• 한국사회복지학
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• 제61권3호
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• pp.77-101
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• 2009

본 연구는 노인돌보미바우처 정책집행분석 사례연구로 일선 집행현장에서 바우처 논리인 소비자 선택과 제공자 경쟁이 실현되는지, 어떤 양상으로 실현되는지 분석하였다. 서울시 ${\bigcirc}{\bigcirc}$ 구를 조사지역으로 선정하여 4개 제공기관과 돌보미, 일선공무원, 이용자를 대상으로 일선집행과정을, 그리고 보건복지가족부, 사회서비스관리센터 등의 정책관련자들을 대상으로 정책설계와 운영을 조사하였다. 총 39명에 대한 심층인터뷰와 참여관찰이 수행되었다. 연구 결과, 노인돌보미바우처 집행 일선에서는 정책설계에서 가정한 바우처 이용자의 제공기관 선택과 제공기관의 경쟁은 실현되고 있지 않았다. 일선공무원은 공급자지원방식에서와 마찬가지의 관행으로 이용자명단을 기관에 전달하고 제공기관은 '제공기관회의'를 구성하여 이용자를 나누고 있었다. 하지만, 이용자의 선택은 다양한 차원에서 이루어지고 있었으며 제공기관과 돌보미는 서비스 제공에서 이용자 중심성을 실현하는 방식으로 변화를 보이고 있었다.

• 한국사회복지학
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• 제39권
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• pp.157-179
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• 1999

이 연구는 사적 소득이전이 우리나라의 빈곤율을 어느 정도 낮추며, 소득계층별로 사적 소득이전에 의한 빈곤감소 효과가 어떻게 차이가 있는지를 실증적으로 분석하고자 하였다. 이 연구는 1996년, 1997년, 1998년 도시가계조사 원자료와, 한국보건사회연구원과 한국노동연구원이 1998년도에 조사한 실업가구조사 원자료를 분석자료로 이용하였다. 분석결과 다음과 같은 사실들을 발견할 수 있었다. 첫째, 우리나라의 사적 이전은 공공복지와는 비교가 안될 정도로 큰 규모를 형성하고 있는 것으로 밝혀졌다. 도시근로자 가구, 실업가구 모두에서 사적 이전소득 수혜율이 공적 이전소득 수혜율 보다 휠씬 높았고, 이전소득의 절대량도 사적 이전이 공적 이전보다 더 큰 것으로 분석되었다. 둘째, 사적 이전에 의한 빈곤감소 효과는 그다지 크지 않은 것으로 분석되었다. 도시근로자 가구 전체를 대상으로 할 때, 사적 이전의 빈곤감소율은 $10{\sim}11%$ 정도이고, 실업가구 전체를 대상으로 할 경우 빈곤감소율은 3% 내외에 불과했다. 셋째, 사적 이전은 극빈층의 빈곤감소에는 거의 기여하지 못하는 것으로 분석되었다. 도시근로자 가구 전체를 대상으로 할 때, 사적 이전은 극빈층이라고 할 수 있는 하위 5% 계층의 빈곤율을 전혀 하락시키지 못했고, 실업가구를 대상으로 할 경우에도 소득이 전혀 없거나 매우 적은 가구들인 하위 40% 이하 계층의 빈곤율을 겨우 $0.6{\sim}0.7%$ 포인트 정도밖에 떨어뜨리지 못하는 것으로 나타났다. 넷째, 사적 이전이 극빈층의 빈곤감소에는 거의 기여하지 못하지만, 극빈층이 현재의 생활을 유지하는 데는 매우 중요한 것으로 밝혀졌다. 도시근로자 가구를 대상으로 할때, 사적 이전소득을 수혜하는 하위 5% 계층의 경우 경상소득 대비 사적 이전소득의 비율이 25.6%에 이르며, 실업가구들에서 사적 이전소득이 있는 하위 20%계층의 경우소득 대비 사적 이전소득의 비율이 1이며, 하위 $21{\sim}40%$ 계층의 경우에도 그 비율은 52%에 달한다.

• 보건행정학회지
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• 제19권1호
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• pp.1-30
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• 2009

Korean medical fee contract system between the insurer and healthproviders was introduced in 2000. However, a continuous discord among contracting parties concerned and an irrational operation of an arbitration committee of Ministry for Health, Welfare and Family Affairs (MIHWAF) have made it difficult for them to reach to an agreement over last 8 years. The purpose of this study is to observe the current problems of contract system from the view of health insurance law and actual examples. Furthermore, I examined the of breakdown of negotiation by analyzing the eligibility of contracting parties, rationality of Resource Based Relative Value System (RBRVS) and contracting method and fairness of arbitration method in case of negotiation rupture. The results were as follows: First, since the introduction of medical fee contract system, there has been a problem in that both the president of National Health Insurance Corporation (NHIC) and health care provider association have not held strong negotiation power. Second, the frequent changes and notifications of Relative Value Units (RVUs) without any mutual consent between the insurer and provider association negatively have influenced the conversion factors and finally hindered the agreement of contract. Third, a current process that the conversion factors are mediated and determined at the arbitration committee of MIHWAF in the case of contract breakdown between contracting parties has some flaw in that the irrational composition of committee provoked the lack of fairness and objectivity of mediation. Fourth, we can not prospect a satisfactory outcome of arbitration committee because the mediation always has failed to proceed smoothly due to boycott of both committee members from insurer and providers over last 8 years. As a result, we have to make an every effort to resolve problems mentioned above and then dream of an advanced national health insurance system.

