공공보건의료체계의 개선방안에 관한 연구

Abstract

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.