韓國 大學 保健機構 規定에 대한 內容分析

신재연 건양대학교 보건복지대학원 2008 국내석사

본 연구는 2008년 현재 한국교육개발원에 등록되어 있는 전국 4년제 대학 및 전문대학 414개 대학교를 대상으로 방송통신대학, 사내대학을 제외한 380개 대학교 중 통합되거나 캠퍼스를 제외한 351개 대학을 대상으로 각 대학 규정을 인터넷 및 전화, 설문조사를 통하여 수집된 자료를 조사․분석한 후, 빈도 및 백분율을 사용한 기술적 분석을 이용하여 얻은 결과로 다음과 같다. 1. 대학보건기구설치와 관련하여, 전체 351개교 중 221개교에 대학보건기구가 설치되어 있었으며, 보건기구의 명칭에 대해 보건소(15.4%), 보건진료소(35.3%)로 50.7%에 해당하는 112개교에서 이용, 기타(49.3%) 건강증진센터, 의무실, 양호실 등 그 명칭이 통일되지 않았다. 2. 학교 내 행정기관에서의 위치로는 대부분 산하기구(학생복지처) 및 부속기관으로 소속되어 있었으며, 복지시설로 분류되어 있는 학교도 38개교로 17.2%나 되었다. 3. 각 대학보건기구의 규정유무를 확인해본 결과 오직 72개교(32.9%)만이 규정이 있었으며, 147개교(67.15)는 요람 및 운영지침을 기준으로 운영을 하고 있음을 살펴볼 수 있었다. 4. 규정에 명시되어 있는 것과는 달리 보건기구 내 인원은 대학병원이 있는 대학을 제외한 대부분의 대학이 간호사만을 두고 있었으며, 기타 촉탁의사제도를 활용하고 있는 대학도 있었다. 5. 보건기구에서 제공하는 보건서비스는 진료위주로 업무진행을 하고 있었으며, 환경위생, 건강관리, 응급처치, 신체검사, 보건교육, 약품관리, 상담, 예방 등으로 정리해볼 수 있었는데, 이는 현 법령에서 정하고 있는 보건교사의 직무에서 크게 벗어나지 않음을 정리해볼 수 있겠다. 6. 보건기구 운영경비는 주로 학교예산 및 기타수입에 의존하고 있었으며, 학생 및 교직원 보건비, 보조금, 기성회비, 기타수입금 순으로 운영경비를 충당하고 있었다. 7. 수당지급과 관련하여서는 규정 상 명시되어 있는 것처럼 촉탁의사, 진료부장, 보건부장등에게 수당이 지급되도록 하고 있었다. 연구결과 나타난 문제점을 해결하기 위해서는 대학교의 학교보건조직의 체계적이고 효율적인 운영을 위한 관련 규정 및 지침이 마련되어야 하고, 전문인력이 배치되어야 하며, 특히 학생보건관리에서도 각 대학이 일관성 있는 활동을 수행해야 할 것이다.

