충북지역 학교급식 영양(교)사의 식단관리 운영실태 및 개선방안(1) - 식단계획 - (Current and Future Operation of Menu Management in the School Foodservices of Chungbuk (1) - Menu Planning -)
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- 한국식품영양과학회지
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- 제41권8호
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- pp.1118-1133
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- 2012
본 연구는 충청북도 지역 학교 영양(교)사를 대상으로 학교급식 식단관리 운영실태 및 인식을 조사함으로써 학교급식의 효율적인 개선방안을 제시하고자 하였으며 조사기간은 2010년 9월 1일부터 9월 15일까지로, 배포된 설문지는 328부이며 이 중 265부(80.8%)가 분석에 이용되었다. 연구 결과의 요약은 다음과 같다. 첫째, 조사대상의 일반사항으로 학교유형은 초등학교 55.8%, 중학교 22.3%, 고등학교 21.9%로, 급식유형은 도시형이 54.0%, 농촌형이 46.0%로 나타났다. 학교에서 1일 제공하는 끼니 수에 대해 1식이 80.8%, 2식이 5.3%, 3식이 13.9%로 중식 한 끼를 제공하는 학교가 가장 많았으며, 식단형태는 98.8%가 단일식단을, 0.4%가 선택식단, 0.8%가 단일식단과 선택식단을 같이 사용하였다. 둘째, 학교급식 식단 작성 시 고려요인의 중요도 및 어려운 정도에 대한 조사결과로 중요도 점수가 식품비예산(평균 4.53점)으로 가장 높았으며, 식중독위해요소(4.42점), 영양기준량(4,42점), 피 급식자의 기호도 및 선호도(4.18점), 조리시간(3.90점), 급식시설 및 기기수준(3.88점), 식재료의 원산지(3.79점), 음식의 색과 모양(3.77점) 순이었으며, 모든 고려요인의 중요도 점수가 3점(보통이다) 이상이었다. 어려운 점은 '식품비예산'(평균 4.27점)에 대한 사항이 가장 높게 나타났으며, '피 급식자의 기호도 및 선호도'(4.06점), '식중독위해요소'(3.98점), '급식시설 및 기기수준'(3.90점), '조리시간'(3.82점), '조리종사원 수'(3.68점), '조리종사원의 숙련도'(3.67점), '적온배식'(3.51점) 순으로 나타났으며, 모든 고려요인의 어려운 정도 점수가 3점(보통이다) 이상이었다. 셋째, 식단 작성 시 영양관리에 관한 조사결과 식단 작성 시 고려주기에 대해 주별이 63.8%로 가장 높았고, 끼니별 31.3%, 월별 3.8%, 계절별 1.1% 순이었다. 식단 작성 시 가장 먼저 고려하는 영양소로 1순위는 에너지가 90.1%로 가장 높은 응답률을 나타냈다. 식단 작성 시 가장 초과되는 영양소는 단백질이 41.9%로 가장 높았고 에너지 36.2%, 칼슘 9.8%, 비타민류 7.9%, 철분 4.2% 순이었다. 반면, 식단 작성 시 가장 부족한 영양소는 칼슘이 37.7%로 가장 높게 응답률을 나타냈고, 철분 33.6%, 비타민류 17.0%, 에너지 10.2%, 단백질 1.5% 순이었다. 