보건행정학회지 (Health Policy and Management)

  • 제19권3호
  • /
  • Pages.71-91
  • /
  • 2009
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  • 1225-4266(pISSN)
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  • 2289-0149(eISSN)
한국보건행정학회 (Korean Academy of Health Policy and Management)
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국가필수예방접종 보장범위 확대 시범사업에 따른 의사의 예방접종 관리행태 및 만족도 비교

A Comparative Study of the Administrative Behavior of Vaccination and Satisfaction of Physicians according to the National Expanded Programme on Immunization in Korea

  • Kim, Chun-Bae (Department of Preventive Medicine, Yonsei University Wonju College of Medicine) ;
  • Lee, Sok-Goo (Department of Preventive Medicine, School of Medicine, Chungnam National University) ;
  • Lee, Jung-Jeung (Department of Preventive Medicine, Keimyung University College of Medicine) ;
  • Jeon, So-Youn (Department of Emergency Medical Technology, Daejeon Health Sciences College) ;
  • Hyun, Sook-Jung (Department of Preventive Medicine, Yonsei University Wonju College of Medicine) ;
  • Lee, Yeon-Kyeng (Division of Vaccine Preventable Disease Control and National Immunization Programme, Korea Centers for Disease Control and Prevention) ;
  • Go, Un-Yeong (Division of Vaccine Preventable Disease Control and National Immunization Programme, Korea Centers for Disease Control and Prevention) ;
  • 발행 : 2009.09.30
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초록

To assess comparatively the administrative behavior of vaccination and satisfaction of physicians by the provision method according to the National Expanded Programme on Immunization (NEPI) between 2005 and 2006 Demonstration Project in Korea. A questionnaire was performed at 582 and 64 physicians in Daegu metropolitan city and Gunpo city on 2005 (a response rate of 39.3%, 45.3%, respectively). Also, we sampled 31, 56, and 28 physicians in Gangneung city, Yangsan city, and Yeongi county on 2006 (a response rate of 35.5%, 98.2%, and 60.7%, respectively). We analyzed these data set using descriptive analysis and $\chi^2$-test through SPSS for Windows (12.0). Most question categories in Daegu metropolitan city and Gunpo city on 2005 were higher than those in the 2006 Demonstration Project regions. These were 'preparing and signing informed consent to vaccination', 'doing physical examination before periodic immunization', 'searching past shot history and inputting the current shot record through the immunization registry management program by physician', 'filing a medical record', 'satisfying the impact of 2005 and 2006 Demonstration Project and achieving the expectation of this Project', and 'improving the immunization coverage rate', et al. In conclusion, we show that the attitudes and practices of physician should be more sensitive to free vaccination services by private clinics and hospitals than public health centers. In the near future, the government must consider the opinion of physicians in implementing the NEPI by the affordable method of the public-private dynamics.

