지역사회 기반 조직을 이용한 지역사회역량의 측정과 건강증진 기획

정민수(Minsoo Jung),길진표(Jin-Pyo Gil),조병희(Byong-Hee Cho) 한국보건교육건강증진학회 2009 보건교육건강증진학회지 Vol.26 No.3

Objectives: The community network is a foundation laid by the local community which has been formed historically and geographically to develop itself. This paper as a Korean way of healthy network survey for the community capacity building is an exploratory research to grasp the character of Korean society and then to organize an resident-governing partnership for that. Methods: Research objectives are CBOs(Community-Based Organizations) in S-district of Seoul. This region is a new town, however the solidarity and volunteerism of this resident is lively. The survey tool is Cho's CBOs Evaluation Questionnaire which was originated to measure the community capacity. The period of survey is from the January 2009 to the March 2009 and the study organizations which were collected by snowball sampling were 80. Results: The result shows two main networks: one is the civil society and craft union cluster, the other is welfare organization cluster. Groups of high centrality were organizations whose members are mainly women and craft organizations which were organized before 1990's. The group of high betweenness was the Association of Women's Organizations(0.188). Bi-components were six and they could be divided by organization's aim. In terms of the determinants of the participation to the health center enterprise, only the number of link(B=-0.60, p<0.04) was statistically significant. It means that when organization variables are controlled a tendency appears: the more the voluntary associations network, the less participation in the health enterprise. Conclusion: CBHOs(Community-Based Health Organizations) enhances residents' spontaneity and cohesion to increase the capability of the local community. If the surveyed healthy network, together the community health project, are used for various community development projects, the existing CBOs including CBHOs will be reorganized and furthered newly. For this it will be needed to construct an effective partnership of healthy network by restructuring the existing networks of voluntary associations.

韓國 醫療體系의 葛藤構造分析

趙炳熙(Byong Hee Cho) 계명대학교 산학연구소 1990 經營經濟 Vol.23 No.1

한국 의사의 전문직업성과 의료지배구조의 변화

조병희(Byong-Hee Cho) 한국보건사회학회 2019 보건과 사회과학 Vol.0 No.51

한국의 의사는 서구의 의사와 달리 의료기관을 소유하면서 성장해왔다. 전문지식의 소유에다가 의료 생산수단까지 소유하고 통제하게 됨으로써 의사들은 의료체계에 대한 확고한 지배구조를 확립했었다. 그런데 1990년 국민건강보험제도가 전국민에게 적용되었고, 이어서 의료시장이 급성장하고 뒤이어서 대형병원들이 설립되어 의료시장을 독과점하게 되면서 의사의 지배에는 심각한 위기가 발생하였다. 대형병원은 집중하는 환자 치료를 위하여 일종의 조립식 치료방식을 개발함으로써 의사의 노동강도를 크게 높인 관계로 의사들은 과로와 소진, 환자와의 교감 제한, 불법적인 진료 권한 위임 등이 발생하였고, 중소병원들은 환자의 부족으로 어려움을 겪게 되었다. 의사들은 자신들의 어려움이 초래된 원인을 병원보다는 낮은 의료수가 때문으로 인식하여 정부를 상대로 불만을 제기해 왔다. 환자들은 의사의 진료에 대체로 만족하는 것으로 보이지만 의사 폭행 등 불안정한 모습을 동시에 보인다. 결국 의료시장의 확대와 기술의 발전으로 의료의 영향력은 커지고 있으나 의사의 의료지배구조는 매우 취약해진 것으로 볼 수 있다. Unlike Western countries, in Korea, doctors established the solid medical dominance over the health care system by owning hospitals and clinics as well as learning highly professional medical knowledge by the 1980s. However, the situation has changed when the government introduced the national health insurance and the big hospitals has been built during the 1990s, which shared the large portion of the health care market. Since a lot of patients were gathered, big hospitals has developed a kind of assembling line of treatment. Doctors became overworked and exhausted. Their communication with patients were limited. Their rights were forced to transfer to nurses, as showed in PA. Small hospitals faced with the shortage of patients. However, doctors thought that the fundamental cause of their hardship were due to low level of health insurance cost, not to big hospitals. Patients showed the positive attitude for the health care services. However, frequently happening violence against doctors implies the lowering trust for doctors. In conclusion, doctors came to lose their dominance in the health care system, even if heath care are getting influential more than before.