一部 國軍兵士의 口腔保健 知識, 態度 및 實踐에 관한 調査硏究

윤준호 建陽大學校 保健福祉大學院 2005 국내석사

본 연구는 2004년 6∼7월 까지 장병들의 구강 보건에 대한 지식, 태도 및 실천을 파악하고 상호 연관성 조사를 목적으로 춘천지역 군부대 근무중인 국군병사 300명을 단면조사 연구 하였다. 구강보건 지식, 태도 및 실천은 고소영(1999)의 도구를 수정 보완한 설문지를 사용하여 조사하였다. 수집된 자료는 SPSS WIN 10.0 프로그램을 이용하여 빈도, 평균, 표준편차, t-test, one-way ANOVA, 피어슨 상관계수, 다중회귀 분석등으로 분석하였다. 본 연구의 주요결과는 다음과 같다 대상자의 구강보건 지식정도는 100점 환산시 평균 61.25점, 구강보건 태도정도는 평균 65.3점, 구강보건 행동은 평균 53점으로 구강보건에 관한 대상자들의 지식, 태도, 실천정도는 높지않은 것으로 조사되었다. 대상자의 연령, 학력과 구강보건지식, 태도, 실천간에는 유의한 차이를 보이며 연령이 높을 수록(22세 이상) 행동이 적극적이었고(p < 0.05), 고졸보다는 대재이상이 지식이 높고(p < 0.01), 태도가 긍정적이며(p < 0.01) 실천행동이 높은 것으로(p < 0.05)나타났다. 또한 음주, 흡연 또한 구강보건 태도에서 유의한 차이를 보였다. 구강보건 요구도 면에서는 구강검진 및 치료가 꼭 필요하다고 대상자의 70.3%가 답하였고, 구강검진 주기에 대하여는 6개월에 한번이 47.9%, 3개월(29.8%), 1년단위(18.2%)의 순으로 나타났다. 연구대상자의 일반적 특성과 구강보건지식, 태도 및 실천의 상관관계에서는 학력과 태도, 지식, 실천행동간에는 약한 양적 상관관계를 보였고, 지식과 태도는(p < 0.001) 중간수준의 양적 상관관계를, 지식과 실천(p < 0.001), 태도와 실천간(p < 0.001)에는 약한 양적 상관관계를 보여 구강보건에 관한 지식과 태도와 행동간에는 서로 관련이 있는 것으로 나타났다. 구강보건 지식, 태도 및 실천과 관련된 영향을 미치는 요인들을 알아보기 위해 다중회귀분석을 실시한 결과 구강보건 지식에 대해 유의한 영향을 주는 변수는 학력(p = 0.002)인 것으로 나타났으며, 구강보건 태도에 유의한 영향을 보이는 독립변수는 지식(p < 0.001)과 연령(p = 0.022)등으로 나타났다. 그리고 구강보건 실천에 대한 유의한 영향을 미친 요인은 태도(p = 0.001)등 이었다. 이상의 연구결과에 의하면 학교 교육에서부터 구강보건 교육은 실시되어야 하며 특히, 군입대시 전문적인 교육과 군생활간 보완 교육을 실시함으로써 구강보건 지식, 태도 및 실천이 향상 될 것으로 조사되었다. 군의무담당자가 구강보건 교육을 실시할 때 장병에게 단순히 지식을 전달하기보다는 태도 및 실천행동의 변화까지 유발하는 실천적인 실습교육과 계속적인 반복교육으로 구강관리 습관을 함양할 수 있도록 해야한다. This study was conducted to identify actual dental care status, levels of know ledge, attitudes and practice of dental health in some military personnel and analyze the related factor the levels of knowledge, attitudes, practice of dental health for 300 soldiers from June to July, 2004. The data was collected through a structured questionnaire and analyzed into frequency, percentage, mean, standard devioation, t-test, one-way ANOVA and Pearson's correlation analysis by SPSS 10.0 program. The main results of this study were summarized as follows ; The level of knowledge, attitudes, practice of dental health was found to (when convert to 100 points) mean score 61.25 points in knowledge, 65.3 points in attitudes and 53 points in behavior, therefore the soldiers are not active to the knowledge, the attitude, behavior of dental health care. The age and educational level of soldiers were statistically significant in the knowledge, attitude, and behavior of dental health(p<0.01). The older group id the more active in the behavior of dental health. In the educational level, compare to the graduators of the high school, the soldiers who educated in the college above were the more affirmative in the attitude, the better in the behavior, the more in the knowledge of dental health. And the variable of the drinking and smoking were statistically significant in the attitude of the dental health. In the aspect of the need of dental health service, the examination and treatment of dental health service were essentially needed 70.3%, a period of the examination of dental health service was needed once in 6 Month(47.9%), 3 Month(29.8%), 1 Month(18.2%). The relationships of between the knowledge, attitude, and behavior about dental health and general characteristics showed educational level in weak level of positive correlations. And there sult of correlation among knowledge, attitude and behavior was found knowledge and attitude id moderate level of positive correlation(p < 0.001)) in knowledge and weak level of positive correlation in knowledge and behavior(p < 0.001) attitude and behavior(p < 0.001). The multiple entered regression results related each variable to behaviors of dental health, the knowledge is significant affecting to school career, the attitude is significant affecting to knowledge and age, the behavior is significant affecting to attitude. According to the result of the study, the education of the dental health care should be performed from the begining of the school education. Especially, It was founded that the knowledge, attitude and practice of dental health will improve by conducting of the professional education of the dental health care when starting military service and continuous education during the whole time in military service. When the health care provided educated the military personnel, then we should educate the practical performance causing the change of attitude and behavior, compared to just give then the simple knowledge of dental health care. And we should give them the repeated education continually and having the good habit of the dental health care.