에너지 구성 권장비 중 가장 초과되는 영양소는 단백질이 47.2%로 가장 높았고, 탄수화물 29.4%, 지방 23.4% 순이었다. 넷째, 학교급식법령에 제시된 식단 작성 시 고려해야 할 사항 및 영양관리기준에 대한 인지도, 중요도 및 수행도 점수를 조사결과 학교급식법령에 제시된 식단 작성 시 고려하여할 사항은 '전통식문화의 계승발전을 고려', '곡류 및 전분류, 채소류 및 과일류, 어육류 및 콩류, 우유 및 유제품 등 다양한 종류의 식품을 사용', '염분, 유지류, 단순당류 또는 식품첨가물 등을 과다하게 사용하지 않음', '가급적 자연식품과 계절식품을 사용', '다양한 조리방법을 활용' 모두 5개 항목으로 인지도 점수결과 '전통식문화의 계승발전을 고려'(평균 3.78점) 이외의 항목은 4점(준수한다) 이상이었으며, '곡류 및 전분류, 채소류 및 과일류, 어육류 및 콩류, 우유 및 유제품 등 다양한 종류의 식품을 사용'(4.40점), '가급적 자연식품과 계절식품을 사용'(4.40점)이 높게 나타났다. 중요도 점수결과 '전통식문화의 계승발전을 고려'(3.77점) 이외의 항목은 4점(준수한다) 이상이었으며, '곡류 및 전분류, 채소류 및 과일류, 어육류 및 콩류, 우유 및 유제품 등 다양한 종류의 식품을 사용'(4.45점), '염분, 유지류, 단순 당류 또는 식품첨가물 등을 과다하게 사용하지 않음'(4.45점)이 높게 나타났다. 수행도 점수결과 '다양한 조리방법을 활용'(3.71점)과 '전통식문화의 계승발전을 고려'(3.29점) 이외의 항목은 4점(준수한다) 이상이었으며, '가급적 자연식품과 계절식품을 사용'(4.24점)이 높게 나타났다. 5개 항목 중 '전통식문화의 계승발전을 고려'가 인지도, 중요도, 수행도 모든 부분에서 다른 항목에 비해 낮은 점수를 나타냈다. 학교급식법령에 제시된 학교급식 영양관리기준 '학년별 성별 에너지공급기준
최근 독감 예측이나 당선인 예측, 구매 패턴, 투자 등 다방면에서 웹검색 트래픽 정보. 소셜 네트워크 내용 등 거대한 데이터를 통해 사회적 현상, 소비 패턴을 분석하는 시도가 이전보다 늘어났다. 구글, 네이버, 바이두 등 인터넷 포털 업체들의 웹검색 트래픽 정보 공개 서비스와 함께 웹검색 트래픽 정보를 활용하여 소비자나 사용자와 관련된 연구가 실시되기 시작했다. 웹검색 트래픽 정보를 활용한 사회 현상, 소비 패턴 분석을 연구는 많이 수행되었으나, 그에 비해서 도출된 여행 수요 모델을 토대로 의사결정을 위한 실질적 대책 수립으로 이어지는 연구는 많이 진행되지 않은 실정이다. 관광산업은 상대적으로 많은 고용을 가능하게 하고 외자를 유치하는 등 고부가가치를 창출하여 경제 전체에 선순환 효과를 일으키는 중요한 산업이다. 그 중에서도 국내 입국외래객중 수년간 2위와의 큰 차이로 1위를 차지해왔던 중국 국적의 관광객 '유커' 및 그들이 지출하는 1인당 평균 관광 수지는 한국 경제에 매우 중요한 한 부분이다. 관광 수요의 예측은 효율적인 자원 배분과 합리적인 의사 결정에 있어서 공공부문 및 민간부문 모두 중요하다. 적절한 관광 수요 예측을 통해서 한정된 자원을 더욱 효과적으로 활용하여 더욱 많은 부가가치를 창출하기 위한 것이다. 