병원의 위원회제도에 관한 연구 : 서울시내 대학병원을 중심으로

Abstract

[한글]

대학병원의 위원회 운영실태 및 관리인식을 파악하여 문제점 및 개선방안을 제시하기 위해서 1995년 10월에 서울시내에 위치한 12개 대학병원의 위원회 간사 138명를 대상으로 설문조사를 실시, 분석하였으며 다음과 같은 결과를 얻었다.

1. 위원회 설치배경에 대해 병원의 합리적 결정을 도모하기 위하여 위원회가 설치되었다고 응답한 대상자가 109명(78.99%), 병원표준화심사를 준비하기 위해 설치된 경우가 17명(12.32%), 행정기관의 지침에 의한 경우가 12명(8.70%)이었으며 위원회 종류별로 통계학적인 차이는 없었다.

2. 위원회 운영사항을 보면 위원장은 대부분 진료직(115명, 83.3%)이며 위원회 종류별로 직종간 차이가 있었다. 위원구성도 진료직 인원이 월등히 많았으나 위원회 종류별 차이는 통계학적으로 유의하지 않았다. 위원회가 규정상 연간 개최해야 하는 회수에 대해

실제운영율을 보면 진료관련 위원회가 90.15%로 가장 높았으며, 일반관리 위원회 87.27%, 교육연구관련 위원회가 78.83%였다. 또한 위원회는 관련규정을 대부분 갖고 있었으며 규정유무는 위원회 종류별로 통계학적인 차이가 있었다.

3. 위원회의 유용성과 성과에 대한 인식은 대체로 낮게 평가하였으나 문제점에 대한 인식은 비교적 높았다. 위원회의 유용성에서 진료위원회는 공정한 업무, 교육연구관련 위원회는 조정통합, 일반관리 위원회는 공정한 업무를 다른 항목보다 높게 평가하였다. 위원회의 문제점에서 진료관련 위원회는 위원자격 부적절(평균 3.90)과 유명무실(평균 3.57), 교육연구관련 위원회는 위원자격 부적절(평균 3.76)과 병원장의 인식부족(평균 3.58)을

문제점으로 인식하고 있었다.

4. 위원회의 운영성과와 관련된 요인을 분석한 결과 사무행정직이 의료전문직보다, 과장이상 직급이 계장이하 직급보다 운영성과에 대해 긍정적으로 인식하였으며, 진료관련 위원회보다는 일반관리 위원회에서 운영성과에 대해 긍정적이었다. 위원회의 유용성으로서 효율적인 업무집행에 대한 인식정도, 위원회의 문제점으로서 책임 불명확에 대한 인식정도와 유명무실에 대한 인식정도가 위원회의 운영성과와 유의한 관련성을 보였다. 또한 2차모형에서 유용성은 통계학적으로 유의한 양의 관계가 있었으며, 문제점은 통계학적으로 유의한 음의 관계가 있었다.

5. 위원회의 운영의 개선방안으로 관리자는 병원장 또는 최고경영자의 관심이 가장 중요하다고 인식하고 있으며, 위원회의 목적과 기능, 회의 진행절차 등에 대한 명백한 규정이 필요하다고 응답하였다.

A Study on the committees of University Hospitals in Seoul

Kang Young Lee

The graduate school of health science and management Yonsei University

Directed by Professor Myoung Sei Sohn, M.D.)

This study was made to identify problems and to present the direction of reform

relating to the working status and operating conditions of the committees of

university hospitals by surveying 138 working-level administration managers of

committees from 12 university hospitals in Seoul in October, 1995. The results were

as follows:

1. For the purpose of the committees, 109 respondents(78.99%) replied that

committees were installed for the reasonable decision making in the hospitals, 17

respondents(12.32%) for Hospital Standardization Inspection, and 12(8.70%) to meet

the administrational instructions. There were no statistical differences among

committees.

2. For the jobs of chairmen, majority were doctors(83.3%, 115 committees),

administrators in 703%(10), technicians and nurses in 4.4%(6) and no responses in

5.1%(7). doctors also comprised larger portion of committee members than others,

recording 8.02 doctors in medical care-related committees, 8.15 in education and

research-related ones, and 7.2 in general management committees.

