• 지역사회간호학회지
• /
• 제6권1호
• /
• pp.5-33
• /
• 1995

The objective of the study are two-fold: one is to explore the relationship between environment, organizational structure, and organizational effectiveness of public health centers in Korea, and the other is to examine the validity of contingency theory for improving the organizational structure of public health care agencies, with special emphasis on public health nursing administration. Accordingly, the conceptual model of the study consisted of three different concepts: environment, organizational structure, and organizational effectiveness, which were built up from the contingency theory. Data were collected during the period from 1st of May through 30th of June, 1990. From the total of 249 health centers in the country, one hundred and five centers were sampled non proportionally, according to the geopolitical distribution. Out of 105, 73 health centers responded to mailed questionnaire. The health centers were the unit of the study, and a various statistical analysis techniques were used: Reliability analysis(Cronbach's Alpha) for 4 measurement tools; Shapiro-Wilk statistic for normality test of measured scores of 6 variables: ANOVA, Pearson Correlaion analysis, regressional analysis, and canonical correlation analysis for the test of the relationships and differences between the variables. The results were. as follows : 1. No significant differences between forma lization, decision-making authority and environmental complexity were found(F=1.383, P=.24 ; F=.801, P=.37). 2. Negative relationships between formalization and decision-making authority for both urban and rural health centers were found(r=-.470, P=.002 ; r=-.348, P=.46). 3. No significant relationship between formalization and job satisfaction for both urban and rural health centers were found (r=-.242, P=.132, r=-.060, P=.739). 4. Significant positive relationship between decision - making authority and job satisfaction were found in urban health centers (r=.504, P=.0009), but no such relationship was observed in rural health centers. Regression coefficient between them was statistically significant($\beta=1.535$, P=.0002), and accuracy of regression line was accepted (W=.975, P= .420). 5. No significant relationships among formalization and family planning services, maternal health services, and tuberculosis control services for both urban and rural health centers were found. 6. Among decision-making authority and family planning services, maternal health services, and tuberculosis control services, significant positive relationship was found between de cision-making authority and family planning services(r=.286, P=.73). 7. A significant difference was found in maternal health services by the type of health centers (F=5.13, P=.026) but no difference was found in tuberculosis control services by the type of health centers, formalization, and decision-making authority. 8. A significant positive relationships were found between family planning services and maternal health services and tuberculosis control services, and between maternal health services and tuberculosis control services (r=-.499, P=.001 ; r=.457, P=.004 ; r=.495, P=.002) in case of urban health centers. In case of rural health centers, relationships between family planning services and tuberculosis control services, and between maternal health services and tuberculosis control services were statistically significant (r=.534, P=.002 ; r=.389, P=.027). No significant relationship was found between family planning and maternal health services. 9. A significant positive canonical correlation was found between the group of independent variables consisted of formalization and de cision-making authority and the group of dependent variables consisted of family planning services, maternal health services and tuberculosis control services(Rc=.455, P=.02). In case of urban health centers, no significant canonical correlation was found between them, but significant canoncial correlation was found in rural health centers(Rc=.578, P=.069), 10. Relationships between job satisfaction and health care productivity was not found significant. Through these results, the assumed relationship between environment and organizational structure was not supported in health centers. Therefore, the relationship between the organizational effectiveness and the congruence between environment and organizational structure that contingency theory proposes to exist was not able to be tested. However decision-making authority was found as an important variable of organizational structure affecting family planning services and job satisfaction in urban health centers. Thus it was suggested that decentralized decision making among health professionals would be a valuable strategy for improvement of organizational effectiveness in public health centers. It is also recommended that further studies to test contingency theory would use variability and uncertainty to define environment of public health centers instead of complexity.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
• /
• 제12권2호
• /
• pp.51-58
• /
• 2006

This study is about the Spatial Composition and Area Distribution in the Urban Health Centers. The purpose of this study is to suggest the basic direction of urban health center plans which has urban characters according to the changes of public health systems and environments. The methods of this research was executed by surveys of documents and plans and field observations. The targets of this study are public health centers that have been constructed since 2000 and are constructing until now and investigated this facilities.

