• Title/Summary/Keyword: Health centers and subcenters

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보건소 및 보건지소 정보체계의 프로그램 설계에 대한 고찰 (An Approach to program Design of Management Information Sytems for Health Centers and Subcenters)

  • 이영조;권순호;최재준
    • 보건행정학회지
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    • 제1권1호
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    • pp.109-115
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    • 1991
  • We are in the process of developing information systems that can be helpful for the effective management of community health services provided by the health center and subcenters in Hwachon Gun, Kangwon Do. In doing so, we have employed a different program design from those programs of information systems developed in other health centers or subcenters. The main idea of our design is dividing all the programs into two parts. One part is for the control of operation functions such as addding, seeking, editing, and printing needed to all the tasks. The other consists of a set of programs each of which deals with a specific task. It is believed that this program design would result in an information system that is simple to use, easy to modify and expand, and flexible to new computer technologies.

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일개 도지역 보건기관 근무 치과위생사의 직무실태와 개선방안 (Task Status of Dental Hygienists of Health Centers and Subcenters)

  • 은종영;감신;임지선;양진훈;김종연;한창현;유윤선;차병준;송근배
    • 농촌의학ㆍ지역보건
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    • 제27권2호
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    • pp.35-54
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    • 2002
  • 보건기관에 근무하는 치과위생사의 직무실태, 직무만족도, 그리고 향후 직무개선 방안을 알아보기 위하여 경상북도 보건소 및 보건지소에 근무하고 있는 치과위생사 전원(203명) 대상으로 2002년 4월에 설문조사를 실시하였다. 타부서에 비해 업무량이 많다고 응답한 대상자는 52.2%였고, 보수 수준에 대하여는 61.6%가 보통, 36.5%는 만족한다고 하였다. 대상자의 73.9%가 업무에 대해 긍지와 보람을 느낀다고 하였고, 32.0%가 전직의사가 있다고 응답하였는데, 전직의사 이유로는 승진기회의 부족이 가장 높았다. 대상 치과위생사의 47.3%가 직무교육에 참여한 경험이 있었고, 19.2%가 특수사업에 참여한 경험이 있었다. 치과위생사가 공무원계급에 6급직이 없는 이유에 대해서는 60.6%가 타직렬의 견제 때문이라고 응답하였다. 보건기관에서 타업무에 종사하는 치과위생사에 대해서는 53.7%가 구강업무에 종사하도록 해야 한다고 하였고, 치과의사가 배치되어 있지 않은 지역의 치과위생사에 대해서는 61.9%가 치과질료실을 구강보건실로 전환하여 구장질환 예방사업에 종사하도록 하여야 한다고 하였다. 보건기관의 유휴 치과장비에 대해서는 89.1%가 지역실정에 맞게 치면세마사업에 활용하야야 한다고 하였다. 보건기관 근무 치과위생사외 구강보건업무 담당시간은 전체 업무시간의 57.8%를 차지하였고, 투입시간 비율은 치과실내에서의 치과진료업무가 41.6%로 가장 많았다. 구강보건업무 중 가장 중요하게 다루어야 할 업무로는 구강보건실 내에서의 구강보건업무 학교구강보건사업, 수직적 구강보건사업 순이었다. 보건기관에서의 구강보건 업무를 수행하는데 문제점으로는 공중보건치과의사의 부족으로 치과위생사 고유 업무에 종사 하지 못함, 구강보건사업에 대한 관심부족, 예산 및 인력부족 순이었다. 개선방안으로는 보건복지부와 도에 치과위생사 배치, 인력 및 예산확보 등이었다. 이상의 결과, 보건기관 근무 치과위생사의 효율적인 활용방안이 강구되어야 하겠는데, 타업무에 종사하고 있는 치과위생사의 재배치를 통해 구강보건업무에 종사하도록 하여야 하겠고, 치과위생사의 업무를 치과진료실 내에서의 진료보조 업무에서 구강보건교육과 예방진료 등으로 전환하는 것이 필요하겠으며, 공중보건 치과의사 미배치지역에 대해서는 지역설정에 맞게 치과 진료실을 구강보건실로 전환하여 구강보건사업에 활용하도록 하여야 하겠다. 또한 치과위생사익 전문성 제고를 위하여 직무교육, 연구사업, 특수사업 등의 참여 기회를 확대 부여하도록 하여야 하겠고, 치과위생사에 대한 6급 승진 기회 부여와 시 도에 구강보건 담당부서 설치 및 치과위생사 배치도 고려되어야 할 것이다.

