보고서 정보
주관연구기관 |
순천향대학교 SoonChunHyang University |
보고서유형 | 최종보고서 |
발행국가 | 대한민국 |
언어 |
한국어
|
발행년월 | 2003-12 |
주관부처 |
보건복지부 [Ministry of Health & Welfare(MW)(MW) |
등록번호 |
TRKO201500006684 |
DB 구축일자 |
2015-06-13
|
초록
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1. 연구 배경, 목적 및 방법
□ 법적인 제개정을 통해 지역보건의료의 실무를 담당하는 보건소의 기능은 계속 확장되고 있으나 보건소의 조직과 인력에는 큰 변화가 없거나 정부조직의 구조개혁과정에서 축소되어 건강증진사업을 포함하여 각종 법령에서 제시된 보건소의 기능을 수행하는데 한계가 있다는 비판이 최근에 증가하고 있다. 즉 급변하는 보건의료 현실에 발맞추어 보건소 전체사업에 대해 전반적인 구조조정이 필요하고 이에 맞추어 조직의 정체성 특히, 보건소의 기능 및 역할 재정립차원에서의 지역특성간 조직과 인력의 재편성 내지 재구성이 시
1. 연구 배경, 목적 및 방법
□ 법적인 제개정을 통해 지역보건의료의 실무를 담당하는 보건소의 기능은 계속 확장되고 있으나 보건소의 조직과 인력에는 큰 변화가 없거나 정부조직의 구조개혁과정에서 축소되어 건강증진사업을 포함하여 각종 법령에서 제시된 보건소의 기능을 수행하는데 한계가 있다는 비판이 최근에 증가하고 있다. 즉 급변하는 보건의료 현실에 발맞추어 보건소 전체사업에 대해 전반적인 구조조정이 필요하고 이에 맞추어 조직의 정체성 특히, 보건소의 기능 및 역할 재정립차원에서의 지역특성간 조직과 인력의 재편성 내지 재구성이 시급한 것으로 평가되고 있다(강성호, 1996; 국민건강 2010 Task Force와 농어촌의료서비스기술지원단, 1998; 보건복지부와 한국보건산업진흥원, 2000).
□ 본 연구에서는 보건소를 둘러싼 환경의 변화에 따른 보건소 조직 및 전문인력배치 기준의 적정성 등을 분석하고, 보건소가 지역주민 평생건강관리 중심기관으로 기능 및 역할을 효율적으로 수행할 수 있도록 지역별 특성에 적합한 보건소의 발전모형을 개발하는 것이다.
① 효율적인 건강증진사업 추진을 위한 사업수행 모형 개발
② 건강증진사업의 효과적 수행을 위한 보건소의 조직 및 인력관리 방안 개발
□ 이를 위해 문헌조사 및 외국의 사례조사, 의견조사 등을 실시하였다.
○ 문헌고찰
- 국내외의 건강증진사업과 관련된 문헌고찰
- 보건소의 인력 및 조직 관련 문헌 및 발표문 고찰
○ 이차자료 분석
- 기존의 연구 중 보건소 조직의 투입요소(인력, 시설, 장비, 예산) 조사결과 분석
○ 외국의 선진사례 분석
- 우리나라와 유사한 보건행정 체계인 일본의 건강증진사업 수행체계 및 보건소 조직 및 인력운용 현황 분석
- 일본의 일개 현을 방문하여 도도부현 차원에서 수행하고 있는 각종 건강증진사업 수행체계 및 인력운영방안에 대한 사례조사를 실시한다.
○ 건강증진 및 보건소 관련 법령검토를 위한 정책협의회 개최
○ 법령검토 결과 및 개선방안에 대한 보건소장의 의견조사
- 조사내용은 법령검토작업과 관련된 것 또는 법령 개정방안에 대한 것으로 보건소의 설치, 조직, 공무원 정원과 채용, 승진, 교육훈련 등에 대한 의견을 묻는 것이다.
