보건의료서비스의 형평성 개념에관한 이론적 연구

목차

I. 서론

1. 문제제기
2. 연구의 목적
3. 연구의 방법과 범위

II. 이론적 배경

1. 개념 분석에 대한 정의
2. 개념분석을 위한 이론
1) 정의 규정을 통한 방안
1-1) 외연적 정의 (denotational definition)
1-2) 내포적 정의 (connotative d.)
1-3) 선언적 정의 (declarative d.)
2) 내포와 외연의 탐색을 통한 것
2-1) 내포의 탐색과 규정
2-2) 외연의 탐색과 규정
2-3) 내포와 외연의 관계와 추상의 정도
3) 용어에 대한 의미분석을 통한 것
3-1) 이의동어의 사용과 문제
3-2) 동의어의 사용과 문제
3-3) 어의적 장
3-4) 신조어와 문제
4) 개념의 재구성

III. 형평성에 대한 개념 분석

1. 형평성의 정의에 대한 문헌조사
2. 형평성 개념분석

IV. 연구결과

1. 형평성 개념의 재정의
2. 형평성 지수 개발

V. 요약 및 결론

본문내용

ublic Health
Seoul National University
(Academic Advisor : Prof. Ok Ryun Moon)
It has been urged that the concepts of equity and justice are better guide for public health policy against economic rationality. But equity and justice have not yet become the key role and main idea of health service systems and discussion of equity and justice in health care has been occasional and scattered while rapid quantitative growth in health care had been acquired.
This study aims to find out definition and defining properites of equity concept and to improve alternative policy or principles reconceptualization of equity.
To accomplish this study, a library survey and secondary analysis was carried out in 1996.
The major findings of this study are as follows;
1. Equity concept is using with defining properites as well as synonyms, such as justice, equality, fairness, rationality etc. indiscriminately. In particular, 'Ability' and 'Need' using as defining properites of equity concept are also indefinite.
2. Equity concept has been developed in accordance with history of society and philosophy. Therefore equity concept is different by utilitarianism, liberalism, egalitarianism (Rawlsism) and socialism. So we can't leave what historical and philosophical concept is suited to current health care services in Korea.
3. Rawls's theory, specially 'difference theory' and 'pure procedural justice', is useful to solve many problems in Korean Health sevice System. According to this 'difference theory', health care resources should serve improvement of the health of the least adventaged. This interpretation make it possible that utility would be allowed to modify inequity. But It is controversial who the least adventaged is.
'Pure procedural justice' is inevitable focus when we consider health care as a primary social good comparable to civil rights and liberties. Because services would be embodied by systems consist of organizations and manpower.
Judging above results, the equity concept in Korean health care services should be reconstruct as follows;
"pay according to ability, use according to need."
In this, need is divided two categories, basic need and special need. Basic need should be provided in accordance with the principle of human dignity and state responsibility. Special need, namely above basic need, should be provieded in accordance with maximin theory of Rawls.
Finally I suggest a new index which is available to evaulate on the equity of Health Care Services.
Contribution occupancy rate Premium Occupancy rate
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Population occupancy rate Income occupancy rate
If index price converge to zero, we can interprete degree of equity is good and desirable. If price is below zero, the group burden more premiums than benefits and services, vice versa.
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Key words : Health Care Service, Equity, Concept analysis, Basic need, State responsibility, Maximin theory

키워드

형평성 개념의 재정의,   형평성 지수 개발,   개념 분석에 대한 정의,   개념분석을 위한 이론,   외연적 정의,   내포적 정의