Seodaemun-gu is building a prevention-focused integrated care system that proactively identifies residents in need and connects them with tailored services.
The district, led by District Mayor Park Un-gi, announced Thursday it will run an intensive outreach period through September to identify residents facing complex challenges in health, daily living and housing — a group it calls the "priority integrated care target population."
The initiative aims to reach residents who need care but are unaware of available services or have yet to receive support, providing personalized integrated care plans to prevent health deterioration, hospital readmission and premature entry into care facilities.
The drive also aligns with the Act on Integrated Support for Community Care, Including Medical and Long-term Care, which took effect March 27, and is intended to further strengthen a community-centered integrated care framework under the new law.
The district has identified about 3,000 residents as priority outreach targets, including users of at-home long-term care benefits, those who narrowly missed qualifying for long-term care ratings, elderly people with disabilities, patients recently discharged from hospitals and residents who have left care facilities.
Neighborhood community centers will serve as the hub for consultations and needs assessments. Staff will analyze each resident's health status, living conditions and care needs, draw up individual support plans and connect residents with appropriate services.
Eligible residents will receive both existing public care services and specialized support under Seodaemun-gu's own integrated care program.
Key services include home visits by both Western and traditional Korean medicine practitioners, a dedicated health physician for people with disabilities, hospital discharge accompaniment, oral health management, personalized in-home exercise programs, medication management support and residential environment improvements — all focused on helping residents recover and return to daily life after a hospital stay.
Through these services, the district aims to move beyond reactive crisis response and build a care system centered on prevention.
To improve the program's effectiveness, the district will also provide capacity-building training for integrated care team leaders and care managers at neighborhood community centers. The training covers the full process from identifying residents and conducting assessments to drawing up individual support plans, coordinating services and conducting follow-up monitoring.
"This intensive outreach is the practice of preventive, proactive welfare — going to residents who need help before they have to come to us," District Mayor Park said. "We will build a tight-knit integrated care system so that vulnerable residents can continue to live healthy and safe lives in the communities they know."
seouldream01@heraldcorp.com
