• 제목/요약/키워드: Health Facilities

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초고령 사회의 노인 돌봄 정책에 관한 융복합 연구 (A Study on the Care Policy for the Elderly in Super-aged Society)

  • 김동건
    • 디지털융복합연구
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    • 제22권2호
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    • pp.21-28
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    • 2024
  • 본 연구는 초고령 사회로 진입한 우리나라의 당면한 돌봄 정책의 현황과 노인 문제를 분석하여 바람직한 융복합 정책에 관한 개선 방안을 제시하고자 하였다. 우리나라의 노인 문제는 가족 개념, 가치관, 사회경제적인 구조의 변화로 노인의 건강 문제, 빈곤 문제, 역할상실의 문제, 돌봄 문제로 나타났다. 또한, 빈곤한 노인은 일자리와 취업 정책이 필요하며, 건강한 중산층 노인들은 여가생활과 자원봉사 활동을 할 수 있는 정책적인 개발이 필요하다. 특히 지역사회의 돌봄 정책을 통하여 노인요양시설과 노인 요양 병원 등 여생을 보낼 수 있는 정책적인 수립이 필요하다. 초고령 사회는 65세 이상 노인인구 중 총인구의 20% 이상을 차지하며, 통계청의 예상으로 2025년이면 초고령 사회로 진입할 것으로 보인다. 노인 복지정책은 다양한 프로그램과 노인 돌봄의 필요성과 서비스가 제공되어야 하며 향후, 초고령 사회는 많은 재원의 확보와 재원을 충당해 줄 생산인구의 유지가 필요하다. 즉 인간의 생애 주기는 출생에서 사망까지 노인의 자연 사망자와 출생 유아의 비율이 적절할 때 그 사회와 국가는 안정적이며, 활기가 있는 건강한 사회를 이룰 수 있다고 볼 수 있다.

일부도시국민학교취학아동의 보건생활에 관한 실태조사연구 (A Study on Health Aspects of Daily Life of Elementary School Children in an Urban Area)

  • 구외행
    • 대한간호학회지
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    • 제3권3호
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    • pp.36-49
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    • 1973
  • This study was carried out for the objectives to collect the basic informations on the health behaviors of the elementary school children in an urban area in Korea. Seven hundred students were drawn to fill in the designed questionnaire which carries variety of Questions on health re-lated behaviors in general, eating habits, disease history, mental health, and sex education. Questionnaire were filled in by their parents. Major findings are as follows: ① 55.7% had habits of washing the hands before eating whereas 59.8% trashing their hands after toilet. The others had no idea of washing hands before eating and after toilet. ② 26,5% had habits of brushing the teeth twice a day 54.7% only once in the morning, and 2.6% once only in the evening. Thus, the idea of prevention from decayed teeth seems to be lacking among the school children. ③ Bathing habits were also inquired to get 40.3% of bathing more than once a week, 43.1% once every two weeks, and the rest of 16.6% once every one to three months. ④ 41.7% keep the regular bedding time whereas 58.3% irregular. Physical exercises were con-ducted by 76.6% on the ground while 23.5% did not practice any physical exercises at all. Of those physical exercises, rope skipping occupied 37.5%, and the other 66.9% consisted of 14 different kinds of individual type physical exercises such as gymnastic exercise. The main reasons for not enjoying exercises were different by sex; boys largely complained the inadequacy and lack of gymnastic facilities and girls felt in short of friends who could join the exercises. ⑤ 31.9% of the school children had been taking not much of food while 28.3% had unbalanced diets. Of these unbalanced diets, meat occupied 33.2% to be the priority to have an order of the following items such as vegetables, bread or noodle, and fishes as next to each. For eating habits, 88.5% take simple snack such as bread (38.4%, cookies, fruits, and candies in order. 25.8% of the children were provided such snacks or their parents regularly. Breakfast was sufficiently taken by 45.0% whereas 8.4% had never sufficiently. As to the lunch, 63.6% had sufficiently while 16.8% insufficiently. 70.6% take breakfast with all family members together and 30.4% separately. Correlation of sufficient taking of breakfast and eating together of tile family member's seems to be significant when we compare 72.5% of sufficient takers who enjoy breakfast together with the family members with 55.6% of insufficient takers who enjoy it with the family. This finding allows the investigator to point out the importance of table circumstances for children's eating. ⑥ The most common disease was catching a cold (38.8%), and the second was stomach trouble to be followed by the frequency of car sickness, headache, and skin infection. Doctors are consulted only by 23.9% when they are sick whereas 59.7% resorted to the drug stores. The lower the educational attainment of the parents, the lower the rate of visiting clinics. ⑦ 36.7% of their parents pointed out the problems of personality guidance as the most difficult thing at home 71.3% of their parents worried about and unsatisfied with their children's personality traits. Of these complains of the parents, impatience stood at the top to be tabulated at 24.1%, and 21.1% indicated narrow-mindedness. In line with this primary socialization at home, the most crucial problem seems to be related with the lack or recognition of the parents'own role when we find only 43.1% of the parents understood the importance of their own role for the home education of children; the latter group attributed tile responsibility of personality formation to the children themselves. ⑧ As to the sex educational aspects, 30.9% of children have ever asked about the physiology of reproduction or sexual matters to their parents, of those parents only 17.0% could give the constructive responses to the inquiries of the children. In companies on with these data, 25.6% recognized their own role in sex education for their own children while the large segments of the parents (51.1%) attributed the responsibility of sex education to tile low level of 38.3% who recognized the importance of sex education in the school curriculum and 25.1% of the parents insisted to wait until they get to know naturally about sex. 38.1% of the parents said they had some knowledge on sex from books while 16.9% through mass media. The next groups had common senses of sex from their own parents, school friends and other sources.