• Nutrition Research and Practice
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• 제4권1호
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• pp.51-57
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• 2010

We performed this study to examine lifestyle patterns and dietary behavior based on the level of Internet addiction of Korean adolescents. Data were collected from 853 Korean junior high school students. The level of Internet addiction was determined based on the Korean Internet addiction self-scale short form for youth, and students were classified as high-risk Internet users, potential-risk Internet users, and no risk Internet users. The associations between the students' levels of Internet addiction and lifestyle patterns and dietary behavior were analyzed using a chi-square test. Irregular bedtimes and the use of alcohol and tobacco were higher in high-risk Internet users than no risk Internet users. Moreover, in high-risk Internet users, irregular dietary behavior due to the loss of appetite, a high frequency of skipping meals, and snacking might cause imbalances in nutritional intake. Diet quality in high-risk Internet users was also worse than in potential-risk Internet users and no risk Internet users. We demonstrated in this study that high-risk Internet users have inappropriate dietary behavior and poor diet quality, which could result in stunted growth and development. Therefore, nutrition education targeting high-risk Internet users should be conducted to ensure proper growth and development.

• 농촌의학ㆍ지역보건
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• 제19권2호
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• pp.159-173
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• 1994

Since the establishment of health centers in the 1960s, the centers have been played an important role in providing basic health care for the people. Although the health centers made a great effect to prevent diseases and promote the health status of the people for the last three decades, the function of health centers should be strengthened to meet the health care need of individual, family and community. Over the last ten years, there have been great changes and developments in health related environments, such as population size and age, rapid urbanization, up-grading of the educational level, increase of income, health care demand for promotive health care measures and practical measures for chronic diseases and also practicing healthy life. According to the great changes in health related environments, the health centers should be reformed. The following policy options are recommended as a summary; First, the function of health centers should be converted from providing basic health services into promotive and preventive health care services, to meet changing needs of people. Second, the health center personnel should be reinforced for their competency to provide a qualitative services to people and also the operation of health center should be reactivated. Third, a close linkage of health centers with the private sector is an essential requirement for the operation of the health care delivery system within a health district in order to improve the health status of people. Fourth, type of manpower mix, scope of organization and health care program should be varied, based on the health care needs of people, geographical characteristics and size of population etc. Fifth, a comprehensive health care delivery system should be developed, for maintaining healthy life style of people and also the health and welfare services should be integrated in order n ensure an effective service.

• 대한지역사회영양학회지
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• 제14권2호
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• pp.147-157
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• 2009

The purpose of this study was to find out the information on nutrition labeling and how many calories and nutrients the high school students consumed for 1 day from cookies. A total of 74 male and female high school students in Suwon were surveyed and 56 cookies that they consumed were examined. Background data were collected by questionnaire, cookie intake by 24-hr recall, and the calories and nutrients content in cookies and the amount of intake by nutrition information on the wrapping paper of cookie. The statistical analysis for the data was done by SPSS 12.0. Energy contents in 1 serving size of cookie were $90{\sim}315\;kcal$, average of 170 kcal. The protein contents were $0{\sim}7\;g$, fat $2{\sim}20\;g$, cholesterol $0{\sim}55\;mg$, and sodium $30{\sim}390\;mg$ in 1 serving size of cookie. Most of the cookies(80%) examined contained no trans fat at all, which is desirable. Among the types of cookies, snacks contained higher quantities of calories and sodium, the pie contained more sugar and cholesterol, and the biscuit had more trans fat. One fourth of the cookies examined belonged to 'high calorie, low nutritious food' according to the criteria proposed by The Ministry for Health, Welfare and Family Affairs. Thus the excessive intake of cookies might result in nutritional imbalance. There were large differences in calorie intake among students, from zero who did not intake any cookies at all to maximum 818 kcal/day, an average of 75 kcal/day. When the students who did not intake cookies were excluded, energy 205 kcal. fat 10 g, sodium 177 mg were consumed from the cookie for a 1 day on average.

