프로세스 마이닝을 이용한 군수품 계약업무 분석 : 공군 군수사 계약업무를 중심으로 (Analysis of Munitions Contract Work Using Process Mining)
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- 지능정보연구
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- 제28권4호
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- pp.41-59
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- 2022
군수물자의 적기 조달은 군의 작전능력 유지를 위해서 필수적이며, 계약업무는 적기 조달을 위한 첫 단추라고 할 수 있다. 또한 신속한 계약체결은 수요자의 여유로운 납기설정을 가능케 하며, 예산 집행의 가능성을 높여주기 때문에 예산의 조기집행과 이·불용 방지를 위해서도 계약 프로세스 개선이 필수적이다. 최근 빅데이터를 이용한 연구가 여러 분야에서 활발히 진행되고 있으며, 빅데이터를 이용한 프로세스 분석 및 개선 기법인 프로세스 마이닝 역시 민간에서 널리 활용되고 있다. 하지만 군 내 계약업무에 대한 분석은 업무 담당자의 경험과 단편적인 정보를 활용한 이·불용 문제사례별 원인 파악 및 대응적 모색과 같은 개별적 분석수준에 그치고 있다. 본 연구는 계약 프로세스 개선을 위해 공군 군수사령부 재정처가 2019년 11월부터 약 1년간 직접 계약한 총 560건의 계약업무에 관한 데이터를 가지고 프로세스 마이닝 기법을 이용하여 분석하였다. 분산된 데이터를 종합하여 프로세스 맵을 도출하고, 프로세스의 흐름, 수행시간 분석, 병목 분석 및 추가 세부분석을 실시했다. 분석결과 다수 계약 건에서 의뢰 후 재검토/수정이 반복 발생하고 있음을 발견할 수 있었다. 반복적인 재검토/수정은 원가계산 완료까지의 소요일수 지연에 크게 영향을 미치고 있으며, 이는 병목 지점 시각화를 통해서도 명확하게 드러났다. 재검토/수정은 계약의뢰가 많은 상위 5개 부서에서 60% 이상 발생하고, 의뢰가 집중되는 상반기에 주로 발생하는데 이는 소요부서의 계약의뢰 전 면밀한 사전검토가 필요함을 의미한다. 그리고 재정처의 계약업무는 법령에 따른 절차대로 수행되고 있었으나, 일부 업무의 순서조정이 필요함을 알 수 있었다. 본 연구는 군 내 계약업무 분석에 프로세스 마이닝을 이용한 첫 사례이다. 이를 기반으로 프로세스 마이닝을 군대 내 다양한 업무에 적용하기 위한 연구가 더욱 수행된다면, 각종 업무의 효율화를 이끌어 낼 수 있을 것으로 기대한다.
운항승무원은 항공기 운항에 필요한 적합한 자격요건을 충족해야 하며 이를 위해서는 항공기 운항에 필요한 자격요건과 항공기간 유사성 등으로 인해 불필요한 자격요건이 무엇인지 확립되어 있어야 한다. 시카고협약은 국제민간항공에 있어서 가장 기본이 되는 국제조약이며 시카고협약 체약국은 시카고협약 부속서에서 정한 '표준 및 권고방식(SARPs)'에 따라 항공법규를 제정하여 운영 중이며, 안전하고 효율적인 기준 수립 및 적용을 위해 지속적으로 노력하고 있다. 본 논문은 운항승무원의 항공기 2개 형식 운항에 대한 ICAO, 한국, FAA, EASA 등의 국내외 기준의 차이점을 인식하고 이를 토대로 한국의 관련 제도를 개선 보완하고자 한다. 운항승무원의 항공기 2개 형식 운항에 대한 국내외 기준을 비교하면서, 한국의 관련 법규가 국제기준 대비 불합리한 측면이 있어 이를 토대로 개선방안을 제시하였다. 기본적으로 항공기 운영자는 기장 또는 부기장이 동일 형식의 비행기로 90일 내에 적어도 3회의 이륙과 착륙을 행한 경험이 없는 기장 또는 부기장을 해당 항공기를 운항하도록 승무시켜서는 아니 된다. 또한 운항승무원은 모든 운항하는 항공기 형식에 대하여 장비 및 절차에 대한 중요 차이점에 익숙해야 한다. 또한 항공기 운영자는 조종사의 조종 기능 및 비상절차 수행능력이 해당 항공기 형식에서 수행능력이 있도록 적합한 방법으로 심사가 수행되어야 한다. 이와 관련해 정기적으로 기량심사가 수행되어야 한다. 한편 항공기 운영자가 운항승무원에게 항공기 간의 유사성을 토대로 서로 다른 항공기 형식을 운항하도록 하는 경우, 항공당국은 각각의 항공기 형식을 운항하기 위한 면제 요건을 설정하여 적용할 수 있다. 결론적으로 운항승무원이 2개 형식의 항공기를 운항하기 위해서는 해당 형식 항공기 운항을 위한 유효한 자격이 있어야 하며, 이를 위해서는 이에 합당한 훈련프로그램을 이수해야 한다. 