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농촌지역 일차건강관리 기관의 고혈압환자 관리실태 -전남지역을 중심으로- (The control of the hypertension in rural primary health care settings in Korea)

  • 정영해;강혜영;정미영
    • 지역사회간호학회지
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    • 제5권2호
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    • pp.162-180
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    • 1994
  • The control of the chronic degenerative diseases becomes a challenge in Korea as the aging of the population progresses. Accordingly, the importance of the control of the hypertension, one of the major chronic degenerative diseases, in the primary health care settings increases. However, such control activities are still minimal. This study gives brief description of how the rural residents who are currently registered for the control of the hypertension feel about the activities of the health centers, subcenters and the CHP posts, in relation to the control of the hypertension. We also describe the knowledge and practice of the registered hypertensive. In general, the knowledge, the acceptance and the satisfaction of the respondents about the hypertension control activities were not very high. Respondents being managed by the health center showed the highest knowledge, acceptance and satisfaction, and those being managed by the subcenters ranked lowest. The knowledge about the hypertension was not satisfactory. There were great variations among the items in terms of the proportion answered correctly. As many as 60% of the respondents take medication regularly but only 4.5% were practicing weight control regularly. Despite some limitations of the study, the results can be very useful for those planning hypertension control programs. The educational materials and the dietary protocols need to be developed in accordance with the regional social and food pattern, so that they can be utilized with minimal modification for each beneficiary. We also suggest to minimize the area a health personnel covers. In other word, running several small health posts at village level would be more effective than running a subcenter at the township level, in terms of the hypertension control.

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노인건강문제와 간호의 방향 (Geriatric Health Problems and Directions for Nursing Improvements)

  • 김희자
    • 지역사회간호학회지
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    • 제9권1호
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    • pp.89-103
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    • 1998
  • The elderly population will increase from 5.8% in 1996 to 12.5% in 2020. The related problems of health will also become a very important issue in the future. Therefore it is important to address the problems of geriatric nursing and geriatric health. 87.6% of the aged were ill with chronic degenerative diseases in 1994. In 1995, hospital admission rates (86.8) for those aged 60 or older were higher than that (56.3) of the total age group. Such high medical utilization will increase national health costs. For the development of geriatric nursing, active nursing intervention in various settings combined with education and research should be developed. Considering the health and welfare of the aged and the present status and views in Korea, I suggest the following: First, the health needs of the elderly in the institution, must be met by a plan that fosters geriatric nurses and programmed service development. Second, health service for the residential elderly must be provided in day care centers, short stays, nursing homes and geriatric hospitals. Geriatric nursing services should be provided in home residential areas, public health centers, public health subcenters as well as having, community health practitioners in primary health care posts and home health nurses. Third, geriatric nursing curriculum must be developed adjust to situations and culture of Korea and be included in the nursing curriculum. And gerontological nurse practitioner or geriatric specialist must be fosteraged to provide the professional care for the aged. Geriatric nursing research should be also achived for geriatric nursing improvements.

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일차보건의료조직에서의 방문간호사업 실태조사연구 (A Study on Visiting Nursing Service in Primary Health Care Units)

  • 임영옥;소애영
    • 지역사회간호학회지
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    • 제10권2호
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    • pp.480-493
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    • 1999
  • The visiting nursing service is an essential part of public health. The purpose of this study was to analyze the visiting nursing service in primary health service centers. The data were collected from visiting nurse records in Wonju City Health Center, Myun Health Center and Community Health Subcenters. The period of data collection was from April 6 to July 15, 1998. The major findings were as follows: 1. Characteristics of 36 service providers. 1) Age : Over 40 years old - 66.7% 2) Educational level: The proportion of registered nurses was 47.2% and nurse aids 52.8% 3) Career: The proportion of providers who worked over 11 years in Public Health Service was 7.8% 2. Characteristics of Subjects 1) The major health problems were cerebro vascular attack, hypertension, D. M., arthritis, gastrointestinal problems and psychiatric problems. The prevalence of chronic health problems increased with age, except for mental illness. 2) The prevalence of cancer was 4.3/1000. 3. Contents of Home Visiting Nursing Services. 1) The major service was education and counseling. 2) The other services were Direct Care(ROM exercise, wound care, physical therapy, basic nursing care etc,) as 56.5%, of the work involved Indirect Care(teaching, counseling, emotional support, etc,) 30.3%, medication - 11.7%, and referral to hospitals - 1.5%.

