감염병 시대 서울시 공공의료체계의 변화 방향

나백주 서울시공공보건의료재단 2020 SEOUL HEALTH ON AIR 건강정책동향 Vol.1 No.11

신종 감염병인 코로나19 팬데믹 시대에 서울시 공공의료 체계 강화 방향에 대해 정리한 본고는, 그동안 한국 공공의료가 처해왔던 체계의 빈약성에서 서울시도 예외는 아니라는 점을 지적한다. 향후 감염병 중환자 진료와 시립병원의 기능 강화, 역학조사 체계 강화 등 공공의료 기능을 획기적으로 강화할 필요가 있음을 주장하고 있다.

서울시 건강안보를 위한 공공보건 인프라 전략

나백주 서울시공공보건의료재단 2021 SEOUL HEALTH ON AIR 건강정책동향 Vol.1 No.34

코로나19 범유행으로 한국의 공공의료 취약성이 여실히 드러나게 되었다. 또한 코로나19 같은 신종감염병 유행은 일정한 주기를 가지고 인류의 건강을 위협하고 있으며, 단순히 보건의료 대응만이 아닌 도시 문명 전반의 개혁을 요구하고 있다. 이러한 측면에서 공공의료를 중심으로 한 건강안보의 개념이 도시정책의 중요한 화도로 제기되고 있다. 이에 건강안보 측면에서 공공보건의료 특히 공공보건의료 인프라는 어떻게 구축되어야 하는가를 정리해보았다.

의과대학 신입생의 동기향상을 위한 의료봉사활동 프로그램 시행 경험

나백주,허예라,윤정민,강재구,한승연,황원민,이금호,이정민 한국의학교육학회 2013 Korean journal of medical education Vol.25 No.3

Purpose: A task force identified 4 core properties of motivation-related improvement and developed a medical volunteer program for 63 medical freshmen in 2012. Three overarching topics were examined: What were the contents of the program? Did students' motivation improve? Were the students satisfied with the course? Pretest and posttest motivation levels and program evaluation forms were analyzed. Methods: We organized a series of committee meetings and identified 4 core factors of motivation. The program was conducted for 63 medical freshmen in March 2012. The program evaluation form was analyzed using SPSS 17.0. Results: The core factors of motivation were interest in medical studies, volunteer-mindedness, medical humanities, and self-management. The program was composed of lectures, medical volunteer hours, and program evaluation and feedback sessions. Students’ motivation differed significantly with regard to interest in medical studies (t=-2.40, p=0.020) and volunteer-mindedness (t=-3.45, p=0.001). Ninety percent of students were satisfied with the program, 67.8% of students were satisfied with the medical volunteer activity, and the feedback session of the program was meaningful (66.1%). Conclusion: The medical volunteer program, held in the first month of the medical education year, was meaningful, but the reasons for dissatisfaction with the program should be examined. We should also develop a system that has lasting beneficial effects on academic achievement and career selection.

서울시의 지역사회 중심 남녀 건강출산지원사업 소개

나백주,이미점,이화선,민승기,김혜옥,안기훈,이우령,손인숙,하은희,주성홍,김희선,김영아,한정열 한국모자보건학회 2020 한국모자보건학회지 Vol.24 No.3

Community-based preconception care for men and women of childbearing age has been introduced in Seoul. The program aims to focus on problem areas such as low birth rate, fertility issues potentially due to late marriages, preterm or premature births, and low-birthweight in newborn babies. The district administration officials of Seoul, as well as, academics from the Korean Society of Maternal and Child Health, developed a protocol by using a questionnaire and laboratory test for screening risk factors in pregnancy. The protocol was tested on a trial basis in four local districts in Seoul from July 2017 to 2018, extended to 12 local districts in 2019, and all 25 districts in Seoul in 2020. The protocol includes Anti- Mullerian Hormone tests to assess women’s ovarian reserve and male health checkups that include semen analysis and physical examinations of genitalia. These tests are conducted for early detection and treatment of infertility, especially in cases of late marriages. In order to prevent women being abandoned during pregnancy (leading them to single-parenting), the protocol also emphasizes building a gender-sensitive environment by encouraging more male participation. A monitoring group comprised of Seoul city district officials and academics from the Korean Society of Maternal and Child Health, regularly visited the local districts to observe improvements and keep the program officials up to date. In addition, the group also conducted a mobile phone survey for feedback on the program. The interest and support of the residents in Seoul city, and positive results and development in pregnancy care and childbirth, are needed to stabilize and extend this protocol.

