보건의료체계에 대한 지역주민의 태도와 관련요인에 관한 연구 : 제주시민을 대상으로 = Public Attitude toward National Health Care System in Cheju City

다국어 초록 (Multilingual Abstract)

Over the several decades, along with the economic development in Korea, there has been a series of rapid changes in health policies by which the current health care system has been shaped. Such changes or reforms, however, were largely a response to cost containment, productivity and/or equity concerns. But, it seems also crucial to analyze the views of the public since health reforms increasingly aim at meeting citizens' needs properly.
This paper provides an in-depth analysis of an opinion survey, conducted in Cheju city in 1998, on citizens' views on the national health care system and spending. The findings of the survey were based on self-administered questionnaires. Finally analyzed sample sizes are 732 with 60.5% responded to the survey, in which the initial sample sizes were to systematically represent Cheju citizens(2% of households). The multiple logistic regression and other descriptive analyses were made using the SAS?? system. The key results from the study are as follows:
1. When the citizens were asked about their satisfaction with national health care system, 30% of the respondents expressed their satisfaction with the system. The single most responsible for the high dissatisfaction with the system was health insurance(HI) factor. People dissatisfied with HI were likely to dissatisfy with the system by 17 times more, compared to those satisfied with HI. The most dissatisfied with health care system were among professionals, higher position managers, and the wealthier.
2. Citizens were also asked to express their views concerning the need for reform of the health system. More than 80% of respondents believed that the current health system should change anyhow, though the extent of changes demanded were rather various among citizens. less-educated, and middle- income groups, especially those with frequent medical encounters tended to show support for fundamental changes or complete rebuilding of the health system.
3. Regarding the public's attitudes to health spending, the public offered support for increasing health expenditure (about two-thirds of respondents) but it opposed raising taxes or health insurance contributions(90% of respondents).
Given the above results of the public's highly negative attitudes toward health system, this study draws two tentative conclusions. First, it is of necessity that consensus building on the concept of 'socially desirable health policy' among citizens, policy makers and experts because such negative attitudes among citizens infallibly suggest that there is inconsistency of views among them. second, as one of the prerequisite to build and successfully implement the 'desirable' health policy, it is important that health policies in other countries be analyzed, through which would lead to the well-organized model of health system with higher acceptability in our own territory.