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보건(지)소 치과위생사의 구강보건직무교육실태에 관한 단면적 조사연구 (A Cross-Sectional Study on Job Training Course of the Dental Hygienists at the Public Health (sub)Centers)

  • 김승희;김순복
    • 치위생과학회지
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    • 제9권1호
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    • pp.83-89
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    • 2009
  • 본 연구는 구강보건관련 직무교육에 대한 실태를 파악하고 효율적인 직무교육프로그램 개발에 도움이 될 수 있는 기초자료를 제공하고자 2004년 4월부터 5월까지 전국 보건(지)소에 근무하는 1,255명의 치과위생사 중 층화무작위추출법에 의해 추출된 380명의 대상자들에게 2003년도 구강보건사업관련 직무교육실태 및 교육과정내용의 필요에 대한 인식도를 분석하기 위하여 대상자들에게 설문을 실시하여 다음과 같은 결론을 도출하였다. 1. 보건(지)소의 치과위생사 집단의 일반적 특성에서 보건지소 근무치과위생사가 61.1%이었고, 보건소 근무 치과위생사가 35.3%이었으며, 연령은 36~40세가 62%로 높은 비중을 차지하였고 경력은 11~15년이 48.4%, 16년 이상이 35.7%, 10년 이하가 15.9%순으로 나타났다. 또한 가장 높은 직급은 의료기사 7급이 85.5%로 나타났다. 2. 2003년 구강보건관련 직무교육 수료자율은 28.9%, 미수료자율은 71.1%이었고 '직무교육이 업무수행에 도움이 되었다'가 65.6%, '보통이다'가 34.4%, '도움이 되지 않았다'가 0%로 업무수행에 도움이 되는 의견이 높았다. 또한 교육받지 않은 이유로는 '행정상 시간상 이유로 신청하지 않았다'가 44.6%, '신청을 하여도 선정이 안 되었다'가 29.3%순이었으며, 치과위생사업무가 아닌 타업무에 종사하여서 교육을 받지 않은 경우도 13.4%로 나타났다. 3. 직무교육의 교육과정내용별 필요에 대한 인식도는 초등학교 예방진료가 4.42, 구강보건교육이 4.41, 유아구강보건사업과 노인구강보건사업이 4.04, 장애인구강보건사업이 3.92, 구강보건기획 평가가 3.85, 구강보건진단이 3.69순으로 나타났다. 그러나 근무기간에 따른 인식도의 차이는 통계적으로 유의하지 않았으며(p > 0.05), 근무지에 따른 인식도의 차이는 구강보건 기획 평가와 구강보건진단에서 보건소와 보건지소 근무치과위생사간에 유의성이 나타났다(p < 0.001). 4. 직무교육의 적당한 시기로는 전반기가 39.8%, 연중 무관하다가 34.4%, 중반기가 12.2% 로 나타났고, 전문치위생사 양성과정이 필요하다는 의견도 79.2%로 나타났다.

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1차보건의료와 바람직한 정책방향 (Primary Health Care and Desirable Policy Directions in Korea)

  • 박형종;김공현
    • 보건행정학회지
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    • 제1권1호
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    • pp.95-108
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    • 1991
  • The World Health Organization and its member states, in 1978, declared that primary health care is a key to attain the goal of Health for All by the goal of Health for All by the yeas 2000. As a member state of WHO, the Republic of Korea has participated in the declaration of ALMA-ATA and committed to put national efforts for devedoping and implementing primary health care approach with the spirit and content of this Declaration. Since 1978, to translate the spirit of the Declaration into realization, Korean goverment has developed a new category of health manpower such as Community Health Practitioners serving people living in remote rural areas and Village Health Workers serving voluntarily their own village, strengthened the function of Health Centers and Health Subcenters through their reorientation and improved the infrastructure by their new construction or renovation. While primary health care is viewed as an essential health care in Korea, there are some circles who follow a narrow definition in referring to the health care at the periphey of a health system, which is erroneous. Considering the PHC is accepted as the best alternative approach to health care to solve problems that modern health systems are facing, we propose the followings as desirable health policy directions that modern health systems are facing, we propose the followings as desirable health policy directions which might translate the persopective into action at the national level after reviewing past and current PHC approach in Korea : 1. To improve the equity through the reduction of gaps between those who have access to health care and those who have not. 2. To reinforce multisectoral approach and intersectoral coordination through the re- establishment of the National Health Council or establishment of equivalent organization at the central level. 3. To stengthen community participation through lacal people's empowerment by leadership training, changing planning process from the top-down approach to bottom-up and giving the priority to human resources rater than technology, 4. To reinforce the Ministries of Health and Social Affairs through upgrading its role and function to Coordinate Ministries which involve human welfare policies, and creating a Division which is in charge of PHC in the Ministry.