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울릉도 지역의 헬리콥터를 이용한 응급환자 후송 실태 (Study on the Patterns of Helicopter Emergency Medical Services in Ullung Island)

  • 김태훈;임현술;이관
    • 농촌의학ㆍ지역보건
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    • 제27권1호
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    • pp.115-123
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    • 2002
  • 1997년 1월 1일부터 2001년 12월 31일까지 5년간 울릉군 보건의료원 응급실을 내원하여 헬리콥터를 이용하여 육지병원으로 후송된 환자를 조사하였다. 헬리콥터가 운행된 회수는 5년간 88회, 후송된 환자들은 110명으로 113건이었다. 헬리콥터의 연도별 운행 회수는 1997년은 13회(14.8%), 1998년에는 17회(19.3%), 1999년에는 18회(20.5%), 2000년에는 17회(19.3%), 2001년에는 23회(26.1%) 운행하여 연도에 따라 헬리콥터 운행 회수가 증가하는 경향을 보였다. 헬리콥터 종류는 해양경찰 헬리콥터가 46회(52.3%), 119 소방 헬리콥터가 19회(21.6%), 해군 헬리콥터는 14회(15.9%), 민간 헬리콥터가 7회(8.0%) 운행하였다. 후송 시간대는 오전 6시부터 오후 6시 이전까지 79회(89.8%)가 후송되었다. 후송 환자의 계절별 분포는 가을에 25회(28.5%), 봄에 23회(26.2%) 운행하였다. 최종 후송 지역은 경상북도 포항시 47건(43.1%), 강원도 강릉시 34건(31.2%), 대구광역시 16건(14.7%) 서울 10건(8.8%) 등의 순이었다. 후송 환자의 성별 분포는 남자가 71건(65.1%), 여자가 38건(34.9%)으로 남자가 많았다. 연령별 분포는 60세 이상이 31건(28.4%), 30대가 20건(18.3%), 40대가 16건(14.7%) 등의 순이었다. 진료과별 분포는 신경외과 42건(37.1%), 내과 21건(18.6%), 일반외과와 정형외과가 각각 13건(11.5%) 등의 순이었다. 질병별 분포는 뇌졸중이 27건(23.9%)으로 가장 많았으며, 골절이 13건(11.5%), 두부손상 11건(9.7%), 임신과 관련된 출혈 및 통증 10건(8.8%), 복막염 8건(7.1%) 등의 순이었다. 한국표준질병사인분류(3-KSCD)에 의한 분포는 순환기계의 질환(IX)이34건(30.1%), 손상, 중독및기타(XIX)가34건(30.1%), 소화기계질환(XI)이 23건(20.4%) 등의순이었다. 울릉도를 비롯한 도서지역의 응급환자 후송에는 헬리콥터의 이용이 필수적이다. 보다 효율적인 응급환자 후송을 위해서는 헬리콥터의 야간 운행, 헬리콥터 내의 환자감시장치 등의 의료장비의 확보, 공식적인 응급후송용 헬리콥터의 확보 및 이를 위한 법 제정 등이 이루어져야 할 것이다.