건강보험료 체납자에 대한 급여제한 사전통지제도의 효과성 분석

조병희 ( Byong Hee Cho ),유태균 ( Tae Kyun Yoo ),윤성원 ( Seong Won Yun ) 한국사회복지연구회 2013 사회복지연구 Vol.44 No.3

One of the challenging tasks of the National Health Insurance Corporation(NHIC). the only public insurance institution administrating the Korea’s compulsory national health insurance(NHI) system, is to make those NHI beneficiaries who fail to make a scheduled monthly premium payment to pay. For this purpose, the NHIC has been using a measure known as ‘Benefit Limit Measure(BLM)’ in which those who miss premium payment for six or more month’s in total are classified as ‘late payer’ and are sent warnings and late payer status notices. If the late payers fail to make a full payment of missed premiums even after receiving the written notices, the NHIC can order a temporary seizure of the late payer’s property until all missed premiums plus interest are paid. Recently, the BLM has been criticized by the public of its cruel nature, and its effectiveness has been questioned because no empirical evidence has been collected. In this study, the authors using the NHIC data set attempted to analyze the effectiveness of the BLM. Those late payers for whom the BLM was administered were compared to those not in terms of the likelihood of paying missed premium payments with a series of logistic regression analyses models. Data analyses results showed that the likelihood of paying one or more month’s unpaid premium of the former group was 14 to 46 times higher than the latter. It, however, was also found that the BLM was only effective to make no more than 12% of the late payers to pay at all. Based on the study findings, the authors made a few recommendations regarding the BLM.

미얀마 농촌지역 보건서비스 개발을 위한 수요조사 실행과 3대 지체요인의 분석

조병희(Byong-Hee Cho),민상희(Sang-Hee Min),손애리(Aeree Sohn) 서울대학교 보건환경연구소 2015 보건학논집 Vol.52 No.1

Objectives: This paper aims to set the priority of health programs and to analyze the so called “3 delays barriers inherent in such programs. Methods: A questionnaire was developed to evaluate the size of health problems in rural Myanmar and the effects of new health programs to be implemented, with the consultations of .Korean community health professors and the health bureau of the Myanmar local government. NIBP(needs impact based planning) was applied for 23 local health practitioners to set the priority of health programs. 3 delays barriers were asked in depth to key informants among local health practitioners. Results: The 1st priority programs were the supports to under 5 clinic, construction of birth room, innovation of facilities of health center, computerization of health administration, provision of safe water. The next priority programs were expansion of health education, NCD management, strengthening of the function of auxiliary midwife and community health worker. The low priority was put on the programs such as health fair and nutrition for adolescents. Among the barriers, weak health perceptions of the rural people were not so severe issue. Rather, poverty, humble transportation condition, and low quality of health services of health centers were more important factors lowering the use of health services. Conclusion: Rural health practitioners in Myanmar wanted the supports to upgrade the health care facilities such as under 5 clinics, birth rooms, and health centers. But group discussions made change to some degree their opinions toward improving rural residents’ health behaviors instead of upgrading their own services. Thus, group discussion could be useful in need assessment in addition to formal NIBP method.

생의학과 한의학의 사회적 관계

조병희(Byong-hee Cho) 한국의철학회 2006 의철학연구 Vol.2 No.-

지역사회 중심 건강증진의 과거와 현재

조병희(Byong-Hee Cho) 한국보건교육건강증진학회 2010 보건교육건강증진학회지 Vol.27 No.4

Objectives: This paper aims at addressing the importance of community-based health promotion. It would identify the origin of community health programs in Korea, which emphasized community involvement. And it would reveal the discontinuity of community-oriented health programs in the current health promotion activities. Finally, the methods of attaining community-based health promotion would be suggested. Results and Conclusion: Community-based health promotion had been implemented in rural areas by medical schools in the 1970s and 1980s, which emphasized the role of village health workers. But their roles has disappeared since the government-initiated health promotion policies and programs have been implemented in the mid-1990s. This paper addressed the factors contributing to this discontinuity, such as the expansion of heath insurance system, the change of health care discourses, the monopoly of resources for health promotion by government, and the bureaucratic approach to health promotion, etc. This paper suggested the utilization of voluntary and civic organizations in community for realizing the goal of community-based health promotion.

중소기업 근로자의 건강의식과 건강행동에 관한 연구

조병희(Cho Byong-Hee) 계명대학교 사회과학연구소 1996 한국사회과학연구 Vol.15 No.-

의료보험제도의 실시와 의료체계의 변화

趙炳熙(Cho Byong-Hee) 계명대학교 사회과학연구소 1993 한국사회과학연구 Vol.12 No.-

김대중 정부의 의료정책의 성과와 과제

조병희 ( Byong Hee Cho ) 민주사회정책연구원 2001 민주사회와 정책연구 Vol.1 No.-

Kim Dae Jung government has promoted health care reform by implementing such two policies as the integration of health insurance associations and the separation of prescription and preparation of medicines. These policies aimed at increasing equity, efficiency and public participation in the health policy making process. These were the first attempt for health reform in Korea. However, these policies were limited by their narrow scope, insufficient funds, and weak intergovernmental cooperation. By integrating health insurance associations, it was possible to levy the equitable premiums among workers and among the self-employed. However, the equity between workers and the self-employed was not achieved, due to the failure of identifying reasonable sources of income and property of the latter. The separation policy focused on dividing the roles of doctors and pharmacists and removing the drug margin occurring in trading medicines between pharmaceutical firms and hospitals/doctors. However, doctors opposed to this policy strongly and the government changed the contents of the separation policy substantially, resulting in the withdrawal of reform. The chance for public participation was also reduced because of the same reason.