• Title/Summary/Keyword: 보건진료원

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Community Health Practitioner (새로운 건강요원$\cdot$보건진료원)

  • Kim S J
    • The Korean Nurse
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    • v.23 no.1 s.124
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    • pp.25-35
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    • 1984
  • 인간 궁극의 목적은 ''행복한 생활''이며 이를 위한 가장 중요한 조건이 ''건강''이라는데 이론을 제기할 사람이 없다. 그간 우리나라는 1970년대를 거치면서 절대빈곤을 해결하느라고 경제개발계획을 수립하는 등 최선의 노력을 해 왔으며, 따라서 보건정책은 등한시 해 왔던 것이 사실이며 이는 극히 당연한 일이라고 생각한다. 최근 경제 개발 계획의 성공적인 시행으로 중진국의 대열에 서게 되었다. 산업 전략이 빚는 인구 이동의 불가피성, 인구의 도시집중 현상과 사회 구조의 변화는 생활방식 뿐 아니라 의식구조의 변화와 가치관의 변화를 가져왔으며 질병 양상과 건강 문제의 양상을 변화시켰다. 이로 말미암은 경제적, 지역적, 심리적 및 문화적 불균형 상태는 건강관호와 보건의료제도에도 불균형 상태를 갖고 와 불가피하게 된다. 이러한 불균형은 해소되어야 하는 시점에 온 것이며 정부가 목표로 하는 복지사회 건설을 위한 가장 중요한 보건 정책에 정부가 역점을 두게 된 것은 극히 당연하다. 이에 1976년 발족한 한국 보건 개발 연구원이 1977년부터 시작한 시법 사업을 실시한 결과, 지역 주민의 반응, 수용성, 의료 이용도, 의료비 절감 등을 분석하고 그 효율성을 인정받아 1981년 12월 31일 농어촌 보건의료를 위하여 특별 조치법을 제정하고 의료시설, 요원의 도시편중 교통의 불편, 고가의 의료 수가로 소외되어 오던 보건의료 취약지역 주민에게 기본권으로서의 기초 건강 서비스를 제공하기에 이르렀다. 이 건강 관호 제도에 그 바탕을 두며 보건 진료원이 그 척추의 역할을 담당한다. 1981년도와 1982년도에 선발되어 교육을 받고 배치된 738명의 보건 진료원은 38만명의 벽오지주민에게 현재 의료의 손길을 펴고, 질병의 예방을 위한 조치를 취하며 건강의 유지, 증진을 위하여 활동하고 있다. 건강관호는 시설이나 장비가 하는 것이 아니고 건물이 하는 것은 더욱 아니며, 지식과 기술을 갖춘 자격있는 의료인이 소명의식을 갖고 임할 때만 가능하다. 오랜숙원이었던 보건의료의 지역간 경제, 사회적, 문화적 계층간의 불균형을 해소하고 온 국민에게 기본권으로서의 건강을 갖도록 하는 이 새로운 제도는 패기에 넘치는 열정을 지닌 많은 젊은 간호학도들의 참여없이는 성공을 기대할 수 없다. 어떠한 제도이건 새로운 제도가 사회에 정착되기까지는 여러 해 동안의 시행착오와 고난이 반드시 수반되어 왔다는 사실을 우리는 역사를 통해 알고 있다. 그러나 그 제도가 다수를 위해 정의롭고 바람직한 제도일 때 반드시 성공을 거두었다는 사실도 알고 있다.

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Internal Changes and Countermeasure for Performance Improvement by Separation of Prescribing and Dispensing Practice in Health Center (의약분업(醫藥分業) 실시(實施)에 따른 보건소(保健所)의 내부변화(內部變化)와 업무개선방안(業務改善方案))

