지역보건의료계획에 대한 보건소 직원의 참여도, 활용도, 평가인식

Abstract

[한글]본 연구는 지역보건의료계획에 대한 보건소 직원의 참여도와 활용도, 평가에 대한 인식정도를 분석하여 향후 지역보건의료계획 작성에 대한 보건소 직원의 인식과 참여와 활용을 높이기 위한 기초 자료를 제공하고자 시도되었다.연구대상은 서울시 25개 보건소의 보건소장과 기능직을 제외한 일반직 전직원 1,755명을 대상으로 하였으며, 자료수집은 보건소 지역보건의료계획 담당자에게 연구목적을 설명한 후 질문지를 우편 발송하여 인편 또는 우편으로 회수하고, 최종 1,434부를 분석에 사용하였다.본 연구의 결과를 요약하면 다음과 같다.1) 대상자의 84.1%가 지역보건의료계획이 필요하다고 인식하고 있었으며 20.9%가 지역보건의료계획에 참여한 경험이 있었다고 응답하였다. 지침내용에서는 지역현황과 전망, 지역보건의료기관과의 기능분담 및 발전방향, 지역보건의료와 사회복지사업과의 연계성 확보 순으로 중요하다고 인식하고 있었다.2) 지역보건의료심의위원회 운영에 대한 인지율은 60.0%였으며, 지역보건의료계획 관심도는 63.1%로 나타났다.3) 지역보건의료계획의 업무 활용성에 대한 평균점수는 5점 만점에 3.30점 이었으며, 가장 활용도가 높은 분야는 단위사업별 목표설정 및 평가 3.53점, 보건사업 방향설정 3.50점 순으로 나타났으며 전반적으로 보통수준의 활용도를 나타냈다.4) 지역보건의료계획 평가 인식 분석에서는 보건소 직원의 평가 인지도는 59.3%였으며. 평가 참여율은 19.2%, 평가 필요성은 59.5%, 평가에 대한 부담감은 63.5%로 나타났다.5) 지역보건의료계획 수립의 가장 큰 문제점은 인력 및 예산부족이 44.0%, 담당자의 전문지식 부족 17.8%, 보건소 직원의 인식부족 16.0%순이었으며, 지역보건의료계획의 개선방안으로는 인력 및 예산 확보가 39.3%, 기획전담부서 확보 21.4%, 직원교육확대 20.4% 순으로 나타났다.결론적으로 보건소 직원의 지역보건의료계획에 대한 필요도는 높으나 참여도는 매우 낮았으며 활용도는 보통수준으로 나타났고, 직원의 관련교육 참여율도 저조한 실정으로 나타났다. 또한 지역보건의료계획의 평가에 대한 인지도와 평가에 대한 참여도는 매우 낮고 평가에 대한 부담감은 높은 것으로 나타났다. 한편 지역보건의료계획 수립의 문제점과 개선방안에서는 인력 및 예산확보가 가장 우선순위로 나타나고 있는바, 참여도를 높이기 위한 전략으로 기획 전담부서 확보와 관련교육 확대, 전문인력 확보, 기획능력 배양을 강화해야하며 국가나 시·도 차원에서 예산지원이 병행되어야한다. 또한 평가에 대한 인식을 높이기 위한 전략으로는 평가 결과에 대한 인센티브나 포상제 도입, 전문인력 확보와 교육 기회 확대, 직원들의 인식개선 등이 강화 되어야 할 것으로 보인다.

[영문]This study was intended to provide basic materials for enhancing the understanding, participation and utilization of employees in the public health center concerning the framing of the future regional healthcare plan. For this purpose, it attempted to analyze an understanding of the participation, utilization and evaluation of employees in the public health center on the regional healthcare plan.The questionnaire research was conducted for the directors of 25 public health centers and all the employees of general service except technical service in Seoul. The questionnaire was posted after explaining the purpose of study to the person in charge of the regional healthcare plan of the public health center and returned by person and by mail. 1,434 questionnaires were used for final analysis. As a result, the following findings were obtained:1) 84.1% of the respondents were aware of the need for the regional healthcare plan and 20.9% of them responded that they had the experience of participating in the regional healthcare planning. They understood the importance of the contents of the guideline for it in orders of the present situation and prospect of the district, the sharing of functions with the regional healthcare institutions and the direction of its development, the establishment of linkage between the regional healthcare and the social welfare work.2) It was found that 60.0% of the respondents recognized the operation of the regional healthcare deliberation committee, and 63.1% were interested in the regional healthcare planning.3) It was found that the respondents had the average score of 3.30 points on the utilization of the regional healthcare planning in practices, of 3.53 points on the setting and evaluation of the goal by unit business and of 3.50 points on the setting of direction for the health project.4) The result of analysis on the understanding of the regional healthcare planning showed that 59.3% of the responding public health center employees understood their evaluation. And it was found that their rate of participation in evaluation was 19.2%, their need for evaluation was 59.5% and the burden of evaluation was 63.5%.5) The greatest problem in formulating the regional healthcare planning included the lack of manpower and budgets(44.0), the lack of expertise by the person in charge(17.8%), and the lack of awareness by public health center employees(16.0%). And it was found that improvements of the regional healthcare planning included establishment of manpower and budgets(39.3%), the establishment of the department in charge of planning(21.4%) and the expansion of employee education(20.4%).In conclusion, it was found that employees in the public health center had the high need for the regional healthcare planning but the very low participation in it, the moderate level of its utilization and the low rate of participation in related employee education. In addition, it was found that the respondents had the very low level of understanding on and participation in the evaluation of the regional healthcare planning but the high burden of its evaluation.On the one hand, it was found that the securing of manpower and budgets was the highest priority in relation to the problem in the formulation of the regional healthcare planning and its improvements. Strategies for enhancing the level of participation in the regional healthcare planning included the establishment of the department in charge of planning and the expansion of related education, the securing of professional manpower, the reinforced cultivation of the planning capacity and the support of budgets by both central and local government. And strategies for raising the understanding on the evaluation of the regional healthcare planning included the introduction of the incentive and reward system related to the outcome of evaluation, the securing of professional manpower and the expansion of educational opportunity and the improvement of employees'' understanding and the like.