大田市 K大學病院 從事者들의 口腔保健 認知度 및 敎育에 대한 要求度 調査

정재관 建陽大學校 保健福祉大學院 2007 국내석사

This study was conducted to provide educational programs to improve realistic oral health by surveying and researching the recognition of health care workers as well as organize healthy hospital. So questionnaire survey was conducted for 254 workers in K university hospital, Taejeon City and the results of it was as follows. 1. There were more people who thought that their oral state was healthy than those who thought that it was not. Especially, compared with those who were engaged in other occupation, those who were engaged in administration thought that their own oral state was not healthy, which was highest. 2. Compared with those who were engaged in other occupation, it appeared that medical technicians and those who were engaged in administration suffered difficulty in a work place and restraint of activity because of oral diseases, which was statistically significant. 3. As for the recognition of preventive measures of dental caries, those who were engaged in administration recognized that enforcement of fluorine application was not effective(22.7%), which was higher than those who were engaged in other occupation and statistically significant. 4. As for tooth brushing, they brushed their teeth 3 times a day, which was the most, and as for the method of tooth brushing, doctors brushed their teeth with a rotary method more than those who were engaged in other occupation, and those who were engaged in administration brushed their teeth up and down more than those who were engaged in other occupation. 5. Although most of health care workers recognized that oral health education was necessary, they had hardly had the experience of oral health education. Their intention of participation in education if it should be enforced was statistically lower than their necessity of education. 6. According to Logistic Regression Analysis of whether the oral health education by occupation was necessary or not, and whether they would participate in it or not, it was shown that the existence and nonexistence of knowledge and practice didn't affect whether the oral health education by occupation was necessary or not, and whether they would participate in it or not.

노인복지시설 종사자가 인식하는 노인 구강건강관리 중요도

김춘희 건양대학교 보건복지대학원 2014 국내석사

Objectives: This study was performed in order to offer basic data available for being conducive to an educational program of targeting workers of the elderly welfare facilities. Method: The concerned study used a convenience sampling method to select welfare facilities for the aged in Daegu, Busan, Gyeongsangnam-do and Jeollado as research participants. The survey, afterwards, was conducted from December 2011 to January 2012. SPSS 18.0 Program was used for those research data analyses such as the frequency analysis, the factor analysis, t-test, ANOVA. Result: As a result of analyzing general characteristics, 176 women(88%), 111 people(55.5%) in 30s~40s, regarding education, more than college(attending) graduation was 155(75.5%), with regard to occupation, 74 geriatric care helpers(34%) accounted for the highest percentage, as to the experience of seniors oral health training, the response of ‘Non experience' was 121 people(60.5%) which was higher than that of ‘Experience' was 79 people(39.5%). Recognition distribution of importance of oral health care for the aged were respectively responded with ‘importance' in order of items of ‘innately healthy mouth(49.5%),’ ‘oral care by specialist(48.5%),’ ‘connection between institution and dentistry(46.5%),' ‘regular visit to dentistry(44.0%),’ and ‘Intake of healthy food for oral health(38.5%).’ The item of asking ‘regular and proper toothbrushing' was high in ‘very important' with 116 people(58.0%). The analysis results, understood that the regular characteristics of the research participants would not be either statistically or significantly concerned with how the workers in the welfare facilities for the aged see the importance of the seniors' oral health care. Conclusion: In that regard, the necessity of the oral care education program development for all those workers in the welfare facilities for the aged should be recognized now while the welfare facilities for the aged are recommended to take a positive attitude towards improving of the dental health of the aged via dental health care education.

地方自治團體 保健所 豫算 持出水準의 決定要因

박삼영 건양대학교 보건복지대학원 2012 국내석사

이 연구는 지방자치단체의 총예산지출에서 보건의료예산 지출비율을 결정하는 관련요인을 분석하여 효율적인 보건의료 예산 배정에 기여할 수 있도록 기초자료를 제공하는 것이다. 연구 대상은 기초자치단체의 보건의료예산 수준을 연구대상으로 총 230개 기초지방자치단체를 전국의 75개 시, 86개 군, 69개 자치구로 대상을 구분하여 3년간 보건의료예산 지출 비율을 대상으로 실시하였다. 수집된 자료는 SPSS 18.0을 이용하여 독립변수(기초생활수급권자비율, 실업률, 노인인구비율, 인구수, 산업화비율, 재정자립도, 보건소인력비율, 자살사망률, 뇌혈관질환사망률, 심장질환사망률)와 종속변수(보건의료예산 지출비율)의 일반적 특성과 기술통계로 평균과 표준편차를 구하였고, 지역에 따른 변수의 특성과 요인에 대하여 상관분석을 실시하였으며, 마지막으로 연도별 종속변수를 가지고 다중회귀분석과 연도별 시·군·구에 따른 다중회귀분석을 실시하였다.