  • Jeong, Myeong-Sun;Kam, Sin;Kim, Tae-Woong
    • Journal of agricultural medicine and community health
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    • v.26 no.1
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    • pp.19-35
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    • 2001
  • This study was conducted to investigate the internal changes and the countermeasure for performance improvement by Separation of Prescribing and Dispensing Practice (SPDP) in Health Center. Data were collected from two sources: Performance report before and after SPDP of 25 Health Centers in Kyongsangbuk-do and 6 Health Centers in Daegu-City and self-administerd questionnaire survey of 221 officials at health center. The results of this study were summarized as follows: Twenty-four health centers(77.4%) of 31 health centers took convenience measures for medical treatment of citizens and convenience measures were getting map of pharmacy, improvement of health center interior, introduction of order communication system in order. After the SPDP in health centers, 19.4% of health centers increased doctors and 25.8% decreased pharmacists. 58.1% of health centers showed that number of medical treatments were decreased. 96.4%, 80.6% 80.6% 96.7% of health centers showed that number of prescriptions, total medical treatment expenses, amounts paid by the insureds and the expenses to purchase drugs, respectively, were decreased. More than fifty percent(54.2%) of health centers responded that the relative importance of health works increased compared to medical treatments after the SPDP, and number of patients decreased compared to those in before the SPDP. And there was a drastic reduction in number of prescriptions, total medical treatment expenses, amounts paid by insureds, the expenses to purchase drugs after the SPDP. Above fifty percent(57.6%) of officers at health center responded that the function of medical treatment should be reduced after the SPDP. Fields requested improvement in health centers were 'development of heath works contents'(62.4%), 'rearrangement of health center personnel'(51.6%), 'priority setting for health works'(48.4%), 'restructuring the organization'(36.2%), 'quality impro­vement for medical services'(32.1%), 'replaning the budgets'(23.1%) in order. And to better the image of health centers, health center officers replied that 'health information management'(60.7%), 'public relations for health center'(15.8%), 'kindness of health center officers'(15.3%) were necessary in order. Health center officers suggested that 'vaccination program', 'health promotion', 'maternal and children health', 'communicable disease management', 'community health planning' were relatively important works, in order, performed by health center after SPDP. In the future, medical services in health centers should be cut down with a momentum of the SPDP so that health centers might reestablish their functions and roles as public health organizations, but quality of medical services must be improved. Also health centers should pay attention to residents for improving health through 'vaccination program', 'health promotion', 'mother-children health', 'acute and chronic communicable disease management', 'community health planning', 'oral health', 'chronic degenerative disease management', etc. And there should be a differentiation of relative importance between health promotion services and medical treatment services by character of areas(metropolitan, city, county).

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Hypertension Management Status in Vulnerable Rural Areas and the Role of Community Health Practitioners (농어촌 의료취약지역에서의 고혈압관리 실태와 보건진료전담공무원의 역할)

  • Cho, Sooyeoun;Kim, Soonchan;Ryu, Jeougim;Han, Jongsuk;Seo, Kawoun
    • Journal of Korean Academy of Rural Health Nursing
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    • v.13 no.2
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    • pp.3-23
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    • 2018
  • Purpose: This study was a descriptive study to investigate correlations between self-care behaviors and quality of hypertension management by hypertensive patients being cared by community health practitioners. Method: Participants were 583 people who were prescribed antihypertensive medications at a health clinic located in South Chungcheong Province. The survey was done from June 1 to July 30, 2018. A self-report questionnaire was administered, and data analysis was performed using descriptive statistics and Pearson correlation coefficients with the SPSS 24.0 program. Results: The rate of awareness, treatment, and control of hypertension were 97.9%, 99.1% and 92.8%, respectively. The number of hypertensive self-care behaviors was 1.82 (${\pm}0.36$) out of 3 points. The quality of hypertension management was 3.22 (${\pm}0.46$) out of 4 points. There was a moderate correlation between hypertensive self-care behaviors and quality of hypertension management (r=.340, p<.001). Conclusions: Results of this study confirm that the quality of hypertension management by community health practitioners is related to self-care behaviors of hypertensive patients. Therefore, it is necessary to improve the quality of hypertension management by health care specialists for self-management of hypertension patients. In addition, a systematic program to improve the quality of hypertension management by community health practitioner is needed.

Health Medical Center Utilization Pattern and Its Related Factors among the Rural Inhabitants (농촌지역(農村地域) 주민(住民)들의 보건의료원(保健醫療院) 이용양상(利用樣相)과 관련요인(關聯要因))

  • Hwang, Byung-Deog;Park, Jae-Yong
    • Journal of agricultural medicine and community health
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    • v.18 no.1
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    • pp.77-91
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    • 1993
  • This study was conducted to assess health medical center utilization pattern and its related factors among the rural inhabitants for the purpose of contribution to establishment of health medical center institutions. A questionnaire survey was carried out for object of 3,754 population of three primary school and three middle school student's parents (total 832 household) in Kyungbook Ulchin Gun rural area from 24 to 28 September, 1990. The summarized result are as follows, Respondents are 60.3% in male, 39.7% in female and 30-40s 81.3% in age, high school graduates 40.3% in education level and a regional medical insurance scheme in 44.1% in forms of health insurance. Recognition for health medical center was showed higher according to high educational, high income level, and short distance for location of health medical center of respondents (p < 0.01). Recognition for health medical center services was showed higher about care of medicaid in medical treatment services and higher preventive vaccination in health prevention services by respondents. Utilization rates of health medical center by out-patient care and preventive care service were 11.1 and 4.5 per 100 persons by year, but admission utilization rate was 34.6 per 10.000 persons by year. Motivations of health medical center utilization were showed a good care(45.7%), a good drugs(45.2%), and nearby health medical center(42.9%). In comparison health service levels of health medical center with general clinic was better (16.3%), similar(38.7%), 7(19.0%), and worse(19.0%) in view of health medical center utilizators. Inconvinience about health medical center utilized was the most higher longtime waiting, the next was limited utilization times. Transportation utilited were on foot(55%), by bus(35.5%), and so on. As mentioned above, there are many inhabitants who less understanding and less acknowledgement about health medical center and even mistake health center for health medical center. Therefore, there must be more information about health medical center. For higher utilization of health medical center, there must be considered expansion of health equipment, facilities, accomplishment with reinforcement of health staffs and efficiency management.