An Early Stage Evaluation of the Supporting Program for Obstetric Care Underserved Areas in Korea

나백주,김현주,이진용 대한의학회 2014 Journal of Korean medical science Vol.29 No.6

“The Supporting Program for Obstetric Care Underserved Areas (SPOU)” provides financialaids to rural community (or district) hospitals to reopen prenatal care and delivery servicesfor regions without obstetrics and gynecology clinics or hospitals. The purpose of this studywas to evaluate the early stage effect of the SPOU program. The proportion of the numberof birth through SPOU was calculated by each region. Also survey was conducted toinvestigate the extent of overall satisfaction, elements of dissatisfaction, and suggestionsfor improvement of the program; 209 subjects participated from 7 to 12 December, 2012. Overall, 20% of pregnant women in Youngdong (71 cases) and Gangjin (106 cases) usedtheir community (or district) hospitals through the SPOU whereas Yecheon (23 cases) was8%; their satisfaction rates were high. Short distance and easy accessibility was the mainreason among women choosing community (or district) hospital whereas the reasons ofnot selecting the community (or district) hospital were favor of the outside hospital’sfacility, system, and trust in the medical staffs. The SPOU seems to be currently effectiveat an early stage. However, to successfully implement this program, the governmentshould make continuous efforts to recruit highly qualified medical staffs and improvemedical facility and equipment.

중동호흡기증후군 사태 이후 지방의료원과 보건소중심 신종감염병 대응체계 선진화 방안

나백주,김동현 대한의사협회 2015 대한의사협회지 Vol.58 No.8

Healthcare system in Korea was found to be very vulnerable to public health emergency preparedness and response as demonstrated in the recent outbreak of Middle East Respiratory Syndrome Coronavirus. We need to redefine the function of and improve the capability of local district public hospital and local health center to cope with potential threats by newly emerging infectious disease in the nearer future. While central government may be responsible for early detection of newly emerging infectious disease transmitted from outside of the country, local government and its district-level public healthcare agencies need to primarily control over spread of the disease among the local residents. Governance setting for rapid response required in public health crisis situation appears to be possible based on strong local public health infrastructure for health promotion and disease prevention at si-gun-gu district level. Proper and sustainable investment is also needed for local public hospital with high standard facilities and skilled healthcare manpower since there seems little economic incentives to maintain such facilities in private hospitals. In conclusion, it would be urgent task to improve prevention activities for infectious disease of local health centers and clinical activities of local public hospital. Especially, role and competencies of public health physicians working at the public health center need to be specified as an essential component of public health infrastructure.

의료기관의 사회적 책임(CSR) : 일차의료의 사회적 책임

나백주 한국보건행정학회 2013 한국보건행정학회 학술대회 논문집 Vol.2013 No.1

[마을(지역사회)의 보건의료 문제점 및 해소방안] 주민 스스로 건강관리할 수 있도록 돕는 것

나백주 한국자치학회 2014 월간 주민자치 Vol.28 No.-

건양대학교 의과대학 신입생을 위한 동기유발 교육과정 개발과 시행 경험

나백주,이금호,김건일,송다운,허예라 한국의학교육학회 2012 Korean journal of medical education Vol.24 No.2

Purpose: This study aimed to develop a new course for Konyang University College of Medicine freshmen to motivate them with regard to their vision and medical professionalism and experience various learning methods of medical education. Methods: The course was developed by 4 faculty members through several intensive meetings throughout the winter of 2010. A 4-credit course was designed for 61 freshmen of Konyang University College of Medicine to provide structured guidance and an introduction to their medical education and increase their motivation with regard to their studies and school life. The course lasted for 4 weeks (February 28 to March 25), and every session of the program was evaluated by the students. Results: The 'motivation induction course' consisted of the following sessions: university-wide: 'leadership camp' and 'special lectures for future vision;' college-wide: 'major immersion session,' 'Enneagram workshop,' 'STRONG workshop,' 'medical professionalism,' and 'team-based learning.' The group results were presented in a poster and by oral presentation and were awarded prizes for the best performance. Special features included: group discussion session on medical ethics, which used scenarios that were developed by a medical humanity course committee and visiting all departments and mentors of the medical college to fulfill their curiosity of their future major or workplace. Overall, the course was evaluated as satisfactory (M=4.22, SD=0.81). Conclusion: Although there was some dissatisfaction, the overall experience of the “motivation induction course” was a success. The course will continue to be valuable for freshmen in adapting to medical school and its culture and in defining one’s view of a good doctor.

제5기 지역보건의료계획 방향과 지침 소개

나백주 한국농촌의학 지역보건학회 2010 농촌의학·지역보건 Vol.35 No.2