大學生의 性格有形에 따른 肥滿度, 攝食態度 및 肥滿스트레스에 관한 硏究

김선경 건양대학교 보건복지대학원 2010 국내석사

I investigated 285 undergraduate students in Daejeon to know their BMI, eating attitude and obesity stress according to undergraduates' personality types. To measure the personality types of the students, I used the TABP developed by Haynes(1978) on Framingham Heart Study. Next, I used BMI to measure the degree of obesity. For obesity stress, I used the Body Attitude Questionnaire (BAQ) developed by Ben-Tovim and Walker(1991). Finally, I used the Eating Attitude Test (EAT26), which was developed and revised by Garner and Garfinkel(1979) in order to find out the student's eating manner. The results are as follows: 1. The BMI difference, according to the personality types (A-type, B type) of the undergraduates was not shown. 2. The difference of eating attitude, according to the personality types (A-type, B type) of the college students, was not shown. 3. The difference of stress related obesity, according to the personality types (A-type, B type) of the college students, was not shown. 4. As a result of analyzing the factors, the factors influenced on the eating attitude and obesity stress with logistic analysis on eating attitude and obesity stress. The difference, according to the personality types, was not shown. For my research, I had expected there to be a difference in the degree of obesity, the eating attitude, and the obesity stress, according to the personality types of the college students. However, this research's results did not show any difference. I concluded that there was no relation among BMI, the eating attitude, and the obesity stress. So far, there has been no research done the relation between innate personality and obesity. I expect to consider about personality types accomplished in the treatment of obesity related diseases through more researches in the future with the obesity related nutrition education and of sanitation education. 본 연구는 대학생의 성격유형에 따른 비만도, 섭식태도 및 비만스트레스를 알아보기 위해 2009년 11월 2일~ 11월 19일까지 대전지역 일개대학 대학생을 대상으로 설문지를 배포하여 총 285부의 유효부수를 조사에 활용하였다. 각 문항에 대한 빈도분석 와 백분율, 교차분석을 이용하였고, 집단간 차이에 대한 유의성 검증을 위해 카이제곱 과 로지스틱 분석을 통해 다음과 같은 결론을 얻었다. 1. 대학생의 성격유형(A형,B형)에 따른 BMI는 카이제곱 분석을 한 결과 조대상자의 일반적 특성 통계적으로 유의하지 않아서, 성격유형에 따른 BMI 차이를 나타내지 않았다. 2. 대학생의 성격유형(A형,B형)에 따른 섭식태도는 카이제곱 분석을 한 결과 조대상자의 일반적 특성 통계적으로 유의하지 않아서, 성격유형에 따른 섭식태도의 차이를 나타내지 않았다. 3. 대학생의 성격유형(A형,B형)에 따른 비만 관련 스트레스는 카이제곱 분석을 한 결과 조대상자의 일반적 특성 통계적으로 유의하지 않아서, 성격유형에 따른 비만스트레스는 차이를 나타내지 않았다. 4. 섭식태도와 비만스트레스에 영향을 미치는 요인을 로지스틱 분석한 결과 각각에 성격유형에 따른 차이를 나타내지 않았다. 본 논문은 대학생의 성격유형에 따른 비만도, 섭식태도, 비만스트레스에 차이가 있을것으로 예상하였으나, 연구결과 별 다른 차이를 보이지 않아 비만도, 섭식태도, 비만스트레스는 성격유형과 무관한 것으로 나타났다. 이상의 결과에서 볼때 대학생의 성격유형과 비만도, 섭식태도, 비만스트레스는 무관한 것으로 판단되어 진다. 선천적인 성격유형과 비만과의 관계에 대한 다각적인 선행연구가 전무한 실정이므로 앞으로 보다 많은 연구를 통해 비만관련 영양 교육 및 보건교육, 나아가 비만관련 치료시 성격유형에 대한 고려가 이루어지기를 기대한다.