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Cost-Benefit Analysis on Community Health Practitioner (보건진료원 활동의 비용-편익 분석)

  • 이태화;고일선
    • Journal of Korean Academy of Nursing
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    • v.32 no.4
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    • pp.435-446
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    • 2002
  • Purpose : The purpose of the study were to describe outcomes of CHP activities, and to evaluate the economic validity of CHP through a cost-benefit analysis. Method : The sample size was 272. Data were collected using a researcher developed questionnaire from November 1999 to March, 2000. Result : The mean age of CHPs was 39.6 (SD-36). In regard to marital status, 90.8% of the respondents were married. 72% of the CHPs had associate degree. Among CHP activities, providing medical services was 50%, followed by home care visits 20% and health promotion services 20%, preventive services 10%. Total costs per month incurred to CHP activities was \3,053,437($2,442.7). Total benefits per month was \6,711,525($5,369.2). Hence, net benefit was calculated as \3,658,089($2,926). Conclusion : Cost-benefit ratio was 2.20, which provides the evidence of the economic viability of CHP program. The result of cost-benefit analysis, however, would more strongly support the economic value of CHP if intangible benefits of CHP activities such as decreases in pain and suffering and increased quality of life, could be counted.

Utilization Pattern and Percept ion and Attitude of Rural Residents towards Primary Health Post (관할지역 주민의 보건진료소에 대한 태도와 이용양상)

  • Park, Chun-Na;Park, Jae-Yong;Han, Chang-Hyun
    • Journal of agricultural medicine and community health
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    • v.26 no.2
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    • pp.79-96
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    • 2001
  • In order to ascertain the utilization patterns and Perception and attitudes of Primary Health Post(PHP) by rural residents in farm areas, a survey was conducted of 753 households(1,803 persons) in 24 PHPs in Sangju-si, Gyeongsangbuk- do, from December 10, 2000 to January 15, 2001. The morbidly rate of acute illnesses for last two weeks for all households was 29.6%, and the rate of use of medical facilities to treat acute illness was 98.3%. The morbidly rate was highest between the ages of 60 and 69, with a rate of 35.4%. The higher their ages and the lower their educational levels were, the higher the morbidly rate was. The morbidly rate of chronic illnesses for one year for all households was 19.2%, and the rate of use of medical facilities to treat chronic illness was 92.8%. The elderly over 70 years old had the highest morbidly rate of 37.2%. The higher their ages and the lower their educational levels were, the higher the chronic illnesses rate was. For the rate of use of medical facilities to treat acute diseases, the use of PHPs was 89.5%, accounting for the majority of the time. However, for chronic diseases, hospitals and clinics were used more often, with a rate of 48.9%, compared to the use of PHPs, 40.2%. Their previous experiences on the use of PHPs one year before the survey showed that 94.8% used PHPs, 72.2% just visited them, not for the purpose of getting any medical assistance, and 73.3% received health education from PHPs. 98.5% remembered the locations of PHPs, 98.6% thought that PHPs were helpful for their health management, and 84.3% said that PHPs were playing great roles in development of their communities. 97.4% said that they found PHPs necessary. They understood the main job of PHPs as in the order of disease treatment, vaccination and health counseling. The work that they mostly wanted PHPs to do was health counseling and health management, which 31.6% answered. 88.9% said the examination fee was not expensive, 98.4% said CHPs were kind, and 97.0% said they were satisfied with the services at PHPs. Complaints about PHPs included a lack of a variety of medications, said by 42.9%, and poor facilities, by 15.8%. According to the above results, it is concluded that local residents on survey were frequently using PHPs due to their geographical and economical conditions. Also, the residents appeared to be satisfied with the services at PHPs, and they had a high demand for public health service as well as disease treatment. Considering the complaints about medications and medical facilities and equipment, active supports are required to manage PHPs in a way it can provide desirable services to the residents in remote villages through the readjustment of PHPs' functions, reinforcement of facilities and equipment and enhancement of CHPs ' training.

