공공보건의료체계의 개선방안에 관한 연구

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Public healthcare means a medical service provided to improve health of the people or community people by the government or autonomous regional governments. For most of the advanced countries, medical care is mainly provided by public health medical service centers, but in Korea, as private medical centers usually provide medical service, public health sector is only an assistant organization. However, contribution of public health center to improvement of private medical service is not insignificant. In particular, it has made a great contribution to improvement of the public health through management of infectious diseases, the mother and children health project, and the health promotion project, whose result can bot be achieved by private medical centers.
Since our country obtained financial assistance from IMF, reorganization project all over the country has presented a question on a reason of maintenance or abolition. Public medical care is not an exception. In particular, there are desperate disputes on existence of public health organizations and reorganization of management through entrusting it with private sectors.
The proportion of public health centers to the all the medical centers in our country was not more than 11.3%. Community medical centers have to provide pubic medical care and health promotion activities for community people, whose service has to be differentiated from that of private medical centers but in reality, they just have the same roles as private centers. And, as private medical centers in farming and fishing villages have deteriorated reliability and use rate due to decrease of community people population, difficulty of securing medical staff, and insufficient investment for medical facilities, their maintenance or abolition is in critical situation.
Furthermore, advanced medical equipment owned by our country whose GNP is not more than one million is world-best and 43% of women who are going to deliver babies have taken cesarean section because of unreasonable payment compensation system. As patients remarkably prefer the 3rd medical centers, step by step medical care system is in name only. The number of old people who have potential medical care demand is rapidly increasing, which is ranked the world highest. That is, medical service is in an overall crisis and the crisis is specifically visualized as the ruin of health insurance.
Therefore, this study aims to speculate the current status of Korea public health medical care system and present an improvement plan.
This study is composed of six chapters as follows: Chapter 1 presents the purpose, method and scope of the study; Chapter 2 intends a theoretical approach on public health medical service system; Chapter 3 speculates a historical development of the public health medical service system in each generation; Chapter 4 analyses the current status and problems of Korea public health medical service system; Chapter 5 presents an improvement plan of the system based on the identified problems above; finally, Chapter 6 summarizes and concludes the discussions above.
Alternative Title
A Study on the Improvement of Public Healthcare System
Alternative Author(s)
Ahn, Kyung-Sook
조선대학교 경영대학원
경영대학원 산업경제학과
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Table Of Contents
제1장 서론 = 1
제1절 연구목적 = 1
제2절 연구방법 및 범위 = 2
제2장 공공보건의료체계의 개념과 유형 = 4
제1절 보건의료와 보건의료서비스의 개념 = 4
1. 보건의료의 개념 = 4
2. 보건의료서비스의 개념 = 5
제2절 공공보건의료체계 = 6
1. 개념 및 구성요소 = 6
2. 하부구성요소 = 9
3. 공공보건의료체계의 유형 = 11
제3장 공공보건의료체계의 발전과정 = 13
제1절 공공보건의료체계의 역사적 발전과정 = 13
1. 고대기(기원전-서기 500년) = 13
2. 중세기(500년-1500년) = 13
3. 문예부흥기(1500년-1760년) = 14
4. 여명기(1760년-1850년) = 14
5. 확립기(1850년-1900년) = 15
6. 발전기(1900년-현재) = 15
제2절 우리나라 공공보건의료체계의 발전과정 = 16
1. 근대적 보건의료 태동기(1885년-1910년) = 16
2. 일본통치시대(1910년-1945년) = 17
3. 대한민국 수립초기(1945년-1977년) = 18
4. 의료보험 성숙기(1977년-2000년) = 20
5. 국민건강증진기(2000년-현재) = 22
제4장 공공보건의료체계의 현황과 문제점 = 24
제1절 보건의료조직의 현황 = 24
1. 공공보건의료조직 = 24
2. 민간보건의료조직 = 26
3. 보건관계 국제조직 = 29
제2절 공공보건의료체계의 현황 = 31
1. 주요 기관 = 34
2. 보건행정조직 및 관련 타부처 행정조직 = 38
3. 보건의료예산 = 39
4. 보건의료전달체계 = 41
제3절 공공보건의료체계의 문제점 = 42
1. 공공보건의료체계의 목표 설정의 미흡 = 42
2. 각 공공보건의료기관의 기능의 불명확 = 43
3. 행정체계의 혼선과 비효율, 조정능력의 미흡 = 44
4. 공공보건의료기관 운영의 비효율 = 44
5. 공공보건의료기관 평가의 비합리성 = 45
제5장 공공보건의료체계의 개선방안 = 46
제1절 공공보건의료의 중요성 인식 = 46
1. 공공보건의료의 역할 제고 = 46
2. 공공보건의료의 실질적인 중요성 인식 = 46
제2절 국가적 체계적인 전략수립 필요 = 48
1. 중앙단위 전략 = 50
2. 광역단위 전략 = 51
3. 기초단위 전략 = 52
제3절 기타 = 52
1. 공공보건의료 예산의 확충 = 52
2. 보건의료 인력, 시설 및 조직의 확충 = 54
3. 공공보건의료 평가체계의 개발 = 54
4. 보건소에서 강화하여야 할 사업 = 55
제6장 요약 및 결론 = 55
참고문헌 = 58
조선대학교 경영대학원
안경숙. (2004). 공공보건의료체계의 개선방안에 관한 연구.
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