본 연구는 중국인 인바운드를 예측하는 방법에 있어, 이전보다 더 최신의 트렌드를 즉각적으로 반영하고 개인들의 집합의 관심도가 포함되어 예측 성능이 개선된 방법을 제안한다. 해외여행은 고관여 소비이기 때문에 잠재적 여행객들이 입국하기 전 웹검색을 통해 적극적으로 자신의 여정과 관련된 정보를 취득하기 위한 활동을 한다. 따라서 웹검색 트래픽 수치가 중국인 여행객의 관심정도를 대표할 수 있다고 보았다. 중국인 여행객들이 한국 여행을 준비하는 단계에서 검색할만한 키워드를 선정해 실제 중국인 입국자 수와 상관관계가 있음을 검증하고자 하였다. 중국 웹검색 엔진 시장에서 80%의 점유율을 가지는 중국 최대 웹검색 엔진 '바이두'에서 공개한 웹검색 데이터를 활용하여 그 관심 정도를 대표할 수 있을 것이라 추정했다. 수집에 필요한 키워드의 선정 단계에서는 잠재적 여행객이 여정을 계획하고 구체화하는 단계에서 일반적으로 검색하게 되는 키워드 후보군을 선정하였다. 키워드의 선정에는 중국 국적의 잠재적 여행객 표본과의 인터뷰를 거쳤다. 트래픽 대소 관계 확인 결과에 따라서 최종 선정된 키워드들을 한국여행이라는 주제와 직접적인 연관을 가지는 키워드부터, 간접적인 연관을 가지는 키워드까지 총 세 가지 레벨의 카테고리로 분류하였다. 분류된 카테고리 내의 키워드들은 바이두'가 제공하는 웹검색 트래픽 데이터 제공 서비스 '바이두 인덱스'를 통해 웹검색 트래픽 데이터를 수집했다. 공개된 데이터 페이지 특성을 고려한 웹 크롤러를 직접 설계하여 웹검색 트래픽 데이터를 수집하였고, 분리되어 수집된 변수에는 필요한 변수 변환 과정을 수행했다. 자동화 수집된 웹검색 트래픽 정보들을 투입하여 중국 여행 인바운드에 대한 유의한 영향 관계를 확인하여 중국인 여행객의 한국 인바운드 여행 수요를 예측하는 모형을 개발하고자 하였다. 정책 의사결정 및 관광 경영 의사결정 같은 실무적 활용을 고려하여 각 변수의 영향력을 정량적으로 설명할 수 있고 설득이 명료한 방법인 다중회귀분석방법을 적용해 선형 식을 도출하였다. 수집된 웹검색 트래픽 데이터를 기존 검증된 모형 독립변인들에 추가적으로 투입함으로써 전통적인 독립변인으로만 구성된 연구 모형과 비교하여 가장 뛰어난 성능을 보이는 모형을 확인하였다. 본 연구에서 검증하려는, 웹검색 트래픽으로 대표되는 독립변인을 투입한 최종 도출된 모형을 통해 중국인 관광 수요를 예측할 때 유의한 영향을 끼치는 웹검색 트래픽 변수를 확인할 수 있다. 최적 모형 설명력을 가지는 모형을 기반으로 최종 회귀 식을 만들었고 이를 '유커마이닝' 시스템 내부에 도입하였다. 데이터 분석에서 더 나아가 도출된 모형을 직관적으로 시각화하고, 웹검색 트래픽 정보를 활용하여 도출할 수 있는 인사이트를 함께 보여주는 데이터 분석 기반의 '유커마이닝' 솔루션의 시스템 알고리즘과 UX를 제안하였다. 본 연구가 제안하는 모형과 시스템은 관광수요 예측모형 분야에서 웹검색 트래픽 데이터라는 정보 탐색을 하는 과정에 놓인 개인들의 인터랙티브하고 즉각적인 변수를 활용한 새로운 시도이다. 실무적으로 관련 정책결정자나 관광사, 항공사 등이 활용 가능한 실제적인 가치를 가지고, 정책적으로도 효과적인 관광 정책 수립에 활용될 수 있다.