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신생아실 의료인력의 적정성 및 신생아관리료의 타당성 분석 (Adequacy of Medical Manpower and Medical Fee for Newborn Nursery Care)

  • 박정한;김수용;감신
    • Journal of Preventive Medicine and Public Health
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    • 제24권4호
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    • pp.531-548
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    • 1991
  • 신생아의 질적 관리를 위해 신생아실 의료인력과 의료수가의 타당성을 파악하고자 영남지역내 24개 소아과 수련병원 가운데 신설병원과 모(母)병원의 수련프로그램에 의존해 있는 병원을 제외한 20개 병원의 신생아실을 대상으로 1991년 7월 29일에서 8월 14일 사이에 각 병원을 방문하여 자료를 수집하였다. 자료는 신생아실 대장에서 1991년 6월 한달동안 입.퇴원한 정상 및 환아수를 조사하고 신생아실 수간호사와 소아과 의사를 면담하여 정상신생아 관리에 소요되는 최소한의 간호시간, 인력현황, 인력의 적정성, 그리고 인력확보의 문제점을 조사하였고 자 병원 보험심사과에서 정상 질분만시와 제왕절개분만시 산모 1인당 평균 산모 및 신생아관리분의 의료비를 조사하였다. 정상신생아 1명당 하루에 필요한 최소한의 간호시간은 평균 179.5분(${\pm}58.6$)이었고 대학병원은 202.3분(${\pm}50.7$), 종합병원은 164.2분(${\pm}60.5$)이었다. 최소한의 간호 요구시간 대 제공가능한 간호시간 비는 평균 1.42였고 환아에 대한 간호 요구량을 감안했을 때는 평균 비가 2.06으로 간호인력이 매우 부족하였다. 미국 소아과학회가 권장한 신생아실 간호인력을 기준으로 할 경우 간호사는 31%, 간호조무사는 17%가 충원된 상태였다. 신생아실 수간호사의 90%와 소아과 의사의 85%가 간호사가 부족하다고 했고 간호조무사는 각각 75%가 부족하다고 했다. 간호인력 보충이 안 되는 주된 이유는 재정사정이라고 하였다. 간호조무사의 경우는 인력구하기 힘든 것이 재정사정 다음으로 중요한 이유였다. 그러나 국립대학병원의 경우는 의사와 간호사는 T.O.의 제한이 주된 이유라고 했다. 정상 질분만으로 2박 3일만에 퇴원하는 경우 총 의료비는 평균 219,430원이었고 이 중 신생아분은 20,323원(9.3%)이었으며, 제왕절개분만으로 6박 7일만에 퇴원할 경우 평균 732,578원이었고 이 중 신생아분은 76,937원(12.0%)이었다. 원가계산방식에 의한 신생아관리에 대한 최소한의 원가는 3차진료기관의 경우 1일 16,141원, 기타 종합병원은 14,576원으로 원가가 의료보험수가의 각각 5.0배, 4.9배나 되었다. 오늘날의 의료인력의 인건비 수준과 병원시설 및 관리비를 감안할 때 현행 의료수가로 양질의 신생아관리를 기대하기 어려운 것으로 생각된다.