保健診療所에 登錄된 高血壓患者의 順應度 硏究

차선숙 建陽大學校 保健福祉大學院 2005 국내석사

This study was investigated to evaluate the compliance of hypertensive patientsits related factors registered at Primary Health Care Post(PHCP). 304 patients were interviewed by trained nursing students in June, 2004. The questionnaire included general characteristics, knowledge of hypertension, health education experience, constructs of health belief model, self efficacy and so on. In this study compliance group was defined as "having regularly medication and good life style". Good life style included regular exercise, non-smoking, little alcohol, low salt diet and weight control. The results were as following : 1. In compliance group 90.3% of male and 93.3% of female were regularly taking hypertensive medicine, but 45.2% of male and 56.4% of female were having regularly medication and good life style. 2. In both man and woman, the group of higher education were more compliance group, but were statistically significant only in man(p<0.05) 3. In woman, the compliance group have significantly higher score in knowledge of hypertension(p<0.05). The compliance group have significantly higher self-efficacy score in both man and woman (p<0.05) 4. In health belief model, susceptibility and benefit were statistically significant in man, and seriousness, benefit and barrier in woman(p<0.05). 5. In multiple logistic regression analysis, education level, self efficacy in man and knowledge of hypertension, self-efficacy, benefit in woman were revealed as statistically significant variables(p<0.05). In conclusion, it is very important to evaluate and modification life-style adding to having regularly medication in hypertensive patients registered at PHCP. To do this, Health education programs about benefit to compliance (eg. complication prevention) and the methods to improve self-efficacy will be developed.

옥천군 다문화여성의 건강상태, 건강행위 및 보건의료이용 실태

정진영 건양대학교 보건복지대학원 2014 국내석사

bjectives: This research is conducted to compare health status, health behaviors and health care utilization between immigrant women and local women in South Korea.Methods: Research subjects comprised of 62 immigrant women who live in Ok-cheon extracted from survey and health inspection conducted during a period from 1st of August in 2013 to 8th of November in 2013 and 214 local women who were extracted from primitive data from Korea National Health & Nutrition Examination Survey in 2011. Student t-test, Chi-square test, Mann-whitney U test, and logistic regression were conducted using SPSS18.0K program for analysis. Results: As a result of comparison between immigrant women and local women, obesity, hypertension, dyslipidemia, anemia, hepatitis B, previous history of tuberculosis, history of decayed, missing and filled teeth indicated no difference, but there were more immigrant women experienced in decayed, missing and filled teeth compared to local women (p<0.001). As a result of logistic regression which examined factors that affected decayed, missing and filled teeth, 6.28 times higher number of immigrant women were suffered from decayed, missing and filled teeth compared to a number of local women (odds ratio 6.28, 95% CI 2.34, 16.86). In addition, there is 2.4 times higher number of high school graduates had decayed, missing and filled teeth than a number of people who completed university or higher (odds ratio 2.41, 95% CI 1.21, 4.81). 3.16 times higher number of people who had low to moderate income level had decayed, missing and filled teeth than a number of people with high income level (odds ratio 3.16, 95% CI 1.42, 7.04). However, compared between two groups of women, higher numbers were found in immigrant women in a positive meaning (p<0.05) regarding health behaviours such as smoking, alcohol consumption, exercise, eating, and toothbrushing frequency. Conclusions: Immigrant women were more likely to have poor dental health conditions compared to local women. Therefore, it is necessary to put more efforts in order to solve poor dental health conditions for women.

