Urinary disorders are a complex set of conditions that go beyond simple inconvenience and may lead to secondary health issues such as reduced quality of life, social isolation, depression, falls, and infections—especially among the elderly. Severe cases, in particular, are difficult to treat in the short term and require consistent long-term management, including regular medication and appropriate urinary care. In Korea, urinary care still heavily relies on passive methods such as diapers and incontinence pads, while active approaches like self-catheterization and professional intervention remain underutilized. As a result, the quality of urinary care services is deteriorating, and the associated medical costs are steadily increasing.
According to an analysis of Big Data from the National Health Insurance Service (NHIS), the number of patients diagnosed with urinary disorders in Seoul increased by approximately 2.1 times over the past 10 years. In 2023, 14.7% of medical aid recipients and 6.0% of non-recipients in Seoul were diagnosed with urinary disorders, highlighting significant disparities in prevalence between vulnerable and general populations—particularly among the elderly and residents of northern autonomous districts. The number of patients aged 80 and older increased by approximately 3.7 times compared to 2014, and those in their 60s increased by 2.3 times. Despite this trend, few dedicated municipal-level policies or support programs currently exist. Among home health care recipients, nearly two-thirds were identified as experiencing symptoms of urinary disorders, yet 93.5% reported having little to no knowledge of prevention or management. Notably, single-person households composed of women aged 80 and older showed high dependence on diapers and urinary devices, with 18.1% reporting regular diaper use.
A focus group interview with visiting nurses revealed that many older adults in the community experience urinary symptoms but do not perceive them as medical conditions, often neglecting appropriate care. Structural barriers were identified, including the absence of standardized screening tools, limited access to urinary supplies, lack of community education resources, and insufficient private-sector support. These findings point to an urgent need for institutional intervention through standardization of care guidelines and professional training for nurses and caregivers.
In response, this study proposes an integrated three-stage system of screening, referral, and feedback to strengthen community-level urinary care. The first stage involves visiting nurses screening for symptoms using standardized tools and preparing formal requests for care coordination. The second stage connects patients with partnering clinics, and the results are reported back to public health centers. The third stage enables visiting nurses to provide tailored education and lifestyle guidance based on the medical institutions’ treatment plans. This system, implemented in partnership with the Seoul Metropolitan Government and local healthcare providers, aims to establish a sustainable and equitable model for urinary disorder management in the aging urban population.