national cancer screening and referral to cancer treatment fee support projects through the National Cancer Center (Table 6).

Table 5. Status of projects related to hypertension, diabetes, and cardiovascular disease by city, county, and district in Daejeon and Sejong region.

Major category	Minor category	Sub-category (number of regions excluding Daejeon¡‧Sejong)	Daejeon (11)	Donggu (8)	Junggu (8)	Seogu (8)	Yuseong (8)	Daedeok (16)	Sejong (9)
Hypertension‧diabetes(chronic disease prevention) Integrated health promotion programa)	Health behavior	Walk APP challenge (4)	○		○		○	○	○
		Healthy living support center (3)	○	○		○		○
		Healthy life environmental design (3)		○			○	○
	Integrated health promotion program	Moderate drinking (4)	○		○	○	○	○
		Physical activity program (5)	○	○	○	○		○	○
		Nutrition education (3)			○	○		○
		Obesity prevention (4)	○		○	○		○	○
		Counsel (5)	○	○	○	○		○	○
	Support group for smoking cessation	Tobacco cessation service (6)	○	○	○	○	○	○	○
	Mobile healthcare	Monitoring (2)	○					○	○
	Public health information system (PHIS)	Vulnerable (0)
		Monitoring (0)
		Screening financial support (0)
		ICT-based telehealth (1)					○
	Primary health care chronic diseases management pilot program	Follow-up management service (1)						○
		Registry program (3)		○			○	○
	Visiting health management	Mobile screening (1)						○
		Chronic disease management (3)			○		○	○
		AI‧IoT-based health care service for the pneumococcus for the elderly (3)	○				○	○	○
	Registration and management program for hypertension and diabetes	Medical (pharmaceutical) financial support (0)
		Hypertension‧diabetes health school program (1)	○	○
		Registration and measure (3)	○	○		○			○
	Incentives	Chronic disease health point system (2)						○	○

Major category	Minor category	Sub-category (number of regions excluding Daejeon¡‧Sejong)	Daejeon (1)	Donggu (0)	Junggu (2)	Seogu (2)	Yuseong (1)	Daedeok (0)	Sejong (0)
Cardio-cerebrovascular disease Regional emergency medical centerb)	Cardiocerebrovascular disease preventive management program	Education and information (Red Circle Campaign, Blood Vessel Campaign) (3)	○		○	○	○
		Device provide and blood pressure & glucose rental (0)
		Smart healthcare management (0)
		Registration and health counsel (2)			○	○
	Regional cardiocerebrovascular center	Follow-up management service for discharge patients (0)
		Complications screening financial support (0)

PHIS=public health information system; APP=application; ICT=information and communications technology; AI=artificial intelligence; IoT=internet of things. ^a)Health care service support center: practice of healthy living and prevention of chronic diseases. ^b)Regional emergency medical center, regional cardiocerebrovascular center, trauma center, etc.

Table 6. Status of projects related to infectious (respiratory) diseases, mental diseases, and cancer diseases by city, county, and district in Daejeon and Sejong region.

Major category	Minor category	Sub-category (number of regions excluding Daejeon‧Sejong)	Daejeon (3)	Donggu (2)	Junggu (2)	Seogu (3)	Yuseong (1)	Daedeok (3)	Sejong (1)
Transimissible (respiratory) disease Regional infectious diseases control & prevention centera)	National immunization program	Influenza (6)	○	○	○	○	○	○	○
		Legionellosis (0)
		Pneumococcus for the elderly (0)	○
	Chronic lung disease	Vibrio monitoring (0)
	Sexually transmitted disease	Education and management (2)				○		○
		Financial support (0)
		Anonymous testing (0)
		Regular testing for employees in sanitary facilities (0)
	Tuberculosis	Screening service (4)	○	○	○	○		○
		Mobile screening (0)
		Contact financial support (0)
	Hansen’s disease	Mobile diagnosis (0)
		Medical (living) fee support (0)

Major category	Minor category	Sub-category (number of regions excluding Daejeon‧Sejong)	Daejeon (3)	Donggu (8)	Junggu (3)	Seogu (4)	Yuseong (7)	Daedeok (7)	Sejong (6)
Mental disease Regional dementia centerb)	Dementia care center	Early medical checkup (6)	○	○	○	○	○	○	○
		Preventive management (6)	○	○	○	○	○	○	○
		Fee support (3)		○	○				○
		Cognitive rehabilitation program (1)					○
		Assistance goods support (2)		○					○
		Guardian (family) support (2)				○		○
		Public guardianship service (3)		○				○	○
		Community association (1)		○
	Facility expansion	Dementia relief village (1)					○
		Daycare center (1)							○
		Dementia ward (0)
		Dementia patient shelter (1)						○
		Care facility for the elderly (convalescent hospital) public project (0)
		Dementia relief center branch (2)	○					○
	Living environment improvement	Home environment modification program (0)		○
		Living safety support (fire, gas) (0)
	Awareness improvement	Awareness improvement project of dementia (4)		○		○	○	○
		Disappearance prevention program (GPS device supply) (1)					○
		Dementia partner (1)					○