To survive in the global competitive environment, enterprise should be able to solve various problems and find the optimal solution effectively. The big-data is being perceived as a tool for solving enterprise problems effectively and improve competitiveness with its' various problem solving and advanced predictive capabilities. Due to its remarkable performance, the implementation of big data systems has been increased through many enterprises around the world. Currently the big-data is called the 'crude oil' of the 21st century and is expected to provide competitive superiority. The reason why the big data is in the limelight is because while the conventional IT technology has been falling behind much in its possibility level, the big data has gone beyond the technological possibility and has the advantage of being utilized to create new values such as business optimization and new business creation through analysis of big data. Since the big data has been introduced too hastily without considering the strategic value deduction and achievement obtained through the big data, however, there are difficulties in the strategic value deduction and data utilization that can be gained through big data. According to the survey result of 1,800 IT professionals from 18 countries world wide, the percentage of the corporation where the big data is being utilized well was only 28%, and many of them responded that they are having difficulties in strategic value deduction and operation through big data. The strategic value should be deducted and environment phases like corporate internal and external related regulations and systems should be considered in order to introduce big data, but these factors were not well being reflected. The cause of the failure turned out to be that the big data was introduced by way of the IT trend and surrounding environment, but it was introduced hastily in the situation where the introduction condition was not well arranged. The strategic value which can be obtained through big data should be clearly comprehended and systematic environment analysis is very important about applicability in order to introduce successful big data, but since the corporations are considering only partial achievements and technological phases that can be obtained through big data, the successful introduction is not being made. Previous study shows that most of big data researches are focused on big data concept, cases, and practical suggestions without empirical study. The purpose of this study is provide the theoretically and practically useful implementation framework and strategies of big data systems with conducting comprehensive literature review, finding influencing factors for successful big data systems implementation, and analysing empirical models. To do this, the elements which can affect the introduction intention of big data were deducted by reviewing the information system's successful factors, strategic value perception factors, considering factors for the information system introduction environment and big data related literature in order to comprehend the effect factors when the corporations introduce big data and structured questionnaire was developed. After that, the questionnaire and the statistical analysis were performed with the people in charge of the big data inside the corporations as objects. According to the statistical analysis, it was shown that the strategic value perception factor and the inside-industry environmental factors affected positively the introduction intention of big data. The theoretical, practical and political implications deducted from the study result is as follows. The frist theoretical implication is that this study has proposed theoretically effect factors which affect the introduction intention of big data by reviewing the strategic value perception and environmental factors and big data related precedent studies and proposed the variables and measurement items which were analyzed empirically and verified. This study has meaning in that it has measured the influence of each variable on the introduction intention by verifying the relationship between the independent variables and the dependent variables through structural equation model. Second, this study has defined the independent variable(strategic value perception, environment), dependent variable(introduction intention) and regulatory variable(type of business and corporate size) about big data introduction intention and has arranged theoretical base in studying big data related field empirically afterwards by developing measurement items which has obtained credibility and validity. Third, by verifying the strategic value perception factors and the significance about environmental factors proposed in the conventional precedent studies, this study will be able to give aid to the afterwards empirical study about effect factors on big data introduction. The operational implications are as follows. First, this study has arranged the empirical study base about big data field by investigating the cause and effect relationship about the influence of the strategic value perception factor and environmental factor on the introduction intention and proposing the measurement items which has obtained the justice, credibility and validity etc. Second, this study has proposed the study result that the strategic value perception factor affects positively the big data introduction intention and it has meaning in that the importance of the strategic value perception has been presented. Third, the study has proposed that the corporation which introduces big data should consider the big data introduction through precise analysis about industry's internal environment. Fourth, this study has proposed the point that the size and type of business of the corresponding corporation should be considered in introducing the big data by presenting the difference of the effect factors of big data introduction depending on the size and type of business of the corporation. The political implications are as follows. First, variety of utilization of big data is needed. The strategic value that big data has can be accessed in various ways in the product, service field, productivity field, decision making field etc and can be utilized in all the business fields based on that, but the parts that main domestic corporations are considering are limited to some parts of the products and service fields. Accordingly, in introducing big data, reviewing the phase about utilization in detail and design the big data system in a form which can maximize the utilization rate will be necessary. Second, the study is proposing the burden of the cost of the system introduction, difficulty in utilization in the system and lack of credibility in the supply corporations etc in the big data introduction phase by corporations. Since the world IT corporations are predominating the big data market, the big data introduction of domestic corporations can not but to be dependent on the foreign corporations. When considering that fact, that our country does not have global IT corporations even though it is world powerful IT country, the big data can be thought to be the chance to rear world level corporations. Accordingly, the government shall need to rear star corporations through active political support. Third, the corporations' internal and external professional manpower for the big data introduction and operation lacks. Big data is a system where how valuable data can be deducted utilizing data is more important than the system construction itself. For this, talent who are equipped with academic knowledge and experience in various fields like IT, statistics, strategy and management etc and manpower training should be implemented through systematic education for these talents. This study has arranged theoretical base for empirical studies about big data related fields by comprehending the main variables which affect the big data introduction intention and verifying them and is expected to be able to propose useful guidelines for the corporations and policy developers who are considering big data implementationby analyzing empirically that theoretical base.