一般成人 男性과 職業軍人의 保健意識 行態 및 醫療利用 現況 比較分析

양동현 建陽大學校 保健福祉大學院 2009 국내석사

본 연구는 일반 성인남성과 직업군인의 건강형태 및 의료이용에 대해서 비교 연구하였으며, 연구자료는 2005년도 국민건강 영양조사의 데이터 자료를 질병관리본부로부터 획득하여 분석하였고 그 결과는 다음과 같다. 1. 전체조사 대상자는 8,384명으로 21세~55세의 일반성인남성과 직업군인만을 선정하였으며, 직업군인은 76명, 일반 성인 남자는 8,308명이었다. 연령은 일반인 이 41세~50세가 2,732명(32.6%)으로 가장 높은 반면, 군인은 31세~40세가 31명(40.8%)이 가장 높게 나타났다. 교육수준에 있어서 대학 이상의 학력수준은 일반인이 3,958명(47.8%)인 반면에 군인은 52명(68.4%)로 상대적으로 높게 나타났다. 특히 의료보장의 경우는 일반인은 직장의료보험이 4,718명(57.2%)였으나, 군인은 76명(100%) 모든 인원이 직장의료보험에 가입되어 있었다. 2. 보건의식 행태 분포에서 보면 현재 흡연상태는 일반인에 비해 직업군인이 높고, 주관적 체격인식은 일반인의 경우 비만 또는 매우 비만이라 인지하는 비율이 직업군인에 비하여 높게 나타났지만, 실제로 지난 1년간 체중조절 여부는 일반인이 오히려 직업군인에 비해 높게 나타났다. 또한 직업군인의 보건의식 행태는 평균 연령(p<0.05)에서 통계적으로 유의한 차이가 있는 것으로 나타났다. 또한 평소 스트레스 정도에서는 일반인에 비해 직업군인이 높게 나타났다. 2주간 이환일수는 일반인이 3.18일로 직업군인 2.41일에 비하여 높았으며, 2주간 치료 일수에서도 일반인이 2.18로 직업군인 1.78일에 비하여 많았다. 3. 월간 침상와병일수는 직업군인이 상대적으로 높았으나 월간 결석, 결근일수는 오히려 낮게 나타났다. 더불어 월간 결석, 결근일수(p<0.05)는 통계적으로 유의한 차이를 나타났다. 또한 연간 미치료 및 치료 지연율은 일반인이 15.1%, 직업군인이 14.9%로 두 군간에 차이가 없었다. 5. 연간 입원이용율은 일반인이 높았으며, 평균 재원일수, 건당 평균 입원기간은 일반인에 비해 직업군인이 길었다. 입원이유는 일반인은 사고 및 중독이, 직업군인은 질병으로 인한 입원 이용이 많았다. 2주간 외래 이용율은 일반인이 17.2%, 직업군인이 21.6%로 직업군인의 외래이용이 많았고, 평균 외래이용횟수에서도 일반인이 1.92, 직업군인이 2.44로 직업군인이 많았다. 6. 이용한 보건의료기관의 종류에서는 일반인은 의원급이, 직업군인은 병원급의 외래이용이 많았고 2주간 약국 이용율은 직업군인이 16.2%로 일반인 22.0% 에 비하여 낮았다. 평균 약국 이용횟수는 직업군인이 1.25회로 일반인 1.45회에 비하여 낮게 나타났으며, 연간 한방이용률은 일반인에 비해 직업군인의 이용율이 높았다. 7. 연간 사고 및 중독 발생자율은 직업군인이 9.5로 일반인 7.9에 비하여 높게 나타났고, 사고 및 중독 발생횟수에서는 일반인이 직업군인에 비하여 높았다. 의도성별 분포(p<0.05), 주치료기관(p<0.05)은 통계적으로 유의한 차이가 나타났다. 본 연구를 통해 일반적 특성, 보건의식행태, 건강수준의 분석 및 일반적 특성을 보정한 상태에서 일반 성인남성과 직업군인의 보건의식 행태와 의료이용 분포를 비교 분석한 것으로 향후 직업군인의 건강 증진을 위한 효과적인 교육과 정책수립에 필요한 기초자료가 될 수 있을 것으로 기대해 본다. This study is a comparative study of general men's and career soldiers' form of health and healthcare utilization. We analyzed a national nutritional status 2005 which was obtained from the disease control center and the result is as following. 1. To compare participants(n=8,384) registered with health insurance, we have selected 76 career soldiers and 8,308 general men in the age of 21~55. Proportion of general men in 41~50 was 32.6%(n=2,732), career soldiers in the age of 31-40 were 40.8%(n=31) and it was the oldest. The education level of participants with more than a college degree, general men reported 47.8% (n=3,958), career soldiers reported 68.4%(n=51) which was comparatively higher. Especially in case of health insurance, although the general men who had health insurance that the employer provides were only 57.2%(n=4,718), the career soldiers were fully registered with health insurance(100%, n=76). 