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공중보건의의 고혈압 진단 및 치료과정 평가 (Quality Evaluation for the Diagnosis and Management of Hypertensives by Pubilc Health Doctors)

  • 송윤미;김윤;조홍준;정희숙;김용익
    • 한국의료질향상학회지
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    • 제3권1호
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    • pp.126-143
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    • 1996
  • Background : Little work has been carried out regarding quality assessment research in a primary care setting, comparing with that of hospitals. This study aims to evaluate the process of diagnosis and management of hypertension by public health doctors on the basis of pre-established clinical guideline, and to identify several modifying factors associated with them. Methods : Hypertension was selected as the target disease, because it is a chronic disease which is of great public health importance. Self-administered questionnaires were mailed to public health doctors practicing at health centers and health subcenters across the nation. The response rate was 20.9%. The questionnaire included the diagnosis and management process such as measuring blood pressure, history taking, physical examinations, and treatment approches and potentially modifying factors such as level of training, duration of practice as a public health doctor, and education on management of hypertension. Results : Public health doctors pay little attention in measuring BP, hypertension related history taking, performing physical examination and laboratory examination. But they devoted much effort in diagnosing hypertension exactly and giving nonpharmacological treatment. Among various antihypertensive drugs, calcium-channel blockers were the most preferred agent(50.9%). Level of training, duration of practice ad a public health doctor, and education on management of hypertension made no difference on quality of care(p>0.05). Conclusion : These public health doctors showed poor compliance with the pre-established clinical guidelines, which leaves much to be desired in diagnosing and managing hypertensive patients by public health doctors. This study might be able to contribute to develop some strategies, such as educational programs, which would be able to improve the process of care in hypertensives.

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보건소(保健所) 행정(行政)의 기선을 위(爲)한 연구(硏究) (A Study on the Administrative Enhancement for Health Center Activities)

