• Journal of Preventive Medicine and Public Health
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• 제7권1호
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• pp.29-94
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• 1974

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.

• 항공우주정책ㆍ법학회지
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• 제32권1호
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• pp.83-138
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• 2017

한 중 FTA가 2015년 12월 20일 발효되었고, 우리나라 제1위의 교역상대국인 중국과의 FTA로서 발효된 후 1년이 경과하였다. 따라서 본 연구에서는 한국과 중국 간 항공운송 교역 동향을 살펴보고, 한 중 FTA의 항공운송서비스 부문에 대한 양허내용을 검토하고, 항공운송 부문에 미치는 영향을 분석하며, 이에 대응하기 위한 우리나라 항공정책의 방향을 도출하여 제시하고자 한다. 2016년 한 중 간 항공운송 교역 동향을 살펴보면, 대중국 항공운송 수출액은 전년대비 9.3% 감소한 400.3억 달러로서, 대중국 전체 수출액의 32.2%를 차지하고 있다. 대중국 항공운송 수입액은 전년대비 9.1% 감소한 242.6억 달러로서, 대중국 전체 수입액의 27.7%를 차지하고 있다. 한 중 FTA의 항공운송서비스 부문 양허내용을 검토해 보면, 중국은 한 중 FTA 협정문 제8장 부속서 중국의 양허표에서 항공운송서비스 분야의 항공기 보수 및 유지 서비스, 컴퓨터 예약시스템(CRS)서비스에 대하여 시장접근과 내국민대우에 대한 제한을 두고 양허하였다. 한국은 한 중 FTA 협정문 제8장 부속서 한국의 양허표에서 항공운송서비스 분야의 컴퓨터 예약시스템서비스, 항공운송서비스의 판매 및 마케팅, 항공기 유지 및 보수 서비스에 대하여 시장접근과 내국민대우에 대한 제한을 두지 않고 양허하였다. 한 중 FTA가 항공운송 부문에 미치는 영향을 분석해 보면, 항공여객시장에 미친 영향으로, 2016년 국제선 중국노선 도착여객은 996만 명으로 전년대비 20.6% 증가하였고, 출발여객은 990만 명으로 전년대비 34.8% 증가하였다. 항공화물시장에 미친 영향으로, 2016년 대중국 항공화물 수출물동량은 105,220.2톤으로 전년대비 6.6% 증가하였고, 수입물동량은 133,750.9톤으로 전년대비 12.3% 증가하였다. 대중국 수출 항공화물 주요품목가운데 한 중 FTA 협정문 중국 관세양허표 상 수혜품목의 수출물동량이 증가하였고, 대중국 수입항공화물 주요품목가운데 한 중 FTA 한국 관세양허표 상 수혜품목의 수입물 동량이 증가하였다. 항공물류시장에 미친 영향으로 2016년 국내 포워더의 대중국 수출 항공화물 취급실적은 119,618톤으로 전년대비 2.1% 감소하였고, 대중국 수입 항공화물 취급실적은 79,430톤으로 전년대비 4.4% 감소하였다. 2016년 대중국 역직구(전자상거래 수출) 수출금액은 1억 916만 달러로 전년대비 27.7% 증가하였고, 대중국직구(전자상거래 수입) 수입금액은 8,943만 달러로 전년대비 72% 증가하였다. 한 중 FTA에 따른 우리나라 항공정책의 방향을 도출하여 제시해 보면 다음과 같다. 첫째 한 중 간에 항공자유화를 추진한다. 한국과 중국은 2006년 6월 중국의 산동성과 해남성에 대해 여객 및 화물 제3자유 및 제4자유를 범위로 하는 항공자유화 협정을 체결하였으며, 2010년 하계부터 양국 간 항공운항을 전면 자유화하기로 합의하였으나, 중국 측에서 항공협정 양해각서 문안의 해석 상 이의를 제기함에 따라 추가적인 항공자유화는 이루어지지 못하고 있다. 한 중 FTA와는 별도의 항공회담을 통해 중국과의 점진적 선별적 항공여객시장 및 화물시장의 항공자유화를 추진해야 할 것이다. 둘째 항공운송산업 및 공항의 경쟁력을 확보해야 한다. 한국의 항공운송산업 경쟁력의 강화방안으로 국적항공사 경쟁력의 강화를 위한 지원체계를 마련하며, 국적항공사의 새로운 공정경쟁의 기반을 조성하며, 국익기반 전략적 네트워크를 구축해야 할 것이다. 한국의 공항 특히 인천공항의 경쟁력 강화방안으로 항공수요 창출 네트워크 경쟁력을 강화하며, 공항시설과 안전인프라를 확충하며, 공항을 통한 새로운 부가가치를 창출하며, 세계 1위 수준의 서비스 수준을 유지해야 할 것이다. 셋째 항공물류업의 경쟁력을 강화한다. 한국의 항공물류업 경쟁력의 강화방안으로 산업트렌드 변화에 대응한 고부가가치 물류산업의 육성전략으로 신규 물류시장을 개척하며, 물류인프라를 확충하며, 물류전문인력을 양성한다. 또한 글로벌 물류시장의 확대전략으로 물류기업의 해외투자 지원체계를 구축하며, 글로벌 운송네트워크 확장에 따른 국제협력 강화 및 인프라를 확보해야 할 것이다. 인천공항 항공물류 경쟁력의 강화방안으로 기업의 물류단지 입주수요에 대응하며, 신 성장 화물분야의 비교우위 선점을 하며, 물류허브 역량을 강화하며, 공항 내 화물처리속도 경쟁력을 향상해야 할 것이다. 넷째 한 중 FTA 후속 협상에서 항공운송서비스 분야의 추가 개방을 확보한다. 한 중 FTA 발효 후 2년 내에 개시될 후속 협상에서 중국 측 항공운송서비스 분야의 양허수준이 중국의 기체결 FTA에 비해 미흡한 분야인 컴퓨터 예약시스템서비스 및 항공기 보수 및 유지 서비스의 양허에 대해 추가 개방을 요구하는 것이 필요할 것이다. 결론적으로 한 중 FTA가 우리나라 항공여객시장, 항공화물시장 및 항공물류시장에 미치는 영향에 대응하여 추진해야 할 정책과제로서, 국적항공사의 경쟁력과 국민 편익을 고려하여 중국과의 점진적 선별적 항공자유화를 추진하며, 항공운송산업과 공항의 경쟁력 강화를 위한 지원체계를 구축하며, 물류기업들의 항공물류시장 진출을 확대하며, 중국 측 양허수준이 낮은 항공운송서비스 분야의 추가 개방 요구를 위한 준비를 해야 할 것이다.