Major category	Minor category	Sub-category (number of regions excluding Daejeon‧Sejong)	Daejeon (3)	Donggu (1)	Junggu (2)	Seogu (2)	Yuseong (1)	Daedeok (3)	Sejong (3)
Cancer Regional cancer centerc)	National scale support program	National cancer screening service (6)	○	○	○	○	○	○	○
		Cancer patient financial support program (4)	○		○	○		○	○
		Hospice (0)	○
	Regional scale support program	Home-based terminal cancer patient visiting care (1)							○
		Home-based terminal cancer patient goods support (0)
		Cancer survivor support (0)
		Cancer screening visit (0)
		Wig cost support (1)						○
		Cancer patient self-help group (0)
		Cancer screening support (0)

GPS=global positioning system. ^a)Center for infectious diseases control & prevention: prevention and management of tuberculosis, sexually transmitted infections, pneumonia, etc. ^b)Provincial dementia center, dementia care centers, mental health and welfare commission, center or mental health, etc. ^c)Regional cancer center, regional cancer survivorship center.

Discussion

The results of the review of the 8th regional health and medical plan for chronic disease-related projects in the Chungcheong Province (Chungnam, Chungbuk, Daejeon, Sejong) were reviewed at the si‧gun, and gu levels and are summarized as follows. First, communities in this region are promoting the prevention and management of hypertension and diabetes through various healthy lifestyle-facilitating activities as part of comprehensive health promotion projects targeting hypertension and diabetes. Furthermore, they identify and register high-risk groups and vulnerable groups through the public health information system and refer individuals to home health management projects and the hypertension/diabetes registry project at public health centers. Second, the communities promote cardiovascular/cerebrovascular prevention management project and provide education about them and implement systems for emergency department transport and post-discharge management through regional cardiovascular disease, trauma, and emergency medical centers. Third, for respiratory disorders and communicable diseases, the communities implement national vaccination campaigns (e.g., vaccination against influenza and Streptococcus pneumoniae for older adults) as well as sexually transmitted disease management, tuberculosis patient and contact management, and livelihood support for patients with Hansen’s disease through the regional infectious disease management support foundation. Fourth, for mental disorders, the communities provide early screening, prevention, and management of dementia; treatment fee support; and awareness projects through regional dementia centers (dementia support centers). Fifth, for cancer, the communities implement the national cancer screening project, cancer treatment fee support, and comprehensive support for cancer survivors and promote self-help groups for hospice and community-dwelling cancer patients through the National Cancer Center and regional cancer centers. Overall, compared with other regions, the Chungnam region has stronger high-risk patient registration and monitoring for hypertension and diabetes via the use of regional healthcare information systems and mobile healthcare projects. On the other hand, the Chungbuk region focuses on the hypertension/diabetes registry project, and Daejeon and Sejong focus on comprehensive health promotion projects.

For cardiovascular/cerebrovascular diseases, all regions within the Chungcheong area implement education campaigns such as the Red Circle Campaign and Knowing My Blood Vessel Numbers as part of the cardiovascular/cerebrovascular disease prevention and management project. Chungnam provides relatively more complication screening fee support through regional cardiovascular centers, while Chungbuk has more emergency department transport services through regional trauma centers. Regarding communicable diseases, all regions within the Chungcheong area implement the national vaccination campaign (for influenza) and tuberculosis management and screening projects. For mental disorders, all regions within the Chungcheong area implement early dementia screening, prevention, and management through dementia support centers. Chungnam focuses relatively more on caregiver support and the supply of supportive and self-care products, while Chungbuk and Daejeon focus relatively more on the Dementia Awareness Project. With regard to cancer, most regions within the Chungcheong area have implemented the national cancer screening project and cancer treatment fee support project through the National Cancer Center.

Recently, the Chungcheong Regional Centers for Disease Control and Prevention hosted the “2023 Expert Forum for Narrowing the Health Disparities in the Chungcheong Region” and presented the current status and performances of the “Status and Strategy of Health Disparities in Chronic Diseases in the Chungcheong Region” and “Development of Mid- to Long-Term Strategies for the Management of Chronic Diseases in the Chungcheong Region.” Efforts are being made to discuss and address health issues related to chronic diseases by establishing region-specific chronic disease management strategies in the Chungcheong Province. In addition to these efforts, this study reviewed local government-level strategies that have been established according to regional characteristics through links to regional-level chronic disease projects in the Chungcheong Province. For these strategies to be effectively and feasibly implemented by public health centers in each community, systematic standardization based on guidelines for regional-level projects is needed, and it is important to promote sustainable operations of the projects by optimizing overlapping projects and linking to existing projects.