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간호조무사의 근무환경인식과 성격성향에 관한 연구 (A Study on the Working Environment Recognition and the Caracter Disposition of Nurse Aides)

  • 이선이
    • 한국보건간호학회지
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    • 제4권1호
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    • pp.57-74
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    • 1990
  • As the whole world took on the tendency to be highly industrialized, it became necessary for each field of occupation to require professional man power. Especially, since the World War n, the participation of woman power in economic activities has been continually increasing. In our country also, because of the rapid economic growth, change in the way of thinking of women as well as their participation in economic activities are increasing. Thus, woman power is being utilized in various occupational fields from simple physical labor to those that require high-professional skill. Also, continued economic development policies, by setting the establishment of welfare society as the ideology to be fulfilled, brought expansion of medical facilities in the field of public health and increase in man power in that field. As for the nursing specialists, more than 6000 have been being produced per year and as of the end of 1988, the total number of nursing specialists, reached 123, 115. Therefore, this study is done to recognize the professional knowledge and ability of nursing specialists, who take up $40\%$ of the total public-health related man power in our country, through evaluating their working environment and their disposition of character. This study, which was done from September 18th to September 30th 1989, took on the method of using formed questionnaires that had been amended and supplemented during two preparatory investigations, 322 of such questionnaires were used as an analytical material. In the formation of questionnaires, 12 questions were related to the working environment, and 26 in fortotal were related to the disposition of character, 5 for wise-disposition, 11 for activedisposition and 10 for open-disposition. The measuring method, which used 5-point-standard, allowed 5 points for affirmative recognition of the working environment, also 5 points for showing wise, active and open disposition of character and only point in opposite cases. Collected materials were analyzed, through an electronic calculation, into the average value, the standard deflection percentage, pearson corelative number and stepwise multiple regression. Summarizing the results from this study is as follows: 1. It was shown that the nursing specialists with the average of 3.07 have affirmative recognition of their working environment. The questions which drew most affirmative reaction were those concerning finance-management system such as hand, the questions that received negative reaction were those concerning communication method with the average of 2.49. Such reaction seems to have resulted from the cramming regulation by the superior authorities. Concerning the recognition of working environment in relation to employment conditions, more affirmative recognition is shown with the average of 3.14. at hospitals where injection job is not performed. The nursing specialists working at regular hospitals show more affirmative recognition than those at general hospitals, the averages being respectiely 3.16 and 3.03. 2. As for the disposition of character of the nursing specialists, active-disposition was highest with the average of 3.38, next was wise-disposition with 3.20 and the lowest was open-diposition with 2.98. Variable-wise disposition of character shows that wise-disposition and academic background are beneficially correlated by 0.12. Ative-disposition and open-disposition show correlation to the office term by respectively 0.16 and 0.21. In other words. better academic background leads to higher wise-disposition and more - experience results in higher active and open disposition. Also, the class that performs the injection job, in relation to the working environment, might cause change in the self-conceit that identify those in that class with the nurses; however, as far as professional judgment and action, in dealing with nursing job, being wise, active and open is concerned, not much effect is made. 3. The relation between the recognition of the working environment and the disposition of character is that more afirmative recognition- a nursing specialist has about her working environment, the higher the active-disposition becomes by 0.13. The degrees of the relation between recongnition of environment and wise and open dispositions show respectively 0.06 and -0.06 and -0.06. That is to say that when having more affirmative recognition of the working environment, a nursing specialist shows wise but closed disposition of character. This, howerver, didn't mean much statistically. When observing the results mentioned above, it is conspicuous that the nursing specialists, working as substitutes for the nurse at medical institutions of various sizes, get the feeling of being somewhat equal to the nurses and to some extent, fulfill their desire to accomplish their ego; however, as far as professional ability expansion if concerned. they lack wise and open dispositions. Therefore, considiering upon the results of this study, in medical institutions where the work of nursing specialists is regaded equal to that of the nurses, as a medical member who deals with human lives, it is desirable to make the nursing specialists work under the supervision of the nurses and to offer them continuous education to strengthen and improve their natural dispositions.