따라서 특별히 요건이 면제되거나 요구량을 축소하여 적용할 수 있는 법적 근거가 없는 한, 2개 형식 항공기를 운항하기 위해서는 항공기 형식 간의 유사성을 토대로 적용할 수 있는 진보된 훈련 프로그램이 있음에도 불구하고 각각의 항공기 형식에 필요한 모든 운항자격을 충족해야 한다. 항공기 제작사는 표준비행절차 및 안전운항을 위해 새로 항공기를 개발함에 있어서 항공기 시스템에 대하여 기본적인 틀을 유지하면서 기능을 보완 개선하고 있어 항공기 간에 표준화된 적용이 확대되고 있으며 항공기 간의 차이수준은 점차 줄어들고 있다. 또한 다양한 항공 비즈니스 출현 및 레저용 항공시장의 활성화로 운항승무원이 서로 다른 항공기를 번갈아 운항할 필요성이 점차 높아지고 있다. 그럼에도 불구하고 한국은 운항승무원의 훈련 및 운항자격프로그램과 관련하여 신규도입 항공기에 적용할 항공기 간의 차이수준에 따라 실질적으로 다르게 적용할 수 있는 관련 법규 및 체계가 전무한 상태이며, 2개 형식 이상의 항공기를 운항하기 위한 구체적인 기준은 물론 이와 관련하여 항공안전을 위해 금지하거나 제한하는 기준도 없기 때문에 항공기 운영자의 정책적인 판단에 따를 수밖에 없는 실정이다. 따라서 항공당국은 비행표준평가위원회 제도를 도입하여 비행표준평가를 통해 항공기 간의 차이수준을 분석하고 이를 토대로 운항승무원이 합당한 교육훈련 및 자격요건을 효율적으로 적용할 수 있도록 항공기 간 차이수준별 자격요건체계를 수립하여 적용해야 할 것이다. 이와 관련하여 본 논문에서는 항공기 간의 차이수준 평가 및 2개 형식 이상 항공기 운항에 대한 국내외 항공법규를 고찰하고 합리적인 제도 운영을 위한 몇 가지 개선방안을 제시하였다. 본 논문이 1) 정부, 학계 및 항공사 등 유관부문에서 항공안전증진을 위한 국제 동향을 이해하는데 도움이 되고, 2) 국내 항공법규를 개선하는데 도움을 주고, 3) 아울러, 국제표준 준수 및 항공안전증진에 기여하길 기대한다.
재래시장은 지역의 중심지적인 특성과 문화적인 특성이 고스란히 반영된 지역 거점지이며 인근 지역주민의 상거래라는 1차적 장소적 기능과 사회문화적 측면의 상호 정보문화교류, 커뮤니티 공간 형성으로 유통의 집객시설과 집적시설로서 중요한 역할과 기능을 하고 있다. 5인 이하 가족 단위의 생계형으로 취급상품, 구입방범, 판매방식 등이 전근대적인 경영기법을 통해 한국의 대표적 소매업태로서의 역할을 해오고 있다. 1990년대 이후 신유통업태와 대형할인점 진출로 인해 재래시장은 급격한 경쟁력 상실과 소비자들의 생활수준의 향상, 구매패턴의 변화, 인터넷의 급속한 확산 등 외부적인 유통 환경변화에서 경쟁력을 상실하고 설 자리를 잃어가고 있다. 정부의 지역경제 활성화와 국민경제의 발전 측면에서 고령화된 재래시장에 대한 대책 중 정부의 예산지원 정책으로 환경개선사업, 연구용역, 경영현대화중심의 국고지원 사업은 2001년부터 2004년까지 총 3,853억원의 국고가 지원되었으나 활성화 사업의 실효성에는 아직 정확히 나타나고 있지 않은 상황으로 조사되었다. 또한 지원사업을 추진함에 있어 시장상인리더들의 전문성결여로 종합적인 추진전략과 중장기적 계획수립 및 자발적인 상인들의 합의점 유도 반감으로 지속적인 사업추진방향에 한계점을 나타냈다. 재래시장이 단순히 물건을 사고파는 물리적인 장소적 의미에서 벗어나 새로운 지역 장소적 생활공간으로 커뮤니티적 접근을 통한 장소적 창조전략이 필요하다. 이에 시대적 패러다임 변화에 따른 새로운 사업 방향 전환을 통해 재래시장의 장소적 기능 도입을 동해 문화적 경제적 의미를 지닌 공간으로 재조명을 동해 발전방향을 제시하고자 한다. 재래시장은 지역 기반으로 한 지역생활자들과 자연스럽게 커뮤니티를 상호 형성하고 정보와 지식 공유를 통해 부 창출 공간으로 재생되어야 할 것이다 재래시장이 부 창출 공간으로 재생하려면 시대적 장소적 환경에 맞는 시설과 교류활동을 통찬 상호신뢰구축 활동 속에서 고객이 원하는 방향으로 영업환경도 변화하여야 하며, 지역단위 중심 영국의 TCM, 미국의 BID, 일본의 TMO 등 해외 벤치마킹을 통한 단위 시장상가 점포단위의 점(點)정책에서 선(線)단위의 상가로 환경사업과 거시적인 지역단위중심인 면(面) 정책적 접근을 통한 커뮤니티적인 발상 전환이 필요하다. 국내외 사례비교 분석을 통해 사회적 정책수요 발굴과 기존의 추진방법에 대한 선진사례 연구를 통한 NPO, NGO 등의 시민기업가와 이를 수행키 위한 혁신성과 전문성조정능력을 갖춘 리더자 양성이 무엇보다 중요하다. 특히 지역자원 활용 소스 중심의 문화관린 산업의 seeds 발굴과 향토상품의 상품화와 네트워크 조직망 구축을 위한 지역중심의 복합 생활문화 공간이 필요할 것이며, 이를 촉진키 위한 mentor academy시스템 접근을 통해 점점 고령화되어 가고 있는 재래시장에 대해 차별적 특성이 반영된 종합적이고 체계적 접근 방법연구가 필요하다.