  • 문옥륜
    • Journal of Preventive Medicine and Public Health
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    • 제3권1호
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    • pp.97-110
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    • 1970
  • This survey was conducted to evaluate not only the present status of health center directors-their personal histories, their will to private practice in the future, their responses to governmental policies, -but also the distribution of doctorless myons, budget and subsidy, and director's opinions to the enhancement of health center activities. This survey questioned 116 health center directors and 16 health personnel from August to October of 1970 and obtained the following results; 1) The average ages of directors of kun, city, and total health centers were $43.2{\pm}7.8,\;42.1{\pm}7.7,\;and\;42.9{\pm}10.3$ respectively. 2) The average family sizes of directors of kun, city, and total health centers were $5.6{\pm}2.7,\;5.6{\pm}2.1,\;and\;5.6{\pm}2.6$ respectively. 3) Directors holding M. D. degrees were 79.3%, those holding qualified M. D. degrees ('approved director') were 20.7%. 4) M. P. H., M. S., and Ph. D. holders were 6.0%, 6.1%, and 4.3% respectively. 5) The average duration of present directorship in kun and city were 30.2 months and 20.4 months respectively. 6) The majority of directors had been employed in related fields before assuming current position : directorship at other health center 26.7%, army 22.4%, health subcenter 21.6%, private practice 19.0%. 7) Average length of directorship is 41.8 months. Average length of public health career, including health subcenter and present position, is 56.5 months. 8) Both rural and urban experience in health centers for regular directors is 16.3% and for approved directors, 12,5%. A total of 15.5% of all survey directors had experience in both rural and urban health center. 9) A total of 70.7% of health center directorships were staffed by local doctors. 10) Nearly 40% wanted to quit the directorships within 3 years and 60.3% had already experienced private practice. 11) Of the regular directors 17.4% felt strongly about devoting their lives to public health fields, but only 4.1% of the approved approved directors felt so. 12) There wire 432 doctorless myons among 996 respondent myons and 4.5 doctorless myons per kun. 13) The percentage of doctorless myon by Province are as follows, Cholla buk-do 57.2%, Cholla nam-de 55.0%, Kyungsang nam-do 52.0%, Kyungsang buk-do 49.7%, Chungchong but-do 42.4%, Kyonggi-do 32.9%. Cheju-do 30.8%, Kangwon-do 25.8%. 14) Two thirds of health critters have experienced the abscence of the director for a certain period since 1966 and the average span of the abscence was 18.2 months. 15) The percentage of doctorless myons increased proportionally with the span of the director's abscence. 16) The average budgets of health centers, kun, city and ku, were $W15.03\;million{\pm}W4.5\;million,\;W22.03\;million{\pm}W17.80\;million,\;W13.10\;million{\pm}W7.9\;million$ respectively. 17) Chunju city had the highest health budget per capita(W344) while Pusan Seo ku had the lowest(W19). 18) Director's medical subsidies are W30,000-50,000 in kun, and roughly W20,000 in city. 19) The older of priority in health center activities is T.B. control(31.1%), Family Planning and M. C. H.(28.0%), prevention of acute communicable disease and endemic disease (18.2%) and clinical care of patients(14.3%). 20) Nearly 32% opposed in principle the governmental policy of prohibiting medical doctors from going abroad. 21) Suggestions for immediate enhancing the position of director of health centers and subcenters: (1) Raise the base subsidy (48.2%), (2) Provide more opportunities for promotion (20.7%), (3) Exemption from army services(12.1%), (4) Full scholarship to medical students for this purpose only (7.8%). 22) A newly established medical school was opposed by 56.9% of the directors, however 33.6% of them approved. 23) Pertaining to the division of labor in Medicine and Pharmacy, the largest portion (31.9%) urged the immediate partial division of antibiotics and some addictive drugs to be given only by prescription. 24) More than half wanted a W70,000 level for the director's medical subsidies, white 36.2% stated W50,000. 25) Urgently needed skills in the kun are clinical pathologist (38.6%) and doctor (health center director) (25.5%); while in the city nurse (37.1%), doctors(clinical)(31.4%) and health educators(14.4%) are needed. 26) Essential treatment for the better health center administration; raising the base subsidy (22.7%), obtaining the power of personal management (19.3%) and the establishment of a Board of Health (14.3%). etc.

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일부 농촌지역 노인들의 만성질환 유병상태와 의료이용 양상 (Health Status and Medical Care Utilization Patterns of Rural Aged)

  • 오장균
    • Journal of Preventive Medicine and Public Health
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    • 제24권3호
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    • pp.328-338
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    • 1991
  • To find out the state of illness, patterns of medical care utilization, and factors which determine medical care utilization for aged we surveyed 679 rural old persons who live in the Chungnam province from Jan. 10 1991 to Jan. 19. The major findings of this study were as follows : 1. The morbidity rate of chronic illness during last 3 months was 56.4% for all surveyed old persons ; 58.7% for female and 52.8% for male. 2. As expected, 80 years old or above group showed the highest morbidity rate, 60.2% and the 65-69 years age group was the lowest, 50.5%. 3. Old persons who are householder, whose family income is less than 290,000 won per month, and who receive benifits from the public medical assistance program had relative higher morbidity rate than other groups and the difference was statistically significant (p<0.05). 4. The most frequent chronic illness was musculoskeletal disease, 49.6% ; the disease from which the aged had suffered for the longest period was gastrointestinal, 11.6yrs : the cerebrovascular was the disease which inflicts the lowest level of physical ability. 5. 67.1% of 383 persons who were suffering from chronic illness were in need of medical care but unmet ; among the remaining 32.9% who utilized medical care, 19.2% utilized it in local clinics or hospital OPD and 15% in th health centers or subcenters. 6. Old person who are married, whose sons are householder and whose family income is 500,000 won or above per month showed relative higher utilization rate than other groups and the difference was statistically significant (p<0.05). 7. The most common reason why the aged did not utilize, in spite of, need medical care was economic problem, 35.4%. For the aged whose family income per month is 500,000 won or above, however the most common reason was tolerable symptom, 46.9% while persons who answered economic problem were 6.1% of them, the lowest frequency.

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