2. After investigating the distribution of healthcare awareness behavior, we found out that smoking status of soldiers was higher than general men. On the criteria the cognition of subjective physical condition, in case of general men, those who think they have obesity or severe obesity were higher than general men and an effort to weight control during the past year was rather higher than the soldiers. On the case of career soldiers' healthcare awareness behavior, we learned that participants had statistical difference in the mean age(p<0.05). Stress in ordinary times also showed higher values for soldiers than general men. The number of days contracting a disease during 2 weeks period, general men reported 3.18 days, which was higher than soldiers' 2.41 days, and even in the case of the number of days got medical treatment, general men reported 2.18 days when soldiers reported 1.78 days. 3. The monthly number of days lying sick in bed for career soldiers was relatively higher than general men, however, the monthly number of days absent was rather low and the absence rate was statistically comparable. Moreover, the annual rate of not having medical treatment or delay in medical treatment was 15.1% for career soldiers, 14.9% for general men. 4. The annual utilization of hospitalization rate was higher for general men and the mean stay in the hospital, the mean hospitalization period per case of career soldiers were rather longer than general men. Prevalent reasons for the hospitalization were; accident or addiction for general men, a dieses for soldiers. The outpatient service utilization rate during the 2 weeks period was 17.2% general men, 21.6% for soldiers that soldiers use the service more often, and also the mean number of the outpatient service utilization was 1.92 for general men, 2.44 for soldiers, more often than general men. 5. In the research for the type of healthcare center that participants have utilized, general men used doctors' office, soldiers preferred using hospital outpatient service. When analyzed the utilization rate of a pharmacy during 2 weeks period, 16.2% for the soldiers and it was lower than the rate of general men's 22.0%. The mean pharmacy utilization rate of the participants was 1.25 for soldiers and it was also lower than the rate of general men's 1.45. However, the soldiers' annual utilization rate of oriental medicine was higher than general men. 6. An annual rate of accident or addiction problem, 9.5 for soldiers, 7.9 for general men, and the number of accident or addiction problem happened, general men reported a higher value. An intentional distribution(p<0.05), major treatment center(p<0.05) showed statistical difference. Reasons for the injury were; vehicle accident and hit other person or objects for general men, and lot's of fall from high place for soldiers. Through this study, we comparatively analyzed each general characteristics, healthcare awareness behaviors, and health level of general men and career soldiers. Moreover, we tried to research healthcare awareness behavior and medical care utilization of both groups. At the end of the day, we hope that we can implement effective education and policy for the promotion of career soldiers' healthcare by using this study as a standard.