• 보건행정학회지
• /
• 제4권1호
• /
• pp.1-24
• /
• 1994

Recently, two main changes were observed in relation to activities of District Health Centers. One is the rapid increase in the quantity and variety of people's demands for health services due to improvement of income level and the other is an introduction of autonomy in local administration. Unitl recently, the District Health Services were mostly depended on the instructions and orders given by Central Governments, and it would be necessary to prepare for the future implementation of autonomous local administration. Especially, the urban health centers may need more attention than those in rural areas because of their complexity and it would be more difficult in choosing and implementing a most suitable health programs for urban communities. This study was made to find out a feasibl developmental model which could be applicable for the urban bealth centers in Kyeongnam- do area. The most studies relating to health centers activities in the past were made by saking questions to current health center workers, but this study has made an effort to find out the opinions of those who are representing the people in the community. For this study, therefore, the Members of Gity Parliament and Village Headmen from 10 cities is Kyeongnam- do were interviewed for the study and the results obtained were compared to those of health officers. It was found that both Parliament Members and Village Headmen were well aware of the need of health centers, however, they tend to put lower priority for health services in compare with other community activities, and pointed out poor quality of services and lack of public understanding as the problems to be overcome. As to the desirable body for policy decision and implementation of health programs, the Members of Local Parliament think the Local Parliament as ideal, where as Village Headmen prefer health experts, and health officenr prefer District Health Center respectively. The most urgent problems of the District health Centers are mentioned as lack of health manpower. As the results of his study, the followings are suggested for improvement of District Health Services; First : reinforcement of professional health workers, Second : establishment of Community Health Council, Third : strengthening of public health education and support, Fourth : flexibility in Local Autonomy and target system relating to health activities.

• 보건행정학회지
• /
• 제9권3호
• /
• pp.113-128
• /
• 1999

This study was designed to analyze the status of government policy on the computerization of health centers throughout the country and to identify the factors affecting a successful implementation of the information system. As expected, age and commitment of health center director, computer budgets, user training, and technical supports from the information specialists were the important factors influencing the successful implementation of the system. Compared with the urban health centers, fewer rural health centers installed the system perhaps due to lack budgets and the urban-oriented system features. Moreover, the systems were unevenly distributed according to the geographic regions. Some strategies for successful dissemination of the systems were also suggested.

• 보건행정학회지
• /
• 제8권1호
• /
• pp.52-96
• /
• 1998

To find causal factors and improvement plans of organizational commitment of public servants in urban health centers, a hypothetical causal model, which included 2 endogenous variables(organizational commitment & organizational satisfaction) and 15 exogenous variables, was constructed. Exogenous variables consisted of individual factors (sex, age, education, job-grade, and annual salary), psychological variables(pride for organization, extrinsic motivation, intrinsic motivation and support of supervisor) ad structural variables(formalization, centralization, communication, job-conflict, job-decision, and workload). In the hypothetical causal model, organizational commitment was supposed to be effect variable, and organizational satisfaction was presumed to be intervening variable to mediate between organizational commitment and exogenous variables. For data collection, cross-sectional self-administered questionnaire survey was conducted to 1,295 public servants from 32 urban health centers nationwide. The survey responses were from 934, 72.1% of subjects. But 756 responses(58.4%) were analyzed because of excluding ones with missing values. The hypothetical causal model was fitted by covariance structural analysis with maximum likelihood method. Main results were as follows: (1) The fitted causal model accounted for 33 and 55 percent of total variance of organizational commitment and organizational satisfaction of public servants, respectively. (2) In order of effect size, pride for organization, supervisor support, communication, extrinsic motivation and centralization had an indirect effect effect on organizational commitment through organizational satisfaction. However, the effect of centralization was negative. (3) Pride for organiztion, intrinsic motivation, organizational satisfaction, job-conflict, supervisor support, communication, age, centralization, annual salar and extrinsic motivation had indirect or direct effects on organizational commitment in order of effect size. Among them, effects of job-conflict and centraldization were negative. In conclusion, these results suggested that organizational commitment of public servants in urban health centers could be enhanced by pride for organization, intrinsic and extrinsic motivations, prevention of job-conflict and excess centralization, supervisor support and active communication. Especially, pride for organization and intrinsic motivation were expected to play the most important role.

• 농촌의학ㆍ지역보건
• /
• 제33권3호
• /
• pp.292-302
• /
• 2008

- Abstract - Objectives: The purpose of this paper is to determine an efficient operation plan for a smoking cessation clinic in public health centers. To do so, the primary success factors in smoking cessation have been analyzed after classifying the smoking cessation programs of public health centers into urban and rural areas. Methods: A study was conducted with 262,837 smokers age 19 or older who were provided with smoking cessation services for more than 6 months through smoking cessation clinics at public health centers(250 clinics nationwide) from July 16, 2006 to July 15, 2007. Results: Urban areas indicated that gender, age, social security, the frequency of counseling, re-enrollment in the program, the number of cigarettes per day and alcohol problems were all factors that influenced the success of smoking cessation. On the other hand, in the rural areas the total number of counseling, re-enrollment in the program, the number of cigarettes per day and alcohol problems were the influential factors. Furthermore, the urban area confirmed that the frequency of counseling, re-enrollment in the program, the number of cigarettes per day and alcohol problems affected traveling while the rural area was affected by social security, the frequency of counseling and re-enrollment. Conclusions: It has been confirmed that the success rate and factors of smoking cessation clinics can vary depending on the region and enrollment method.