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The Knowledge, Attitude, and Utilization Experience of Community Health Practitioners on Complementary Therapies (보완요법에 대한 보건진료원의 지식, 태도와 활용 경험)

  • Hwang, Sung-Ho;Park, Jae-Yong;Han, Chang-Hyun
    • Journal of agricultural medicine and community health
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    • v.27 no.2
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    • pp.87-105
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    • 2002
  • In order to find out the knowledge, attitude, and experience of community health practitioners(CHP) on complementary therapy, 393 community health practitioners who provide primary health care service in Busan, Kyeongnam, and Daegu, Gyeongbuk regions were interviewed or surveyed by mail from February 1st to March 31st, 2002. In terms of interest of CHPs toward 11 different hinds of complementary therapy, the rate of interest for soojichim was the highest with 75.3%. Aroma therapy had the interest of 71.0% of the CHPs, oriental medicine had 67.4%, and massage had 67.4%. The interest for shiatsu was 64.6%, while homeopath had the lowest rate of interest of 18.1%. In terms of reliance on the treatment results, oriental medicine scored the highest with 92.6%, and soojichim, massage, and shiatsu followed with 85.5%, 83.7%, and 81.7% respectively. Homeopath had the lowest reliance of 18.1%. The 65.1% of the CHPs had the experience of recommending oriental medicine to patients. 50.4% indicated that they had recommended soojichim, and 44.8% had recommended massage before. Shiatsu and aromatherapy followed with 34.4% and Homeopath had the lowest rate of 2.80%. When CHPs were asked if they had received any training in complementary therapy, 33.1% indicated that they had studied soojichim and 13.2%stated that they had learned oriental medicine. Aromatherapy, massage, and shiatsu followed with 11.2%, 8.4%, and 5.6% respectively On the other hand, none of the CHPs had received training in homeopath. In terms of using complementary therapy during the past 5 years, 23.9% had been treated with oriental medicine, and 18.896 had received soojichim. 5.9% had received aromatherapy, 5.3% had used massage, and 5.1% had experience with shiatsu. None of the practitioners had used homeopath during the past 5 years. Significantly many number of practitioners indicated that they had excellent treatment results with all hinds of complementary therapy, and there were rare cares of side effects. When they were asked if they wanted complementary therapy to become part of the curriculum during re-training or training for public service personnels, 78100 wanted soojichim, 69.2% wanted oriental medicine, and 67.9% wanted aroma therapy. 63.9% wanted shiatsu to be included, and 63.1% wanted massage. When CHPs were asked if they wanted to use complementary therapy during primary health care, 63.6% wanted to use soojichim, 52.9% wanted massage, and 51.9% wanted to use aroma therapy. Oriental medicine also showed a high rate of 50.1%. On the other hand, only a small percentage wanted to use chiropractic or homeopath with 17.0% and 12,2% respectively. Among the CHPs, there were some who had administered complementary therapy during the past 5 years. 84% had administered soojichim, 4.6% had administered oriental medicine, and 2.5% had administered massage 2.5% of the CHPs answered that they had administered aromatherapy. However, none of them had administered apitherapy or homeopath. Most of patients showed positive responses, and the rate of side effect was very low. As shown in the above results, although CHPs have a high rate of interest, reliance, and experience in recommending complementary therapy, only a low percentage of them had received any training in complementary therapy. In addition, since there were little side effects when they received or administered complementary therapy, they hoped complementary therapy, which can be beneficial to health, to be introduced to the curriculum. Therefore, in order to provide community members with complementary therapy and the correct information regarding the selection of complementary therapy that could be beneficial to health, a policy of continuous interest and support is needed so that CHPs can he provided with a systemic and rational curriculum of complementary therapy.

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AIDS board

  • 대한에이즈예방협회
    • RED RIBBON
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    • s.65
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    • pp.46-46
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    • 2005
  • 의료혜택을 받지 못하는 노숙자 및 국내거주 외국근로자를 대상으로 입원 및 수술비 등을 무료로 지원하는 사업을 실시하기로 발표하였다. 보건복지부의 무료진료사업 지침에 따르면 현재 입원 및 수술이 필요한 환자나 자원봉사단체 등은 적십자병원 또는 지방공사의료원을 방문하거나 입원 및 전원을 의뢰할 경우 우선적으로 진료를 받을 수 있다고 밝혔다.

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