• 의료법학
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• 제10권1호
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• pp.171-211
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• 2009

Because Korea has the excellent informational technology, it was expected to be able to improve the accessibility to healthcare and compete with other nations in excellence through u-Healthcare. But we can't complete the excellent u-Healthcare because of the law to be able to use only the tele-counselling between doctor to doctor or doctor to nurse. First of all, we must complete the law to be able to use the improved u-Health containing of telemedicine between doctor to patient. Though other factors, the procurement of safe IT, the credibility to healthcare service provider containing of nutritionist and occupational therapist etc. are prepared for erecting u-Healthcare, we can get the final and decisive u-Health policy only by means of Law for supporting u-Healthcare's Activation. The important sections of Law for supporting u-Healthcare's Activation are as follows. Sec. 4 The Minister for Health, Welfare and Family Affairs and the dean of associated administrative division have to erect the combined plan for u-Healthcare's Activation. Sec. 11 Government and local autonomous entity can support the facility and equipment to be necessitated for using u-Healthcare to improve the medical accessibility of person in the region with poor medicine. Sec. 13 Doctor can support other doctor's medical action through IT and if there are not medical risk, doctor can give medical act directly to the special patients. Sec. 21 If pharmaceuticals is necessitated in u-Healthcare, remote doctor has to send the patient the electronic prescription and the pharmaceutist to receive the electronic prescription has to delivery the pharmaceuticals in accordance with patient's demand.

• 의료법학
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• 제11권1호
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• pp.173-198
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• 2010

There is a system in Korea named "Advanced Practice Nurse System" qualified by the Minister of Health, Welfare and Family Affairs for Advanced Practice Nurse besides nurse licence. Medical practice is, in today's medical law, understood as a general concept colligating medical practice, nursing practice and midwife practice and so on, for it is defined as a deed of medical technique practiced by medical personnel. Referring to the fact that the Supreme Court recognizes medical personnel as people who have medical expert knowledge, nursing practice can be recognized as a region of medical business and therefore it is not necessary to prescribe nursing practice separately from the definition of medical practice on a precedent, because nurse belongs to medical personnel. According to the precedent regarding 'Unlicensed Medical Practice of Advanced Practice Nurse for Anesthesia' recently sentenced by the Supreme Court, the medical practice is only allowed a doctor because it is 'in need of special knowledge and experience because of high danger on human body' and it is judged to be an unlicensed medical practice prohibited in medical law if it is to be done by a nurse. When considering the actual situation that System for Advanced Practice Nurse for Anesthesia is established under the circumstance that an anesthetist is in want and therefore the operation has not been performed on time, and that it is being expected an anesthetist to be in need, it is necessary to legislate for the range of medical practice of Advanced Practice Nurse so that Advanced Practice Nurse System can be practically legalized, for the role of Advanced Practice Nurse has the great possibility of shrinking because the precedent has considered Advanced Practice Nurse for Anesthesia doing anesthetic operation in clinic today as a potential wrongdoer.

• 한국안광학회지
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• 제15권1호
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• pp.9-17
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• 2010

목적: 본 논문에서는 증가되는 안경광학과 입학정원의 문제점과 안경사의 수요공급에 대하여 연구하였다. 방법: 교육통계, 보건복지백서, 대학 알리미, 대학의 홈페이지를 통하여 자료를 수집하였다. 결과: 안경광학과의 모집정원을 이용하여 수요와 공급 등을 예측하였다. 결론: 현재 배출된 안경사의 수는 과잉공급이다. 안경사의 과잉 공급은 안경사의 근로여건 악화와 직무만족도 저하 유발하고 따라서 그리고 잦은 이직과 타 직종으로의 전업을 발생시킨다. 이러한 문제점을 해결하기 위해서는 정확한 자료의 조사가 필요하며 안경사 유관 기관들은 결집하여 정부의 인력정책수립에 대응해야 한다. 그리고 안경사의 직무영역 확대, 질적 수준 향상, 근로여건 개선 등은 안경광학과 학제의 통일과 입학정원의 축소를 용하여 이뤄질 수 있다.

• 한국융합학회논문지
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• 제10권1호
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• pp.257-264
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• 2019

본 논문은 1인가구, 부부가구, 부부와 자녀로 이루어진 가구 노인들의 성공적 노후 수준을 확인하고, 각 가구유형별로 성공적 노후에 영향을 미치는 요인이 무엇인가를 집단별로 비교, 분석하여 노인들의 성공적 노후를 위한 정책 및 프로그램 개발의 기초자료로 활용함에 그 목적이 있다. 이를 위해 국민노후보장패널조사 제4차 개인용 조사와 부가조사 자료를 활용하였으며, 1인가구 699명, 부부가구 1,412명, 부부와 자녀로 구성된 가구 238명이 분석에 활용되었다. 분석 결과, 성공적 노후 수준은 1인가구가 부부가구와 부부와 자녀로 구성된 가구에 비해 낮은 것으로 나타났다. 성공적 노후에 영향을 미치는 요인을 파악하기 위해 다중회귀분석하여 비교한 결과, 1인가구의 경우 경제활동, 경제적 독립, 집안일, 이웃관계, 가족관계, 자녀관계가 통계적으로 유의하였다. 부부가구의 경우 경제적 독립, 신체적 건강, 친구관계, 자녀관계가 성공적 노후에 유의한 영향력을 보였다. 마지막으로 부부와 자녀가구는 신체적 건강과 친구관계가 성공적 노후에 유의한 요인으로 확인되었다.