지리정보시스템(GIS)으로 분석한 대전광역시 응급의료서비스 취약지 특성

황지혜 건양대학교 보건복지대학원 2010 국내석사

본 연구는 대전광역시의 응급의료서비스 취약지를 도출하고 취약지역의 보건학적 특성 및 응급의료서비스 취약여부와의 관련성을 분석하여 응급의료 관련 정책의 의사결정에 유용한 기초자료로 제공하기 위한 연구이다. 응급의료서비스 취약지 도출은 Arc GIS의 공간분석 방법 중 가중분석(Cost Weighted distance) 방법으로 응급의료센터로부터의 접근성 분석을 하였으며, 보건학적 특성 및 응급의료서비스 취약여부와의 관련성은 SPSS 17.0을 이용하여 비모수 t-검정 및 다중회귀분석을 시행하였다. 본 연구의 주요 결과는 다음과 같다. 1. 연구지역의 응급의료기관 분포는 동구와 유성구, 대덕구는 지정된 응급의료센터가 없으나 서구와 중구는 응급의료센터가 2개소 이상 위치하고 있어 응급의료기관 분포가 편중되어 있다. 2. GIS를 활용하여 응급의료센터와의 접근성 분석을 수행한 결과, 대전광역시 자치구별 전체 면적 대비 응급의료서비스 취약지의 비율이 높은 자치구는 동구가 41.2%로 가장 높았으며, 대덕구 39.4%, 서구 29.4%, 유성구 28.3%이며, 중구 28.0% 순으로 나타났다. 3. GIS를 활용하여 행정동별 응급의료서비스 취약지를 분석한 결과, 대덕구 신탄진동, 동구 대청동과 산내동, 유성구 구즉동과 노은2동, 서구 기성동, 중구 산성동으로 나타났다. 4. 응급의료서비스 취약지 중 기성동, 대청동이 노인 인구밀도가 높게 나타났다. 5. 응급의료서비스 취약여부에 따른 보건학적 특성별 차이를 분석한 결과, 국민기초생활수급권자, 장애인등록자, 노인인구 비율의 평균은 취약지가 비취약지에 비해 높았으나 통계적으로 유의한 차이를 보이지 않았고, 농업인구 비율의 평균은 취약지가 비취약지에 비해 높았으며 통계적으로 유의한 차이를 보였다(p<0.01). 6. 응급의료서비스 취약여부를 종속변수로 하고 지역별 보건학적 특성을 독립변수로 하여 로지스틱 회귀분석을 시행한 결과, 농업인구 비율과 국민기초생활수급권자 비율이 높았으며 이는 통계적으로 유의하여 응급의료서비스 취약여부를 설명할 수 있는 변수인 것으로 나타났다. 이상의 결과를 종합하면 대전광역시 5개 자치구의 행정동 중 응급의료서비스 접근 불평등지역이 도출되었고 이러한 지역은 보건학적 특성 중 농업인구 비율과 국민기초생활수급권자의 비율이 높았으며 이는 통계적으로 유의하여 응급의료서비스 취약여부와 관련성이 있는 것으로 나타났다. 향후 효율적인 응급의료 자원 분배를 위해서는 GIS를 활용한 의사결정이 필요하며, 응급의료서비스 이용의 형평성을 증진시키기 위해서 응급의료서비스의 사각지대에 놓여있는 지역의 보건학적 특성을 고려한 정책이 시행되어야 할 것으로 사료된다. The purpose of this research is providing with useful basic data for the decision making of policies related to emergency medical service, by finding out emergency medical service vulnerable areas in Daejeon Metropolitan City and analyzing the correlation between the emergency medical service vulnerability and health care characteristic of the vulnerable areas. In finding out emergency medical service vulnerable areas, cost-weighted-distance method among Arc GIS spatial analysis methods had been used to analyze the accessibility of emergency medical service centers. For the correlation between health care characteristic and emergency medical service vulnerability, SPSS 17.0 had been used to do the nonparametric t-test and multiple regression analysis. Major results of this research are as following. 1. While East district, Yooseong district and Daedeok district do not have designated emergency medical service centers, West district and Central district have more than two emergency medical service centers. The distribution of emergency medical service centers in research-object areas in Daejeon is not balanced. 2. Accessibility analysis of emergency medical service centers using GIS showed that East district had the highest weight of emergency medical service vulnerable areas of 41.2%, compared to total district area. Daedeok district 39.4%, West district 29.4%, Yooseong district 28.3% and Central district 28.0% followed. 3. Analysis of emergency medical service vulnerable areas by district using GIS showed that Shintanjin-dong of Dae-deok district was most vulnerable. Daecheong-dong and Sannae-dong of Central district, Goojeuk-dong and Noeun-2-dong of Yooseong district, Giseong-dong of West district and Sanseong-dong of Central followed in vulnerability. 4. Among emergency medical service vulnerable areas, the elders’ population densities in Giseong-dong and Daecheong-dong were high. 5. Analysis of difference in science health characteristics in relation toemergency medical service vulnerability showed that the averages of elders’ population weight, numbers of disabled registered and numbers of people receiving support on basic living were higherthan not-vulnerable areas; however, the differences were not statistically significant. The average of farming population weight of vulnerable areas was higher than not-vulnerable areas; and the difference was statistically significant (p<0.01). 6. Logistic regression analysis result, having vulnerability of emergency medical service as dependent variable and health care characteristic by district as independent variable, showed that the weight of farming population and weight of people receiving support on basic living were high and statistically significant suggesting that they can be variables enabling the explanation of emergency medical service vulnerability. Above results revealed the accessibility-handicapped areas in emergency medical service centers among administrative unit “dongs” of five districts in Daejeon Metropolitan City. The weights of farming population and people receiving support on basic living among health care characteristic of these areas had been found as high and statistically significant, having correlation with vulnerability of emergency medical service. In order to fairly allocate emergency medical service resources hence after, it is believed that decision making using GIS would be required. Also, policies considering health care characteristics of vulnerable areas in emergency medical service should be implemented to achieve the balanced provision of emergency medical service.