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한국의 치매에 대한 대응과 대책 : 국가 전략과 활동계획 (Preparation and Measures for Elderly with Dementia in Korea : Focus on National Strategies and Action Plan against Dementia)

  • 이무식
    • 농촌의학ㆍ지역보건
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    • 제44권1호
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    • pp.11-27
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    • 2019
  • 치매는 세계적으로 주요 유행 질환이 되었다. 한국의 2010년 치매 유병률은 8.7%에서 2050년 15.1%로 예측되고 있으며, 2017년 현재 725,000명의 치매환자가 추정되고 있다. 이 글은 한국의 국가치매 예방관리사업을 현황을 리뷰하고 그에 따른 정책과제 등을 살펴보고자 하였다. 한국은 치매에 대하여 2008년, 2012년, 2016년에 걸쳐 세 차례의 국가치매계획을 개발하였다. 제1차 치매계획은 치매에 대한 예방, 조기진단, 하부구조개발 및 조정, 관리, 인지도 개선 등에 초점을 맞추었으며, 제2차 치매계획은 치매환자 가족지원에 역점을 두었고, 치매관리법의 제정과 더불어 포괄적인 사업의 근거를 마련하였다. 제3차 치매계획은 치매 친화적 지역사회 구축에 목표를 두었으며, 가족부담을 줄이고, 연구, 통계, 기술개발 등에 지원을 마련하였다. 2017년 한국 정부는 국가치매책임제를 도입하였으며, 경증 치매에 대한 장기요양보험제도 혜택을 확대하고, 보건소 치매안심센터의 설치, 운영, 국가 및 공공치매관리시설의 확장 등을 추진하고 있으나 정책의 급속한 추진에 따르는 재정확보 등 많은 과제들이 남아 있다.

아동양육시설과 청소년 쉼터에 거주중인 청소년들의 정신건강 수준 비교 (A Comparative Study on the Mental Health of Adolescents Residing in Child Care Institutions (Orphanages) and Youth Shelters)

  • 전연우;신철규;김현정;오근;서희영;이종국;이제정
    • 정신신체의학
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    • 제31권2호
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    • pp.125-133
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    • 2023
  • 연구목적 본 연구는 아동양육시설과 청소년쉼터에서 거주하는 청소년들의 정신건강을 비교하여 각 시설에 맞는 적절한 정신의학적 개입을 하는 것을 목적으로 한다. 방법 본 연구의 대상자는 한국판 청소년 자기행동 평가척도(K-YSR)를 완료한 아동양육시설 청소년 157명과, 청소년 쉼터 대상자 31명이다. 우리는 두 집단의 K-YSR 점수를 비교하였고, 이들 중 자살경향성과 관련된 요인 들을 살펴보았다. 결과 청소년쉼터 대상자들은 아동양육시설에 비해 나이가 많고 음주(p<0.001), 흡연(p<0.001), '이상수면'(p=0.007)의 비율이 높았으며, 더 높은 자살경향성(p=0.004)과 K-YSR 점수를 보였다. 반면 아동양육시설 청소년들은 '이상수면'(OR 4.194; p=0.006)이나 '이상식이'(OR 2.503; p=0.010), '체중증가에 대한 걱정'(OR 3.897; p=0.002)을 호소할 때 자살경향성이 높았다. 또한 본 연구에 참여한 전체 청소년들의 17.6%에서 자살경향성을 보였고, 자살경향성을 보인 군은 아닌 군에 비해 전체적으로 높은 K-YSR 점수가 높았으며, '이상수면'(OR 3.766; p=0.014)이나 '체중증가에 대한 걱정'(OR 2.864; p=0.032)이 많았다. 결 론 청소년쉼터 대상자들이 아동양육시설 청소년들에 비해 임상적인 어려움이 더 크고 심각하여 정신의학적 개입이 신속하게 필요해 보인다. 또한 아동양육시설 청소년들이 수면이나 식이, 체중증가에 대한 불편감을 호소할 때, 자살경향성을 포함한 정신건강 평가를 고려하는 것이 필요하겠다.

