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Success and Barrier Factors of Integrated Health Promotion Program to Improve Health Indicators - Hypertension Registration Program in Goseong, Gangwon -

건강지표 개선을 위한 통합건강증진사업의 성공 및 장애요인 - 강원도 고성군 고혈압등록사업 -

  • Received : 2018.05.10
  • Accepted : 2018.06.20
  • Published : 2018.06.30

Abstract

Objectives: The purpose of this study was to examine the success and barrier factors of hypertension registration program in Goseong community health center proven improving hypertension treatment rate by community health survey. Methods: We conducted a qualitative research using both a performance review of the program and in-depth interviews with the 8 operators who had worked for this program in April 2018. Results: In this study, the success factors were analysed as follows: First, the willingness to improve health indicators, second, the implementation of large-scale projects, third, improving program processes, fourth, continuous efforts for achievement of goal, not output or reward, and the barrier factors are as follows. First, uniform output monitering, second, evaluation after the fashion of contest, third, the confusing concept of an integrated health promotion program, fourth, the attitude of the person worried with task change. Conclusions: This study suggested that the health community health center should follow the basic principles of public health, and the central government should introduce a health policy of decentralization.

이 연구는 지역사회건강조사에서 고혈압 치료율을 향상시킨 고성군 고혈압등록사업의 성과분석과 질적 연구를 통해 사업의 성공요인과 장애요인을 분석하여, 향후 보건소들이 통합건강증진 사업을 통하여 건강지표를 향상시키고자 하는 욕구를 확산시키기 위해 2018년 4월에 수행되었다. 이를 위해 질병관리본부의 전산시스템 보고자료와 지역사회건강조사 원자료를 확보하여 사업 성과를 분석하였으며, 이 사업을 직접적으로 수행한 8명을 연구대상으로 심층면접을 통하여 질적 연구를 수행하였다. 연구 결과, 건강지표를 변화시킨 성공요인은 첫째, 보건주체의 지표개선 의지, 둘째, 자원을 통합한 규모 있는 사업 추진, 셋째, 업무프로세스의 개선, 넷째, 실적이나 포상이 아닌 지표개선을 위한 지속적인 노력으로 도출되었다. 또한 보건소가 실적이 아닌 지표개선 의지를 유도할 수 있도록 정책적으로 보완해야할 장애요인은 첫째, 획일적인 실적중심의 평가, 둘째, '줄 세우기' 식의 평가와 포상, 셋째, 집단이 아닌 개인적인 통합건강증진 사업의 개념, 넷째, 변화를 두려워하는 담당자의 태도로 도출되었다. 이를 종합하면 보건소는 보건사업의 기본 원칙을 준수하고, 중앙정부는 지역이 주체가 되어 사업을 수행할 수 있도록 지방분권적 정책을 도입해야 할 것이다.

Keywords

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