Much has teed changed in the field of hospital administration in the It wake of the rapid development of sciences, techniques ana systematic hospital management. However, we still have a long way to go in organization, in the quality of hospital employees and hospital equipment and facilities, and in financial support in order to achieve proper hospital management. The above factors greatly effect the ability of hospitals to fulfill their obligation in patient care and nursing services. The purpose of this study is to determine the optimal methods of standardization and quality nursing so as to improve present nursing services through investigations and analyses of various problems concerning nursing administration. This study has been undertaken during the six month period from October 1971 to March 1972. The 41 comprehensive hospitals have been selected iron amongst the 139 in the whole country. These have been categorized according-to the specific purposes of their establishment, such as 7 university hospitals, 18 national or public hospitals, 12 religious hospitals and 4 enterprise ones. The following conclusions have been acquired thus far from information obtained through interviews with nursing directors who are in charge of the nursing administration in each hospital, and further investigations concerning the purposes of establishment, the organization, personnel arrangements, working conditions, practices of service, and budgets of the nursing service department. 1. The nursing administration along with its activities in this country has been uncritical1y adopted from that of the developed countries. It is necessary for us to re-establish a new medical and nursing system which is adequate for our social environments through continuous study and research. 2. The survey shows that the 7 university hospitals were chiefly concerned with education, medical care and research; the 18 national or public hospitals with medical care, public health and charity work; the 2 religious hospitals with medical care, charity and missionary works; and the 4 enterprise hospitals with public health, medical care and charity works. In general, the main purposes of the hospitals were those of charity organizations in the pursuit of medical care, education and public benefits. 3. The survey shows that in general hospital facilities rate 64 per cent and medical care 60 per-cent against a 100 per cent optimum basis in accordance with the medical treatment law and approved criteria for training hospitals. In these respects, university hospitals have achieved the highest standards, followed by religious ones, enterprise ones, and national or public ones in that order. 4. The ages of nursing directors range from 30 to 50. The level of education achieved by most of the directors is that of graduation from a nursing technical high school and a three year nursing junior college; a very few have graduated from college or have taken graduate courses. 5. As for the career tenure of nurses in the hospitals: one-third of the nurses, or 38 per cent, have worked less than one year; those in the category of one year to two represent 24 pet cent. This means that a total of 62 per cent of the career nurses have been practicing their profession for less than two years. Career nurses with over 5 years experience number only 16 per cent: therefore the efficiency of nursing services has been rated very low. 6. As for the standard of education of the nurses: 62 per cent of them have taken a three year course of nursing in junior colleges, and 22 per cent in nursing technical high schools. College graduate nurses come up to only 15 per cent; and those with graduate course only 0.4 per cent. This indicates that most of the nurses are front nursing technical high schools and three year nursing junior colleges. Accordingly, it is advisable that nursing services be divided according to their functions, such as professional, technical nurses and nurse's aides. 7. The survey also shows that the purpose of nursing service administration in the hospitals has been regulated in writing in 74 per cent of the hospitals and not regulated in writing in 26 per cent of the hospitals. The general purposes of nursing are as follows: patient care, assistance in medical care and education. The main purpose of these nursing services is to establish proper operational and personnel management which focus on in-service education. 8. The nursing service departments belong to the medical departments in almost 60 per cent of the hospitals. Even though the nursing service department is formally separated, about 24 per cent of the hospitals regard it as a functional unit in the medical department. Only 5 per cent of the hospitals keep the department as a separate one. To the contrary, approximately 12 per cent of the hospitals have not established a nursing service department at all but surbodinate it to the other department. In this respect, it is required that a new hospital organization be made to acknowledge the independent function of the nursing department. In 76 per cent of the hospitals they have advisory committees under the nursing department, such as a dormitory self·regulating committee, an in-service education committee and a nursing procedure and policy committee. 