농어촌 보건지소 진료실적과 관련요인
Factors Related to the Medical Service Performance of Rural Health Sub-centers
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본 연구는 농어촌 보건지소에서 수행하는 진료실적에 영향을 미치는 관련 요인을 파악하여 향후 보건지소 기능을 활성화할 수 있는 방안을 마련하고자 하였다. 연구의 분석단위는 읍․면 지역에 위치한 보건지소이며, 2009년 12월 31일 현재 설치․운영 중인 1,242개소를 대상으로 하였다. 보건지소간 진료실적의 차이는 지역간 인구의 차이를 보정한인구당 진료실적을 산출하여 분석하였다. 그 결과 보건지소 진료실적은 관할지역 내 민간 병․의원과 보건진료소가 없는 경우, 보건지소에서 보건소 및 가장 가까운 응급의료기관까지거리가 먼 경우, 65세 이상 인구 비율이 높을수록 유의하게 많았다. 반면 0-4세 인구 비율과 공중보건의사 인턴 수료자 배치 유무는 유의한 영향요인이 되지 못하였다. 이상의 결과를 보면 읍․면에 소재한 보건지소의 진료실적은 관할지역 인구와 보건의료환경 특성에 의해 유의한 영향을 받고 있어 이러한 특성을 바탕으로 하여 차별화된 서비스 제공전략을마련할 필요가 있겠다.
Abstract
Objectives: This study was conducted to identify factors that affect medical service performance in rural health sub-centers and to develop a method to improve health sub-center performance that takes advantage of these insights. Methods: This study included 1,242 South Korean health sub-centers that had been in operation at least since December 31, 2009 as units of analysis. After adjusting for population differences between areas, the performance of medical service among health sub-centers was analyzed according to medical services performed per person. We performed t-tests, ANOVA, Scheffe's tests and multiple regression analyses. Results: The following were significant variables affecting the medical service performance of rural health sub-centers: number of hospitals and clinics, presence of community health practitioner posts, distance from health sub-centers to main public health centers, distance from health sub-centers to the nearest emergency medical facilities, and proportion of the local population aged 65 and over. In contrast, the proportion of the local population between ages 0-4 and the placement of public health doctors that had already completed their internship were not significant variables. Conclusions: The medical service performance of health sub-centers located in rural areas is significantly affected by local population and health care environment characteristics, and therefore, it is imperative to develop strategies to provide differentiated service based on these factors.
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