이 연구는 아르헨티나 의료정책에서 건강에 대한 인식의 변화를 살펴 보고 이주민 건강에 대한 함의를 탐색하는 것이다. 아르헨티나 의료정책 의 변화는 건강의 개념이 구성적임을 보여준다. 아르헨티나 의료정책에 서 건강은 노동 생산성과 연결되었다가 정치화되었다. 또한 신자유주의 흐름에서 건강은 자본이자 상품이 되었다. 하지만 건강이 항상 시장 논 리로만 설명할 수 있는 것은 아니며 교육과 함께 정부와 대중 사이의 중 요한 연결고리 역할을 하며 매력적인 정치 도구가 된다. 아르헨티나에서 이주민은 아르헨티나의 경제 상황에 따라 이주 정책에 포함과 배제를 넘 나들었다. 정부는 2003년 이주민의 건강권을 보호하기 위해 법률과 제도 를 마련했지만, 의료현장에는 이주민의 신체, 문화 등에 대한 '일상화된 편견'이 지속되고 있었다. 이주민들은 정책적으로 아르헨티나의 ‘안보’를 위태롭게 하는 존재가 되어 ‘통제’를 받기도 하며, 아르헨티나인의 건강 을 위협하는 의료 문제의 주범으로도 간주 된다. 이러한 상황은 이주민 들의 건강권도 위협하고 있으며 이주민의 건강이 제도적 기반 외에도 사 회적 변화가 필요함을 시사한다.

이 연구는 아시아지역에서 대표적으로 단일문화사회에서 다문화사회로 변모한 일본의 지방자치단체의 외국인주민 보건의료 정책을 중점적으로 살펴보았다. 주요 연구결과는 첫째, 일본의 지방자치단체는 다문화공생 정책의 주체로서의 지위를 가지고, 외국인주민에 대한 행정서비스를 지 원하고 있다. 둘째, 군마현은 다문화공생 추진 기본계획을 바탕으로 외국 인주민이 안전하고 안심하게 살아갈 수 있도록 지원 사업을 추진하고 있 다. 셋째, 군마현은 의료기관에서 외국인주민의 진료를 지원하기 위해 14개 언어의 의료통역 자원봉사자를 활용하고 있다. 한국 지방자치단체 의 외국인주민 보건의료 서비스 강화를 위한 정책적 시사점을 제시하면 첫째, 지방자치단체의 권한과 역할을 강화하여 외국인주민 정책과 보건 의료 서비스 지원 정책을 적극적으로 추진해야 한다. 둘째, 현재 외국인 주민 지원 조례의 내용이 지방자치단체별로 매우 유사하여 향후 지역적 특성과 실태를 반영하는 조례의 개정이 필요하다. 셋째, 외국인주민의 건 강정보와 의료접근성 강화를 위해 의료 통역사를 양성하고 지원하는 공 공의료통역시스템을 구축해야 한다.

This study was conducted to understand the current status of regional health inequalities and nurse supply and demand policies, and to suggest ways to supply nurses to regions where nurses are scarce. Secondary data such as academic papers, government announcements, and related laws were analyzed, and the results were reviewed from various perspectives to derive policy proposals. Health professions were distributed around large cities including Seoul, and those regions had relatively high health levels. However, the number of hospital beds increased steadily, mainly in the non-metropolitan area. This seems to be one of the reasons why there is always a shortage of nurses in the local medical field despite the supply of nurses, and it can be a factor that aggravates regional inequalities. In order to solve the chronic shortage of nurses, supply-oriented policies such as increasing the admission quota and utilizing inactive nurses, and demand-oriented policies such as regulations on the nurse staffing level and improvement of the incentive scheme for quality evaluation of hospital service have been implemented. In the past, the focus was simply on the quantitative expansion of nurses, but recently, policies that emphasize the qualitative aspect of nursing are being promoted. However, the policy for the distribution aspect of nurses is still somewhat incomplete. Therefore, to solve this problem, strengthening the nurse staffing level in medical institutions, promoting nursing policies led by local governments, developing standard wage guidelines, and training nurses as public health personnel were proposed.