9. Personnel arrangement and working conditions of nurses 1) The ratio of nurses to patients is as follows: In university hospitals, 1 to 2.9 for hospitalized patients and 1 to 4.0 for out-patients; in religious hospitals, 1 to 2.3 for hospitalized patients and 1 to 5.4 for out-patients. Grouped together this indicates that one nurse covers 2.2 hospitalized patients and 4.3 out-patients on a daily basis. The current medical treatment law stipulates that one nurse should care for 2.5 hospitalized patients or 30.0 out-patients. Therefore the statistics indicate that nursing services are being peformed with an insufficient number of nurses to cover out-patients. The current law concerns the minimum number of nurses and disregards the required number of nurses for operation rooms, recovery rooms, delivery rooms, new-born baby rooms, central supply rooms and emergency rooms. Accordingly, tile medical treatment law has been requested to be amended. 2) The ratio of doctors to nurses: In university hospitals, the ratio is 1 to 1.1; in national of public hospitals, 1 to 0.8; in religious hospitals 1 to 0.5; and in private hospitals 1 to 0.7. The average ratio is 1 to 0.8; generally the ideal ratio is 3 to 1. Since the number of doctors working in hospitals has been recently increasing, the nursing services have consequently teen overloaded, sacrificing the services to the patients. 3) The ratio of nurses to clerical staff is 1 to 0.4. However, the ideal ratio is 5 to 1, that is, 1 to 0.2. This means that clerical personnel far outnumber the nursing staff. 4) The ratio of nurses to nurse's-aides; The average 2.5 to 1 indicates that most of the nursing service are delegated to nurse's-aides owing to the shortage of registered nurses. This is the main cause of the deterioration in the quality of nursing services. It is a real problem in the guest for better nursing services that certain hospitals employ a disproportionate number of nurse's-aides in order to meet financial requirements. 5) As for the working conditions, most of hospitals employ a three-shift day with 8 hours of duty each. However, certain hospitals still use two shifts a day. 6) As for the working environment, most of the hospitals lack welfare and hygienic facilities. 7) The salary basis is the highest in the private university hospitals, with enterprise hospitals next and religious hospitals and national or public ones lowest. 8) Method of employment is made through paper screening, and further that the appointment of nurses is conditional upon the favorable opinion of the nursing directors. 9) The unemployment ratio for one year in 1971 averaged 29 per cent. The reasons for unemployment indicate that the highest is because of marriage up to 40 per cent, and next is because of overseas employment. This high unemployment ratio further causes the deterioration of efficiency in nursing services and supplementary activities. The hospital authorities concerned should take this matter into a jeep consideration in order to reduce unemployment. 10) The importance of in-service education is well recognized and established. 1% has been noted that on the-job nurses. training has been most active, with nursing directors taking charge of the orientation programs of newly employed nurses. However, it is most necessary that a comprehensive study be made of instructors, contents and methods of education with a separate section for in-service education. 10. Nursing services'activities 1) Division of services and job descriptions are urgently required. 81 per rent of the hospitals keep written regulations of services in accordance with nursing service manuals. 19 per cent of the hospitals do not keep written regulations. Most of hospitals delegate to the nursing directors or certain supervisors the power of stipulating service regulations. In 21 per cent of the total hospitals they have policy committees, standardization committees and advisory committees to proceed with the stipulation of regulations. 2) Approximately 81 per cent of the hospitals have service channels in which directors, supervisors, head nurses and staff nurses perform their appropriate services according to the service plans and make up the service reports. In approximately 19 per cent of the hospitals the staff perform their nursing services without utilizing the above channels. 3) In the performance of nursing services, a ward manual is considered the most important one to be utilized in about 32 percent of hospitals. 25 per cent of hospitals indicate they use a kardex; 17 per cent use ward-rounding, and others take advantage of work sheets or coordination with other departments through conferences. 4) In about 78 per cent of hospitals they have records which indicate the status of personnel, and in 22 per cent they have not. 5) It has been advised that morale among nurses may be increased, ensuring more efficient services, by their being able to exchange opinions and views with each other. 6) The satisfactory performance of nursing services rely on the following factors to the degree indicated: approximately 32 per cent to the systematic nursing activities and services; 27 per cent to the head nurses ability for nursing diagnosis; 22 per cent to an effective supervisory system; 16 per cent to the hospital facilities and proper supply, and 3 per cent to effective in·service education. This means that nurses, supervisors, head nurses and directors play the most important roles in the performance of nursing services. 11. About 87 per cent of the hospitals do not have separate budgets for their nursing departments, and only 13 per cent of the hospitals have separate budgets. It is recommended that the planning and execution of the nursing administration be delegated to the pertinent administrators in order to bring about improved proved performances and activities in nursing services.
