This ethnography is aimed at describing the health care seeking behavior of elderly details in their socio-cultural context. The research question is “under what conditions did elderly informants decide to use certain professional health care services and how do they make use of all the available resources?”

10 sessions of fieldwork were conducted in the two agricultural villages between Sep. 1999 and Oct. 2002. The data for this paper came from participant observation with 14 informants. In the process of analysis I used proxemic and taxonomic techniques.

Informants decided to use a certain health care system according to their folk definition of illness. They prefer to use the health services where they felt more comfortable and free. They wished to be care from intuitive and holistic healers. Social network and having health resources was also important factor.

We need more comprehensive research model to reach a plausible explanation. Combined qualitative-quantitative research is needed to get practical data to develop effective health care systems for the elderly.

This study was done to examine the effect of an integrated care service which included a combination of oriental and western care on health outcomes in elderly patients with degenerative arthritis.

A prospective comparative design was used. Data were collected from May 1, 2008 to June 30, 2009 from 85 elderly patients with degenerative arthritis in the lower extremities who were followed in a hospital out-patient department for 8 weeks. The integrated care service group (n=36) received a combination of physical therapy, acupuncture, western medicines or herbal medicines, and the western care group (n=49) received physical therapy or western medicines. Functional independence, walking speed, rotation balance, pain intensity, service satisfaction and total medical costs for the two groups were compared at 8 weeks.

Functional independence (t=2.14, p=.036) and walking speed (t=2.51, p=.014) improved significantly in the integrated care group while pain intensity improved significantly in the western care group (t=3.35, p=.002). The integrated care group reported higher scores for service satisfaction (t=2.09, p=.041) and higher medical costs than the western care group (t=2.15, p=.035).

The results suggest that integrated care services are effective modalities to improve mobility and quality of life for elders with degenerative arthritis.