산업보건서비스체계의 효율적 관리방안에 관한 연구

A Study on Reforming the Occupational Health Care System is Korea

  • 문옥륜 (서울대학교 보건대학원) ;
  • 한동운 (서울대학교 보건대학원) ;
  • 최병순 (한국산업안전공단 산업보건연구원) ;
  • 최재욱 (한림대학교 의과대학 사회의학교실 및 의과학센터) ;
  • 하은희 (동국대학교 의과대학 예방의학교실) ;
  • 이기효 (한국의료관리연구원) ;
  • 장동민 (한국의료관리연구원)
  • 발행 : 1994.05.01

초록

The objectives of this study are (i) to review current situations and problems of the occupational health care system with emphasis on reforming the organizations and services, (ii) to find out a disirable occupational health system model based on integration of the occupational health system and the general health system, and finally, (iii) to suggest policy implications in occupational health services in the light of objectives of the newly emerging national health insurance reform in Korea. The major policy implications of this study are as follows: 1. In the long-run, within the occupational health system, preventive occupational health services such as employees' physical check-up, working environment examination, etc should financially be integrated with industrial accident compensation insurance. Currently separately paying expenses for each different category of services by the owner of an enterprise should be disbursed once through the payment of contributions of industrial accident compensation insurance. And then, it is necessary to strengthen and expand the role and function of industrial accident compensation insurance to cover preventive occupational health services. 2. The occupational health system should be integrated with general health system for its effective management. For the short-term policy, it is necessary to eliminate fiscal and access barrier between industrial accident compensation insurance and national health insurance by means of ex post facto settlement of accounts. The duplication of employees' physical check- ups between under the health insurance program and under the industrial health services must be coordinated in a manner either through mutual authorization by the two parties concerned or through merge into the health insurance. 3. The intent of current employees' physical check-up system focused on detection of occupational diseases, should be converted to an idea of medical surveillance system or biological moritoring system. The introduction of medical surveillance or biological monitoring system is a necessary condition to build a positive, effective and inexpensive occupational health care system.

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