Today most developed countries provide modern medical care for most of the population. The rural area is the more neglected area in the medical and health field. In public health, the philosophy is that medical care for in maintenance of health is a basic right of man; it should not be discriminated against racial, environmental or financial situations. The deficiency of the medical care system, cultural bias, economic development, and ignorance of the residents about health care brought about the shortage of medical personnel and facilities on the rural areas. Moreover, medical students and physicians have been taught less about rural health care than about urban health care. Medical care, therefore, is insufficient in terms of health care personnel/and facilities in rural areas. Under such a situation, there is growing concern about the health problems among the rural population. The findings presented in this report are useful measures of the major health problems and even more important, as a guide to planning for improved medical care systems. It is hoped that findings from this study will be useful to those responsible for improving the delivery of health service for the rural population. Objectives: -to determine the health status of the residents in the rural areas. -to assess the rural population's needs in terms of health and medical care. -to make recommendations concerning improvement in the delivery of health and medical care for the rural population. Procedures: For the sampling design, the ideal would be to sample according to the proportion of the composition age-groups. As the health problems would be different by group, the sample was divided into 10 different age-groups. If the sample were allocated by proportion of composition of each age group, some age groups would be too small to estimate the health problem. The sample size of each age-group population was 100 people/age-groups. Personal interviews were conducted by specially trained medical students. The interviews dealt at length with current health status, medical care problems, utilization of medical services, medical cost paid for medical care and attitudes toward health. In addition, more information was gained from the public health field, including environmental sanitation, maternal and child health, family planning, tuberculosis control, and dental health. The sample Sample size was one fourth of total population: 1,438 The aged 10-14 years showed the largest number of 254 and the aged under one year was the smallest number of 81. Participation in examination Examination sessions usually were held in the morning every Tuesday, Wenesday, and Thursday for 3 hours at each session at the Namchun Health station. In general, the rate of participation in medical examination was low especially in ages between 10-19 years old. The highest rate of participation among are groups was the under one year age-group by 100 percent. The lowest use rate as low as 3% of those in the age-groups 10-19 years who are attending junior and senior high school in Taegu city so the time was not convenient for them to recieve examinations. Among the over 20 years old group, the rate of participation of female was higher than that of males. The results are as follows: A. Publie health problems Population: The number of pre-school age group who required child health was 724, among them infants numbered 96. Number of eligible women aged 15-44 years was 1,279, and women with husband who need maternal health numbered 700. The age-group of 65 years or older was 201 needed more health care and 65 of them had disabilities. (Table 2). Environmental sanitation: Seventy-nine percent of the residents relied upon well water as a primary source of dringking water. Ninety-three percent of the drinking water supply was rated as unfited quality for drinking. More than 90% of latrines were unhygienic, in structure design and sanitation (Table 15). Maternal and child health: Maternal health Average number of pregnancies of eligible women was 4 times. There was almost no pre- and post-natal care. Pregnancy wastage Still births was 33 per 1,000 live births. Spontaneous abortion was 156 per 1,000 live births. Induced abortion was 137 per 1,000 live births. Delivery condition More than 90 percent of deliveries were conducted at home. Attendants at last delivery were laymen by 76% and delivery without attendants was 14%. The rate of non-sterilized scissors as an instrument used to cut the umbilical cord was as high as 54% and of sickles was 14%. The rate of difficult delivery counted for 3%. Maternal death rate estimates about 35 per 10,000 live births. Child health Consultation rate for child health was almost non existant. In general, vaccination rate of children was low; vaccination rates for children aged 0-5 years with BCG and small pox were 34 and 28 percent respectively. The rate of vaccination with DPT and Polio were 23 and 25% respectively but the rate of the complete three injections were as low as 5 and 3% respectively. The number of dead children was 280 per 1,000 living children. Infants death rate was 45 per 1,000 live births (Table 16), Family planning: Approval rate of married women for family planning was as high as 86%. The rate of experiences of contraception in the past was 51%. The current rate of contraception was 37%. Willingness to use