한국(韓國)의 의료기사(醫療技士) 교육제도(敎育制度)에 관(關)한 조사(調査) 연구(硏究) (A Study of Educational System for Medical Technologists in Korea)

  • 송재관;이건섭;김병락;김정락;조준석;허준;이준일
    • 대한방사선기술학회지:방사선기술과학
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    • 제6권1호
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    • pp.131-181
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    • 1983
  • After the investigation on, and the analysis of, the educational system for medical technicians and the present educational situation for medical technologies in this country, the following conclusions were drawn. 1. As of March 1983 the current academic system for education in medical technologies included the regular 4-year college courses and those of the 2-year professional junior college courses. But except in the cases on clinical pathology and physical therapy, there were no college-level departments. Particularly, no educational institutions, at whatever level, had a department for working therapies. 2. The total number of credits needed for graduation from a department of medical technologies was 150 points at a regular 4-year college and 85 to 96 points at a 2-year professional college. The obligatory minimum number of credits for a student at a professional college was set at 80 points and above. 3. As for the number of the educational institutions for medical technologies in this country, there were one regular college and 14 professional colleges, a total of 15 institutions. As many as 14 colleges had departments of clinical pathology, 12 had departments of Radiotechnology, 11 had departments of physical therapy, 12 had departments of dental technology, and eight had departments of dental hygiene. 4. The total capacity of the professional colleges in admitting new enrollment each year were 1,920 for clinical pathology, 1,552 for radiology, 1,012 for physical therapy, 1,334 for dental technologies, 828 for dental hygiene, an aggregate of 6,646 for all of the professional college departments. 5. The total number of graduates from the 12 professional colleges by department during the period of 1965-83 were 7,595 for clindical pathology, 4,768 for radiology, 2,821 for physical therapy, 3,000 for dental technologies, and 1,787 for dental hygiene, totalling 19,971 for all departments in the professional colleges. 6. In the state examination for licensed medical technicians, 12,446 have passed from among the total of 26,609 participants, representing a 45% passing ratio. By departments the ratios showed 44% for clinical pathology, 39.7% for radiology, 51.2% for physical therapy, 42.5% for dental technology, 72.5% for dental hygiene and 73.1% for working therapy. 7. As for the degree of satisfaction shown by the people in this field, 52.2 percent of the teaching staffs who responed to the questionaires said they were satisfied with their present profession, while the great majority of medical technicians(66%) replied that they were indifferent to the problem. 8. The degree of satisfaction shown by the students on their enrollment in this particular academic field was generally in the framework of indifference(43.7%), but mere students(36.5%) were satisfied with their choice than those were not satisfied(14.4%) 9. As for the student's opinions on the lectures and practicing hours, a good many students replied that, among such courses as general science and humanities courses the basic medical course, the major course and practicing hours, the hours provided for the general courses(47.1%) and practicing(47.6%) were insufficient. 10. When asked about the contents of their major courses, comparatively few students (23.6%) replied that the courses were too difficult, while a convincing majority(58.5%) said they were neither difficult nor easy. As for the appropriateness of the number of the present teaching staffs, a great majority(71.0%) of the students replied that the level of the teaching personnel in each particular field was insufficient. 11. Among the students who responded to the poll, good part of them(49.5%) wanted mandatory clinical practicing hours, and the the majority of them(64.6%) held the view that the experimental and practicing facilities of their schools were insufficient. 12. On the necessity of the attached hospitals, 71.1% of the teaching staffs and 58.0% of the medical technicians had the opinion that this kind of facility was indispensable. 13. As for the qualifications for applicants to the state examination in the licensing system for medical technicians, 52.2% of the teacher's and 36% of the medical technicians replied that the present system granting the qualifications according to the apprenticeship period should be abolished. 14. On the necessity of improving the present system for education in medical technologies, an overwhelming majority(94.4% of the :caching staffs, 92.0% of the medical technicians and 91.9% of students) of these polled replied that the present system should be changed for the better. 15. On the method of changes for the present educational system, a great majority(89.4% of the teaching staffs, 80.4% of the medical technicians and 90.1% of the students) said that the system must be changed so that it fits into the reality of the present day. 16. As for the present 2-year program for the professional colleges, 61.6% of the teachers, 72.0% of the medical technicians and 38.8% of the students expressed the hope that the academic period would be extended to four regular years, hemming a full-fledged collegelevels program. 17. On the life-long eductional system for medical technicians, there was a considerable number of people who expressed the hope that an open university system(38.9% of the teaching staffs, 36.0% of the medical technicians) and a graduate school system would be set up. 18. As for the future prospects for medical technicians as professionals, the optimists ana pessimists were almost equally divided, and 41.1% of the teaching staffs 36.0% of. the technicians and 50.5% of the students expressed an intermediate position on this issue.