전 세계적인 코로나19의 확산으로 인해, 진단시약 등과 같은 감염병 의료 및 의료기기 신제품이 비약적으로 개발·출시되고 있으며, 이의 빠른 수급을 위해 각 국가들은 수입규제를 완화하거나 신속한 인·허가를 위한 정책을 펼치고 있다(NIDS, 2020). 반면, 신종감염병과 관련 없는 신개발 의료기기의 경우 오히려 시험검사 등 지연 및 취소되는 사례가 발생하고 있는 등 여전히 엄격한 인·허가규제를 통해 시장에 진출하고 있다. 이에 본 연구는 의료기기신제품이 시장에 진출하면서 마주하게 되는 정부소관법률에 특화하여 규제강도 영향요인을 도출하고 규제강도를 분석하여 규제대응 프레임워크를 제안하였다. 연구방법은 문헌연구, Failure Mode and Effects Analysis(FMEA)기법 적용, 전문가인터뷰(1차):아이디어수집, 전문가인터뷰(2차) : 타당성검증의 방법으로 진행하였으며, FMEA기법의 적용프로세스를 통해 우선 규제단계별 영향요인의 발생영향도와 규제사무 유형별 부담영향도를 곱하여 규제요인의 중요도를 구하고, 규제영향 심각도를 곱하는 방식으로 규제강도 정량화방법을 제시하였다. 시사점은 최근 해외 주요 국가들 및 우리나라 정부가 코로나19에 따른 신개발의료기기의 신속한 인·허가를 위한 특별규제정책 및 완화정책을 펼치며 적극적으로 대응하고 있는 시점에 본 연구에서 제안된 프레임워크를 통해 향후 기존 의료기기 신제품의 인·허가 정책 규제프로세스에도 보다 적극적이며 선제적인 대응이 될 수 있도록 규제의 개선방향과 규제대응 방안이 이루어지길 기대한다.

This study is aimed at proposing the national policy for medical device control system in Korea as deeply analysed the present status of the system. On 1979, Korean government had started to inspect 24 kinds of the medical devices such as X-ray diagnostic equipments, medical sterilizer and etc. mostly imported from advanced countries which USA, Germany and Japan for the first time according to the Pharmaceutical Affairs Law. However medical devices were becoming consideration as an important partner of diagnosis, curing and alleviation of diseases by medical doctors and also much important keeping the health at home. Furthermore medical devices industry can be designated as a national growth engine industry. So it is necessary not only to harmonize to international standards but also the harmonization of the system including pre-market application and post-market surveillance, is strongly needed by the Korea Food and Drugs Administration(KFDA).

Objective : Liver cancer is common cancer generating 11.3% incidence in Korea. But Oriental medical doctor (OMD) often can't measure therapy on liver cancer positively because that the prognosis on it is not good. It is impossible the results on all of diseases not only liver cancer always to have to be good. Methods : It is studied the literature referencing liver cancer, experimental articles to insist the effects of Oriental medicine planet to liver cancer and the clinical cases on liver cancer to be treated as Oriental medicine therapy to have effects. Results : it is required to find out the causes of diseases and therapy method to conquest the diseases for the medical therapy. But because the results on medical therapy are not always good, it is necessary for the doctor who want to treat the diseases like liver cancer having the prognosis to be death to protect himself, like as the legal system, a medical policy. And consequently, this protecting legal system lead the medical therapy principle or method on some special diseases to therapy completion on it. As a results of policy, medical therapy have to be developed. Recently, there have been many other development in oriental medical therapy. This development can be grouped as two type. One type is clinical part and the other is experimental research part. Specially the experimental research and clinical research on live cancer in oriental medical therapy have been developed. So the present day is the time to make medical policy on liver cancer for OMD to measure oriental medical therapy and develop oriental medical theory. Conclusions : As a above results, we propose that the name of liver cancer have to use in Korean medicine security clinical name (한방의료보험상병명) to make oriental medical policy.