Abstract
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Ⅱ. Background and Objectives
Functions of the health center is continuously expanding through legal revisions. However, criticisms regarding limitations in executing the roles of health center presented in the law due to no major changes in the system and human resources of the health center or t
Ⅱ. Background and Objectives
Functions of the health center is continuously expanding through legal revisions. However, criticisms regarding limitations in executing the roles of health center presented in the law due to no major changes in the system and human resources of the health center or the reduction in human resource in the process of government's structural reformation process are on the rise.
It is necessary to re-organize overall health programme of health center corresponding to continuously changing reality of health environment and immediate re-organization on the health center's function, role, system and human resources is demanded.
An objective of this research is to analyze the susceptibility of the standard of health center system and appointment of specialists and to develop measures to improve health center system and human resources for an effective execution of health improvement programme.
Ⅲ. Problems of Health Center System and Human Resources There is no standard for the organization of health center in regional health law, a law providing base for the health center. When the functions and works of the health center are modified, it is clearly regulated that the organization and staffs of the health center also must be controlled, providing an evidence of deciding the volume and number of organization and staffs. However, in reality, they are decided within the total number of staffs of self-governing body with great differences. And we lack workers in performing the works stated by the law.
We also lack specialists of each field. Ministry of Health and Welfare had set the standard of appointing the minimum number of specialists for each health center and maintaining a fixed level withing the range of staffs. Present status of appointing specialists according to this standard derived extreme lack of dental hygienists and dieticians in Seoul where it is considered to have better proportion of specialists, and all 25 health centers in Seoul need mental & health specialists.
In case of Korea, health welfare programme is separately executed by the health center and health sub-center(branch of health center), and in cases of special health programme or exemplary programme, a guideline is announced by the Ministry of Health and Welfare, the central government, to Health Division of self-governing bodies of each province, which is then notified to the health centers in each city or county.
On the contrary, in Japan, in many hyons(provinces of Japan), the health welfare programmes are executed comprehensively based on the health and welfare policies and the programme announced by the central government is inspected and re-planned so it would be adequate for the characteristics of each hyon. Then, works of health centers in each district are controlled. This process is a plan-control function in the dimension of hyon. In order to apply this system, a great deal of man power and budget are necessary. In case of Okayama Hyon, presently in 2001, there are 260 staffs in the Ministry of Health and Welfare with 28 doctors, 15 pharmacists, 17 hygienists, 4 veterinarians and other specialists. The budget was, 81, 813 million yen, which is about 10% of the total budget.
Ⅳ. Improvement Measures for the Health Center Works, System and Human Resources Management
□ System Reorganization by Selecting and Focusing on Health Center Works According to the Changes in Health Promotion Programme
- Select and focus on the health center works based on the viewpoints of the government led by the 16th President and 21st century
- Maintain the works necessary to be continued through public consignment and management and etc
- Need to focus on the health service for frail class (treatment, visited nursing, Mother and Child Welfare, tuberculosis and Hansen's Disease management and etc), epidemics management, health promotion programme, health welfare plans and administrative works.
□ Change in the Frame of Business Execution
- Health welfare business must approach the problems and emphasize the planning and assessment.
□ Change in the Method of Business Execution
- Health center is for all people in the society, and it must also use public resources in the society along with the health center.
- It is necessary to endow, manage and direct public medical functions and provide diverse financial resources. Works endowed to the public must become a contact point between the administrative organs and the public, as a foundation of performing other works.
□ Intensified Specialized Education for the Staffs
- In order to consign the civil affairs to the public and expand health promotion business, it is necessary to re-train or educate the staffs. Education must be promoted by universities all self-governing bodies in all cities and districts establishing a health promotion human resources development center.
Particularly, it is necessary to execute specialized training about epidemics management, health welfare education, visited nursing, mental and health welfare and etc.
□ Four measures below were proposed as a measure of increasing the health center staffs
- A measure to supplement lacking health center staffs to the maximum appointment standard (Measure 1)
- A measure of restore the staffs who had been restructured (Measure 2): Changes in the health center staffs compared to 1998
- Control the number of patients responsible for each staff (Measure 3)
- Control the number of nurses according to the standard (Measure 4)
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