산업현장의 변화와 요구에 부응할 수 있는 인력을 체계적으로 양성하기 위하여 2001년에 국무조정실을 중심으로 NCS(National Competency Standards, 이하 NCS)와 국가자격체제(National Qualification Frameworks, 이하 NQF)의 도입이 결정되었다. 건설분야 내 조경 역시 2008년 "국가직무능력표준(NCS) -조경"이 시범 개발되어 2009년부터 3년간 시범운영되었다. 특히 2013년 출범한 박근혜 정부의 주요 국정과제 중 하나로 '학벌이 아닌 능력 중심의 사회 구현'이 채택되면서, 이를 실천하기 위한 구체적인 수단으로 NCS 체제 구축이 전국적으로 확산되고 있는 시점이다. 그러나 국가에서 개발한 NCS의 경우, 이상적인 직무수행능력을 명시하였기 때문에 각 대학의 학생수준의 차이, 기자재와 교수들의 확보문제, 현행교육과정의 시수 문제 등 실질적인 운영상의 문제점을 반영하지 못한 단점이 있으므로, 이를 현실적인 교육과정에 연착륙시키기 위해서는 현재의 교육과정과 NCS와의 차이 즉 갭(gap)을 명확히 분석하는 과정이 선행되어야 한다. 갭분석은 기존의 교육과정을 NCS 기반 교육과정으로 개편하기 위한 초기 단계의 방법론으로 NCS 능력단위별 능력단위요소와 수행준거를 기준으로 학과 내 기존 교육과정과의 괴리도 혹은 일치 정도를 1에서 5까지 리커트 척도를 활용하여 기입한 후 분석하는 방법이다. 이처럼 현재의 대학 내 교육과정과 NCS와의 일치 및 괴리 정도를 측정함으로써 향후 NCS 운영을 희망하는 대학에서는 NCS의 적용 가능성과 개발 운영 이후의 효과성을 검증할 수 있는 기초 도구를 확보할 수 있다. 갭분석을 통한 교육과정 개편의 장점으로는 첫째, 정부의 재정지원 사업과 연계하여 정성적인 학과별 NCS 도입률에 대한 정량적 지표를 제공할 수 있으며, 둘째, NCS 기반 교육과정 개편 시 부족한 혹은 포화상태인 부분에 대한 객관적인 기준을 제공해 준다. 즉, 해당 NCS 세분류 도입 시 부족한 능력단위 및 능력단위요소를 추출할 수 있으며, 기존 과목별 능력단위요소별로 보완 사항도 추출할 수 있는 동시에, 이를 통한 상세 강의계획서 및 기초 교과목 개설을 위한 방향성을 제시해 주는 장점이 있다. 다만, 현재까지 개발된 갭분석의 이론을 보완하여 보다 체계적으로 정비해야 하는 과제는 남아 있다. 교육부, 고용노동부는 산업현장의 요구를 교육훈련 및 자격에 체계적으로 반영하기 위해 관련 산업계 인사들이 모여 실무적인 차원에서 NCS 표준을 적극적으로 개발하고 보급하여야 하며, NCS 적용을 희망하는 대학에서는 일과 자격이 연계될 수 있는 교육과정을 NCS 기반으로 개편하여야 할 것이다. 이를 위해 대학에서는 관련 산업 전망 및 대학 내 교수자원과 지역 산업과의 관련성을 고려하여 적용하고자 하는 NCS 세분류를 명확히 선정하여야 할 것이다. 이후 NCS 기반 교육과정 개편을 위해 갭분석을 사용하여 개편의 방향과 기준을 보다 객관적이고 합리적으로 수립하여 교육과정명세서에 대한 명확한 논리적 근거를 확보하고 있어야 과정이수형 자격제도에 효율적으로 동참할 수 있을 것이다.
1994년 가을 한국을 방문하였을 때 놀란 것 온 도시 근교에 숲과 같이 세워진 고층 아파트 단지와 그 수요의 배경이 된 서울, 수원을 비롯한 수도권의 인구 집중이었다. 이러한 인구 집중을 가져온 것은 바로 제2차, 3차 산업의 발달이었다. 그 이후 6년만인 2000년 3월에 다시 농촌과 농촌지도사업의 변화 동향을 살펴보기 위하여 농가 방문, 도 농업기술원 및 시
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.