contraception in the future was as high as 86% (Table 17). Tuberculosis control: Number of registration patients at the health center currently was 25. The number indicates one eighth of estimate number of tuberculosis in the area. Number of discharged cases in the past accounted for 79 which showed 50% of active cases when discharged time. Rate of complete treatment among reasons of discharge in the past as low as 28%. There needs to be a follow up observation of the discharged cases (Table 18). Dental problems: More than 50% of the total population have at least one or more dental problems. (Table 19) B. Medical care problems Incidence rate: 1. In one month Incidence rate of medical care problems during one month was 19.6 percent. Among these health problems which required rest at home were 11.8 percent. The estimated number of patients in the total population is 1,206. The health problems reported most frequently in interviews during one month are: GI trouble, respiratory disease, neuralgia, skin disease, and communicable disease-in that order, The rate of health problems by age groups was highest in the 1-4 age group and in the 60 years or over age group, the lowest rate was the 10-14 year age group. In general, 0-29 year age group except the 1-4 year age group was low incidence rate. After 30 years old the rate of health problems increases gradually with aging. Eighty-three percent of health problems that occured during one month were solved by primary medical care procedures. Seventeen percent of health problems needed secondary care. Days rested at home because of illness during one month were 0.7 days per interviewee and 8days per patient and it accounts for 2,161 days for the total productive population in the area. (Table 20) 2. In a year The incidence rate of medical care problems during a year was 74.8%, among them health problems which required rest at home was 37 percent. Estimated number of patients in the total population during a year was 4,600. The health problems that occured most frequently among the interviewees during a year were: Cold (30%), GI trouble (18), respiratory disease (11), anemia (10), diarrhea (10), neuralgia (10), parasite disease (9), ENT (7), skin (7), headache (7), trauma (4), communicable disease (3), and circulatory disease (3) -in that order. The rate of health problems by age groups was highest in the infants group, thereafter the rate decreased gradually until the age 15-19 year age group which showed the lowest, and then the rate increased gradually with aging. Eighty-seven percent of health problems during a year were solved by primary medical care. Thirteen percent of them needed secondary medical care procedures. Days rested at home because of illness during a year were 16 days per interviewee and 44 days per patient and it accounted for 57,335 days lost among productive age group in the area (Table 21). Among those given medical examination, the conditions observed most frequently were respiratory disease, GI trouble, parasite disease, neuralgia, skin disease, trauma, tuberculosis, anemia, chronic obstructive lung disease, eye disorders-in that order (Table 22). The main health problems required secondary medical care are as fellows: (previous page). Utilization of medical care (treatment) The rate of treatment by various medical facilities for all health problems during one month was 73 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 52% while the rate of those who have health problems which did not required rest was 61 percent (Table 23). The rate of receiving of medical care for all health problems during a year was 67 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 82 percent while the rate of those who have health problems which did not required rest was as low as 53 percent (Table 24). Types of medical facilitied used were as follows: Hospital and clinics: 32-35% Herb clinics: 9-10% Drugstore: 53-58% Hospitalization Rate of hospitalization was 1.7% and the estimate number of hospitalizations among the total population during a year will be 107 persons (Table 25). Medical cost: Average medical cost per person during one month and a year were 171 and 2,800 won respectively. Average medical cost per patient during one month and a year were 1,109 and 3,740 won respectively. Average cost per household during a year was 15,800 won (Table 26, 27). Solution measures for health and medical care problems in rural area: A. Health problems which could be solved by paramedical workers such as nurses, midwives and aid nurses etc. are as follows: 1. Improvement of environmental sanitation 2. MCH except medical care problems 3. Family planning except surgical intervention 4. Tuberculosis control except diagnosis and prescription 5. Dental care except operational intervention 6. Health education for residents for improvement of utilization of medical facilities and early diagnosis etc. B. Medical care problems 1. Eighty-five percent of health problems could be solved by primary care procedures by general practitioners. 2. Fifteen percent of health problems need secondary medical procedures by a specialist. C. Medical cost Concidering the economic situation in rural area the amount of 2,062 won per residents during a year will be burdensome, so financial assistance is needed gorvernment to solve health and medical care problems for rural people.