• 한국보건간호학회지
• /
• 제13권1호
• /
• pp.77-87
• /
• 1999

Poverty directly affects health and well-being, The poor population has a higher rate of chronics illness. higher infant morbidity and motality rates. shorter life expectancy. more complex health problems. and greater physical limitations resulting from chronic disease. In order to activate primary health care for the poverty in urban area the following measures should be taken : 1. Health center must be expended or establish subhealth center. 2. Health center must monitor neighbour's workplace's health management for their working population. 3. Health centers must do active home visiting nursing care for the urban-poor. 4. Health center must carry out flexible problem-centered practice according to the area. 5. For the urban-poor's health care must have organization of the health center & practice according to community's characteristics. 6. Public health care must be closely connected with welfare. 7. For the health care of the urban-poor must demand active community participation. 8. Health center is closely connected with Community hospital. 9. Active management of public health resource system is demanded.

• 보건행정학회지
• /
• 제21권3호
• /
• pp.349-364
• /
• 2011

Objectives : The purpose of this study was to evaluate the relationship between new-building of rural public health centers and the outpatient medical utilization. Methods : The study subjects were 141 public health centers in rural area. The data were collected from 1995 to 2001, medical utilization and local population, healthcare resources, and economic characteristics were included. In order to evaluate new-building effects, we performed paired t-tests and multivariate regression analyses. Results : The following variables are significant affecting the medical utilization of rural public health centers: urban side location of public health centers(p<0.05), pre- and post-IMF economic crisis(p<0.001), number of medical aid recipients(p<0.01), number of private clinics(p<0.05), workers of public health centers(p<0.001), financial independent level of local governments(p<0.001). In contrast, the existence of new-building and number of the aged 65 and over were not significant variables. Conclusions : We could not find out the positive relationship between the existence of new-building and the volume of medical utilization in rural public health centers. In particular the medical utilization of rural public health centers is significantly affected by IMF economic recession and number of the poor strata, the economically depressed area.

• 농촌의학ㆍ지역보건
• /
• 제22권2호
• /
• pp.225-237
• /
• 1997

This study was conducted to the cognition and attitude for internal and external organizational behavior of health centers staff. An analytical model employed in this study was developed by modifying 'organizational behavior model'. Data was collected a mail survey of officers at health center, including 66 directors and 1,768 staffs of the health centers in southern region. The major findings are as follows : Among directors of the health centers 47% of them stated that legislators and chief executive officer(CEO) of local governments are highly concerned about the public health program. However only 15.2% of health center directors reported that legislators and CEO put public health high priority. For leadership type of directors 39.0% of them was classified as controller, 30.3% as participant, 22.7% entertaining and 7.6% comprehending. Regarding sociopsychological characteristics of the health center staffs, about a quarter of them had high degree of group cohesion, while 10.7% had low degree. Those staffs who are older, high educational level, or working in the rural health centers showed higher degree of cohesion than those who are young, low educational level, or working in urban health center. A third of them were less likely to be satisfied by what they are doing at the health centers. The higher educational level, the likely to be satisfied by what they are doing at the health centers. The higher educational level, the more satisfied with their job. Considering these results, policy implication was discussed and suggested. It is suggested that educational efforts be made to improve leadership of the health center directors and concern with public health program by the CEOs and legislators of local governments.

• 가족자원경영과 정책
• /
• 제15권4호
• /
• pp.43-64
• /
• 2011

This study suggests policies to rearrange the status of Health Family Support Centers, targeting hands-on workers and centering on collected problems and improvements. To attain this aim, the study rearranged the materials investigated in 2009. On this basis, the study suggests the following policies. First, Health Family Support Centers changed into Korean Institute Healthy family which could prepare a means for opinion convergence through base organizations. Thus, it is necessary to establish a Gyeonggi-do wide area Health Family Support Center. Second, space and human resource arrangement, suitable to business, are necessary, and so are stable, secure finances. Third, urban areas, agricultural villages, and fishing villages are distributed across Gyeonggi-do. Thus, the development of specialized business, suitable to Gyeonggi-do, is necessary. Consequently, this study suggests executing obligatory family education (education for engaged couples, education for parents). Fourth, case management models, unique to Health Family Support Centers, have to be developed, as well as unified services related to education, counseling, and cultural businesses. Fifth, the Health Family Support Center has to secure its own status as a hub organization of inter-regional family businesses, has to strengthen its organizational identity, and has to promote suitable business development.