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대구시 개원의사와 개국약사의 의약분업에 대한 인식과 태도 (Recognition and attitude to functional division between physicians and pharmacists of practising physicians and pharmacists in Taegu city)

  • 이무식;윤능기;서석권;박재용
    • Journal of Preventive Medicine and Public Health
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    • 제26권1호
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    • pp.1-19
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    • 1993
  • 1989년 10월부터 실시되고 있는 약국의료보험과 의약분업제도에 관한 태도를 조사하기 위하여 대구시내 개원의사 및 재국약사를 계통적 표본추출법(systematic sampling)에 의한 표본을 선정하여 우편설문지법으로 1992년 4월 20일부터 5월 20일까지 조사하여 회신된 개원의사 184명, 개국약사 157명의 설문지를 분석한 결과를 요약하면 다음과 같다. 현재 시행중인 약국의료보험의 성과에 대해 개원의사는 71.2%가 '실패적'이라고 한 반면 개원약사는 13.4%가 '실패적'이라고 하였다. 개원의사의 50%는 약국의료보험을 폐지하고 의약분업을 도입해야 한다고 한 반면, 개국약사는 66.9%가 의약분업제도와는 관계없이 약국의료보험자체만으로도 성공적인 제도라고 하였다. 개국약사의 약국 1일 평균조제건수는 32.2회였으며, 약국의료보험 이용횟수는 6.2회로 조제건수의 20%에 불과했고, 의사처방전을 지참한 약국의료보험이용횟수는 조제건수의 0.7%였다. 그리고 개원의사의 원외처방전 발행경험자는 58.7%였다. 의약분업제도의 실시에 대해 개원의사는 59.2%가 찬성하였으며 27.7%가 반대하였으나 재국약사는 38.0%가 찬성, 45.5%가 반대 하였다. 그리고 약사가 의사보다 의약분업의 내용을 더 많이 안다고 하였다. 의약분업제도 실시의 찬성자중 찬성이유로 개원의사는 '의약품의 남오용 방지' (54.1%)를 많이 지적한 반면 개국약사는 '의사와 약사의 전문직능 발휘'(62.0%)를 많이 제기하였다. 그리고 분업찬성자에서 개원의사는 52.3%가 '완전강제분업'을 원한 반면, 개국약사는 81.7%가 '부분분업'을 원하였다. 의약분업제도 실시시에 처방전의 발행 방법에 대해서는 개원의사와 개국약사 모두 '일반명' 처방을 44.0%, 89.8%로 가장 많이 원하였고 개원의사에서는 '상품명' 처방도 35.3%나 차지하였다. 의약분업제도의 실시가 이루어지지 않은 이유에 대해 개원의사 및 개국약사 모두 '의사 약사단체 상호간의 업권문제'를 가장 많이 지적했으며 '국민들의 인식 및 관심 부족' '정부의 의지력 결여' 순으로 일치된 결과로 나타났다. 의약분업실시를 위한 선결조건으로는 '의료시설과 약국의 도시 농촌간의 균등분포'를 가장 많이 지적하였으며 의사는 '약사들의 수용태세 확립', 약사는 '의사의 수용태세 확립'을 그 다음으로 지적해 서로 상반된 결과가 나타났다. 이상의 결과를 종합해 보면 첫째, 조사대상 개원의사들은 현행 약국의료보험제도에 대해 부정적 견해를 보인 반면 개국약사들은 긍정적 견해를 보였으나 약국의료보험이용은 극히 저조하고 의사의 처방전 발행도 저조한 실정이다. 이에 약국의료보험제도에서 의약분업제도로의 제도적 전환이 고려되어야 할 것으로 생각된다. 둘째, 의사와 약사의 의약분업에 대한 의견이 상이한 점으로 미루어 유추할 수 있지만 의약분업제도 실시의 장애요인으로 의 약사단체 상호간의 업권문제와 의약사간의 갈등이 지적되는 바, 이들 모두를 만족 할 대안을 선택하는 것이 쉬운일 아닐 것이므로 국민의 건강보호차원에서 정부의 중립적 의지가 있어야 할 것으로 생각된다.