3. The number of meeting required to be held in a year is in 8.25 times in case

of general management committees, 5.18 times in medical care-related committees and

4.44 times in education and research-related committees. In practice, general

management committees were held 7.20 times a year, medical care-related committees

4.67 times, and education and research-related committees 2.92 times, showing the

operation ratio of 87.27%, 90.15% and 78.83% respectively. By regulations, the

numbers of meetings to be held in a year showed differences by committees, but

there were no significant differences in practical operation ratios.

4. Most of committees surveyed made related regulations and reported the results

of their meeting to the superintendent of their hospitals in written document. The

existence of regulations by committees did not show any statistically significant

differences.

5. More doctors other than other fields' members thought the medical care-related

committees are useful. The usefulness of education and research-related committees

are highly regarded by the members from medical technician, while the general

management committees by the members from administration field personnels.

6. The committees members form administration fields showed in depth recognition

on the problems of medical care-, education and research-reated committees, but not

having any statistical meanings. Problems of general management committees are more

highly recognized by the medical technician committee members.

7. The results of the medical care-related committee operation were highly

regarded by doctors while that of education and research-related committees were by

medical thchnicians, showing statistically significant differences between jobs of

the respondents. In case of general management committee, the members from

administration fields gave better evaluation to the result of committee operation

than those from other fields, making statistical significant.

8. Most of the respondents answered that the concern of hospital superintendent

or top manager about committees were the most important factors for the improvement

of committee system at hospitals. They also replied that regulations on the

objectives, functions and procedures of meeting of committees were essential.

This study fails in identifying the differences by the characteristics of

hospitals and utilizing the organizational characteristics and variations to

measure the results of committees because the survey is limited tho the 12

university hospitals located in Seoul.

Further studies on the organizational characteristics and operation results whic

include general hospitals in various areas are required.

[영문]

This study was made to identify problems and to present the direction of reform relating to the working status and operating conditions of the committees of university hospitals by surveying 138 working-level administration managers of committees from 12 university hospitals in Seoul in October, 1995. The results were

as follows:

1. For the purpose of the committees, 109 respondents(78.99%) replied that committees were installed for the reasonable decision making in the hospitals, 17 respondents(12.32%) for Hospital Standardization Inspection, and 12(8.70%) to meet

the administrational instructions. There were no statistical differences among committees.

2. For the jobs of chairmen, majority were doctors(83.3%, 115 committees), administrators in 703%(10), technicians and nurses in 4.4%(6) and no responses in 5.1%(7). doctors also comprised larger portion of committee members than others, recording 8.02 doctors in medical care-related committees, 8.15 in education and

research-related ones, and 7.2 in general management committees.

3. The number of meeting required to be held in a year is in 8.25 times in case of general management committees, 5.18 times in medical care-related committees and 4.44 times in education and research-related committees. In practice, general management committees were held 7.20 times a year, medical care-related committees 4.67 times, and education and research-related committees 2.92 times, showing the operation ratio of 87.27%, 90.15% and 78.83% respectively. By regulations, the numbers of meetings to be held in a year showed differences by committees, but there were no significant differences in practical operation ratios.

4. Most of committees surveyed made related regulations and reported the results of their meeting to the superintendent of their hospitals in written document. The existence of regulations by committees did not show any statistically significant differences.

5. More doctors other than other fields' members thought the medical care-related committees are useful. The usefulness of education and research-related committees are highly regarded by the members from medical technician, while the general management committees by the members from administration field personnels.

6. The committees members form administration fields showed in depth recognition on the problems of medical care-, education and research-reated committees, but not having any statistical meanings. Problems of general management committees are more

highly recognized by the medical technician committee members.

7. The results of the medical care-related committee operation were highly regarded by doctors while that of education and research-related committees were by medical thchnicians, showing statistically significant differences between jobs of the respondents. In case of general management committee, the members from administration fields gave better evaluation to the result of committee operation than those from other fields, making statistical significant.

8. Most of the respondents answered that the concern of hospital superintendent or top manager about committees were the most important factors for the improvement of committee system at hospitals. They also replied that regulations on the objectives, functions and procedures of meeting of committees were essential.

This study fails in identifying the differences by the characteristics of hospitals and utilizing the organizational characteristics and variations to measure the results of committees because the survey is limited tho the 12 university hospitals located in Seoul.

Further studies on the organizational characteristics and operation results whic include general hospitals in various areas are required.