With the improvement of standards of living in many countries worldwide, the demand for improved social welfare provisions, low birth rates, and aging societies, health services are changing their structure [1]. Traditional supplier-focused services and post-treatment services are transforming into pre-treatment and user-oriented services, which consider wellness and preventative healthcare more actively than in the past. In South Korea, as low fertility rates (total fertility rate is 1.23 in 2010) and the aging society (people aged 65 and over is 11.3% of its total population in 2008) [2] become increasingly problematic, two health-related problems are emerging: increasing demand for chronic-disease related healthcare services, and the rising cost burden on the government for increased health services. U-health, called telehealth or e-health in other countries, is considered a useful method to manage health-related problems, although evidence of the effectiveness of it is incomplete [3]. In Korea, u-health is defined as "healthcare services delivered through ubiquitous technology such as radio frequency identification (RFID), biometric devices, and ubiquitous sensor networks. In particular, u-health is testing intended to monitor and manage people's health incomes, including those of people with chronic diseases. In this situation, many countries can adopt u-health as a good countermeasure with two positive effects. First, it will ease the burden of healthcare services, which has a ripple effect throughout the healthcare industry. Second, it has policy effects on public healthcare and disease prevention.

Worldwide, the u-health market is expected to increase 15% or more annually by 2013, from US$ 1.057 trillion in 2007 to $ 2.537 trillion in 2013 [4]. It is anticipated that u-health services for elderly people, especially services for remote monitoring, will earn US$ 1.2 billion of net income annually. This market will grow from US$ 1.4 billion in 2010 to US$ 2.6 billion in 2014; this means a 12.5% increase every year [5]. In addition, it is expected that new job opportunities will exist for 39,000 people by 2014. Until now, u-health has been used for telemedicine and as an instrument in home healthcare for patients who have chronic diseases, by means of biosensor devices. Patients monitoring their conditions through u-health services measured their own biometric data, including temperature, blood pressure, pulse, weight, blood sugar, body fat, electrocardiograms, and clinical tests using blood and urine.

It has been proven that telemedicine or telecare services are effective for diabetes [1,6-9], hypertension [10,11], tuberculosis [12], asthma [13], metabolic syndrome [14,15], and quitting smoking [16]. U-health methods to manage or monitor chronic disease are regarded as useful to improve health status and lower medical expenditures [17,18]. However, confirmation of whether u-health services based on ubiquitous technology would also be effective to manage chronic disease in rural Korea is to be determined.

The purpose of this study is to analyze the effectiveness of u-health services for managing people with metabolic syndrome in a health center in Korean county (gun).

This research has intended to reveal whether u-health services could be useful for improving and changing the health status and behavior of people who are living in South Korean urban-rural complexes and diagnosed with metabolic syndrome. It was proven that u-health services are effective for managing the health status of people with metabolic syndrome, although there was not strong evidence for this in the previous research. Some previous research on diabetes showed a blood sugar decrease from 9.7% to 13.2% [1,7], but other research [16] showed no difference in it. In the context of hypertension, the u-health service was effective in promoting adherence to its plan [11]. It was proven that u-health was effective in ameliorating metabolic syndrome by decreasing HbA1C (Glycated hemoglobin), TC, TG, and HDL-C [14,15]. It has also been shown that u-health decreases NRT adherence rate [16], HbA1C, TC, TG, HDL-C, waist size, weight, and BMI [11]. Therefore, we suggest that some u-health service models can effectively align with the offline healthcare programs or services in rural areas, including consulting or education services for patients who have chronic diseases, nonsmoking promotion services, personalized and visiting health-management services, preventive services for chronic diseases, emergency healthcare service for the aged living alone and for people with senile dementia, and care services for children who are obese.

There are differences in the settings between our u-health services and those in the previous research that did not show beneficial effects. We believe that u-health services with appropriate devices and systems can be useful and effective to manage the health of people with metabolic syndrome.

Some limitations of this study should be acknowledged. The first limitation involves the fact that this study used a one-group posttest-only design, that is, we could not be sure of the pure effect of u-health services, because the influence of exogenous variables such as self-care, medical treatment, and other voluntary activities was not controlled for [20]. The second limitation is that we did not compare the results of the present study with those that can be gleaned by other methods.

The present study provides a case of effective management of metabolic syndrome using the u-health method. The findings indicate that real-time information and consultation about health status and behavior can be useful in managing metabolic syndrome. In particular, u-health systems played an important role in measuring bio-information using a u-health device, analyzing the information, and communicating the results and implications to subjects. However, it is important for future research to compare this line of study to other candidate methods. Furthermore, research should also control for exogenous factors, as discussed above.