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한방의료(韓方醫療) 이용자의 질병양상(疾病樣相)과 치료만족도(治療滿足度)에 영향(影響)을 미치는 요인분석(要因分析) (An analysis of factors affecting aspects of disease and satisfied medical treatments for oriental medical users)

  • 안창수;남철현
    • 대한예방한의학회지
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    • 제3권2호
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    • pp.101-128
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    • 1999
  • A study on disease treated at oriental medical treatment facilities (OMTF) and patients' satisfaction levels was conducted in order to figure out why the patients visited oriental medical doctors and the level of satisfaction of the patients for the services offered to them by oriental medical doctors. This study was performed from March 2 through May 31, 1998 by interviewing 1.532 persons living in major and small cities in korea. The results obtained were summarized as follows; 1. The general characteristics of subjects. The highest portion of each part was, 66.9% female, persons in the age group of over 60's 22.7%, high school graduated 34.9%, house wife 30.8%, The married 65.0%, Buddhist 36.9%, maj or city residents 60.2%, company covered insurance benefiter 39.0% and etc. 2. 40.5% of subjects visited OMTF for skeletal and connective tissue diseases. 21.5% for digestive system diseases. 16.2% for respiratory system diseases. 13.3% for circulatory system diseases and 9.0% for neurological problems. 3. 42.7% of males visited OMTF for skeletal and connective tissue diseases, which were the highest and respiratory system disorders, digestive system disorders, circulatory system disorders and neurological diseases in order. 39.4% of females visited OMTF for skeletal and connective tissue disorders which were the highest and other conditions such as digestive system, circulatory, respiratory, and neurological disorders in order. 4. The males with circulatory system disorders were treated by herbal medicine, combination of herbal medicine and acupuncture, only in order. The females with the some conditions above were treated by combination of herbal medicine and herbal medical and acupuncture only in order. The males and females with respiratory system and digestive system diseases were treated by herbal medicine, combination of herbal medicine and acupuncture only in order. But the males and females with skeletal and connective tissue diseases were by acupuncture are the highest in order. 5. The females and persons in the age group of over 60' s and house wife. the not married, the unhealthy persons, residents living in small cities, the persons with high income by medical treatments frequency in circulatory system diseases are the highest. 6, The females, middle school graduated and the married, persons in the age group of over 60's, unemployed, sales and service industry workers, Buddhists, major city residents, the unhealthy persons, the persons with middle income by medical treatments frequency in respiratory system diseases are the highest. 7. The females, persons in the age group of over 60's, under graduated or elementary school graduated, the unemployed and house wife, the unmarried, Buddhists, major city residents, the unhealthy persons, the persons with low income by medical treatments frequency in digestive system diseases are the highest. 8. The males, major city residents, old ages, under graduated or elementary school graduated, go earn officials, people grown in small city, the persons who had health insurance policies, the persons with low income, the unhealthy persons by medical treatments frequency in skeletal and connective tissue disorders diseases. 9. 50.8% of the respondents said that the treatments at the OMTF were very effective. 47.7% of them said that the treatments were effective. The males, persons in the age group of 40's, high school graduates, official workes, the married, the persons who did not have religion, major city residents, the persons who had health insurance policies, the persons with high income and the healthy persons said that the treatment effects at OMTF were satisfactory. 10. The patients' satisfaction rate for OMTF on each disease is, 1st. Musculo-Skeletal system(most satisfied), 2nd. the pregnancy & delivery complications, 3rd. Eye & ophthalmics, 4th. Respiratory system, 5th. Mental & bodily disorder, 6th. Digestive system and etc. 11. The factors affect OMTF are age, satisfaction for OMTF, current disease, religion, efficiency of Oriental Medicine, health condition and etc. This explained power of variable were 39.0%. 12. The satisfied factors for OMTF is correlate to educational level, and economical variables.

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