The purpose of this study is to search Mattie Ingold’s life, the first lady missionary doctor served in Jeonla province. She is known as a founder of the Jesus Hospital in Jeon Ju, 108years old teaching hospital with 600 beds. But her contribution and limitation as a lady doctor was not properly evaluated. She was very well prepared medical missionary graduating Women’s Medical College in Baltimore with the first prize. She had passion for mission to Korean so much that she would not return home for this people. The Rock Hill First Presbyterian Church as a sending church was also very mission oriented enough to take care of her medical education for 5 years before sending her to Korea. However her ministry period as a medical missionary was only from 1898 to 1904. It seems not so long as to raise question if there were any reasons to quit medical ministry while serving in Jeon Ju until 1925. This study traced the Mattie Ingold’s life and circumstances she had faced at the end of 19th century and early 20th century during the Japanese colonialism. As other medical missionaries did in many area of mission fields she played an important role in introducing the Christianity by bridging the gap with the traditional worldview or with the Confucianism. Her warm hearted medical care was definitely contributed to get rid of xenophobia prevailing in those days just few years after the Donghak farmer’s revolutionary movement. Even though, as a lady doctor, her medical work was restricted to caring ladies and children, her zeal for evangelism made her translate the Christian Cathechism Primer into Korean which has been used by all missionaries in Jeonla area. She rather used her limitation as a merit by involving more actively in home visiting and providing medical care for ladies and children which was not easily available to men. She must have struggled with xenophobia, male superiority complex and the health issue of herself which could have shrink her back from active medical work. But most depressing factor might have been the mission policy based on dualistic view on the Christian mission that medical ministry was just subordinate to the evangelistic ministry and that the medical care was just a bait for evangelism. This policy could have resulted in restriction in allocating resources for medical ministry. Moreover, at that time, even mission agency had male dominating atmosphere that ladies could not have a voice in decision making. This study may provide a lesson which is worth in helping individual missionaries of today’s mission by revealing that how the policy of a mission society and the contemporary worldview affects on the individual missionary’s ministry.

When currently it sees from the accommodating actual condition of our country prisoner and the legal position from the medical treatment policy side very is inferior. Attitude of the existing law which relates with the namely hygienic civil official the dimension of hygiene and purity compared to will plant the prisoner generality discriminates with shame causal and it does to have, has become uniform anger living in a group discipline and the character for is stronger. That more from inside this providing is appropriate impossible it is to treat, providing with permission fact of the major general who will reach to also the case which is recognized it is visible with remnant of the authoritarianism line elder brother. Health protection of the prisoners is the fact which belongs in duty of the execution authorities guarantees the medical treatment policy which is good the improvement program for is demanded. It observes the peculiarity of correction medical treatment consequently from this dissertation and after investigating the present condition of regulation and correction medical treatment of the existing law against a report current correction medical treatment the problem point against a correction medical treatment and a improvement program and to sleep it presents it does.

21세기에는 본격적인 노인시대가 열릴 전망으로, 인구학적 변화에 따른 보건복지 국가정책방향에 대한 노인 작업치료의 효율적인 준비가 절대적으로 필요하다. 먼저 고령화 사회로 진입한 일본에서의 작업치료가 국가의 복지서비스방향에 따라서 변화하고 발전해온 것을 참고하기 위하여 우리나라와 일본의 보건의료복지서비스 정책, 작업치료사의 연도별 추이, 취업 현황, 교육 상황을 비교 하여서 노인작업치료의 발전방향과 준비를 위한 기초 자료를 제시하고자 하였다.앞으로 우리나라의 노인보건의료정책이 급속한 고령화에 따른 제반문제에 효율적, 합리적으로 대처해 나가길 바라며, 노인작업치료가 이러한 사회적 변화를 주도해 나가기 위한 더 많은 연구가 진행되기를 바란다.