키워드

참고문헌

  1. 강진한. 국가필수예방접종 보장범위 확대사업의 필요성과 시범사업 결과. 소아감염 2007;14(1):26-29
  2. 고운영. 국가필수예방접종 보장범위 확대사업. 대한의사협회지 2007;50(8):660-661
  3. 김영택. 국가 예방접종사업의 현황 및 향후 정책방향. 대한의사협회지 2004;47(6):576-588
  4. 김영택. 국가필수예방접종 보장범위 확대 시범사업. 대한의사협회지 2005;48(6):579-586 https://doi.org/10.5124/jkma.2005.48.6.579
  5. 김용익. 보건의료 주민참여의 정의와 전략에 대한 연구. 보건행정학회지 1992;2(2):90-111
  6. 김춘배, 안양희, 차병호, 김효열, 이석구, 이중정 등. 국가필수예방접종 보장범위 확대 시범사업의 정책 내용분석 - 국가필수예방접종 공급방식을 중심으로 -. 보건행정학회지 2008;18(3):58-89 https://doi.org/10.4332/KJHPA.2008.18.3.058
  7. 김춘배, 이석구, 이중정, 안양희, 김민경, 김영택 등. 민간의료기관 참여방식과 보건소 서비스 강화방 식의 국가필수예방접종 보장범위 확대 시범사업에 관한 보건소 직원의 인식 비교. 한국모자보건학회지 2009;13(2):145-157
  8. 김혜련. 영유아 예방접종사업의 관리현황과 정책과제. 보건복지포럼 2001;59:47-60
  9. 대한소아과학회. 백신 Q & A. 광문출판사 2000:4-5, 101-2
  10. 박기동. 민간의료기관 결핵관리의 오늘과 내일. 결핵 및 호흡기질환 2002;52(6):579-589
  11. 박종구, 김춘배, 조경숙, 최서영, 이종찬, 이선동 등. 양·한방 상호보완 방안에 관한 인식도 연구 - 의사, 한의사 및 보건의료전문가간 비교를 중심으로 -. 보건행정학회지 2000;10(4):57-74
  12. 박혜숙, 김경효, 김옥수, 백성희, 유원섭, 최용준. 2006년 보건소 예방접종 확대 시범사업 평가 연구 최종 보고서. 2007
  13. 백승희, 정은희, 엄미령, 신손문, 이우길, 이미나 등. 소아 예방접종시 예진표(동의서) 사용에 관한 보호자 설문조사. 소아과 2003;46(7):647-654
  14. 손영모, 이종구. 우리나라 예방접종사업의 문제점과 대책. 소아감염 2001;8(1):36-42
  15. 우상덕. 주사와 주의의무. 대한법의학회지 1984;8(1-2):60-62
  16. 이건세, 조희경, 신은영, 배선환, 김윤정, 오현경. 홍역 예방접종증명서의 신뢰도 및 증명서 제출에 대한 개원의들의 인식도. 가정의학회지 2006;27(12):1005- 1012
  17. 이무식, 김은영, 이건세, 이석구, 홍지영, 김건엽 등. 국가예방접종전산등록체계 개발을 위한 민간의 료 기관 하부구조 및 환경 조사연구. 한국모자보건학회지 2003;7(2):193-206
  18. 이석구, 전소연, 김영택, 이정희, 김이경, 임미란. 군포시 국가필수예방접종 보장범위확대 시범사업 경험. 한국모자보건학회지 2008;12(2):166-180
  19. 이석구, 이건세. 전국민 예방접종등록사업의 평가와 지역사회 예방접종기록보고 관리체계의 효율화 방안 연구. 보건복지부 2002
  20. 이종구. 신년사. 질병관리본부 News Letter 2009;1:1-2
  21. 이종구. 우리나라의 예방접종사업 현황, 문제점 및 향후 정책방향. 한국모자보건학회지 2000;4(2):161-177
  22. 이중정, 양진훈, 황인섭, 천병렬, 감신, 이경수 등. 예방접종비 보건소 지불방식도입을 위한 대구광역시 시범사업에서의 BCG, DTaP, IPV 예방접종률 및 보건소 예방접종 분담률. 한국모자보건학회지 2007;11(1):33-43
  23. 이현승, 홍재석, 강희정, 오희철. 인천지역 보건소의 민간의료기관에 대한 예방접종 실적 상세보고 권고사업의 효과. 대한보건협회지 2005;31(2):146-152
  24. 임수흠. 국가필수예방접종 민간의료기관 보장확대사업. 의료정책포럼 2007;5(1):84-89
  25. 임현술, 배근량, 민영선, 김영택, 이연경. 일부 보건소에서 실시한 인플루엔자 예방접종 실태. 한국역학회지 2004;26(2):62-70
  26. 정도석, 송명선, 강동호, 김성훈, 이상현, 박일환. 소아의 부적절한 예방접종에 영향을 주는 요인. 가정의학회지 1993;14(3):147-155
  27. 진선미, 이석구. 도시지역 초등학교 입학생의 예방접종 실태와 적기 예방접종 관련 요인. 한국모자보건학회지 2007;11(1):44-53
  28. 질병관리본부. 예방접종등록평가사업단. 예방접종등록 월간소식지. 2005
  29. 조인성. 필수예방접종경비 국가부담 사업의 확대계획에 따른 소아청소년과의 준비. Korean J Pediatrics 2008;51(12):1275-1281 https://doi.org/10.3345/kjp.2008.51.12.1275
  30. Auxilia F. Compliance of hospital personnel to vaccination policy. Ann Ig 2000;12(4 Suppl 2):265-272
  31. Bath SK, Singleton JA, Strikas RA, Stevenson JM, McDonald LL, Williams WW. Performance of US hospitals on recommended screening and immunization practices for pregnant and postpartum women. Am J Infect Control 2000;28(5):327-332 https://doi.org/10.1067/mic.2000.109886
  32. Bhattacharya S. The World Health Organization and global smallpox eradication. J Epidemiol Community Health 2008;62(10):909-912 https://doi.org/10.1136/jech.2006.055590
  33. Bonu S, Rani M, Razum O. Global public health mandates in a diverse world: the polio eradication initiative and the expanded programme on immunization in sub-Saharan Africa and South Asia. Health Policy 2004;70(3):327-345 https://doi.org/10.1016/j.healthpol.2004.04.005
  34. Centers for Disease Control and Prevention (CDC). Progress in development of immunization registries--United States, 1999. MMWR Morb Mortal Wkly Rep 2000;49(13):274-278
  35. Davis TC, Fredrickson DD, Arnold CL, Cross JT, Humiston SG, Green KW, et al. Childhood vaccine risk/benefit communication in private practice office settings: a national survey. Pediatr 2001;107(2):E17 https://doi.org/10.1542/peds.107.2.e17
  36. Domínguez D. The reemergence of pertussis in immunized populations: a case study. Clin Lab Sci 2005;18(4):233-237
  37. Gaudelus J, Ovetchkine P, Cheymol J, De Courson F, Allaert FA. Compliance with the vaccination recommendations for 0- to 24-month-old infants in general or paediatric practice. Arch Pediatr 2003;10(9):781-786 https://doi.org/10.1016/S0929-693X(03)00409-3
  38. Gordon M, Roberts H, Odeka E. Knowledge and attitudes of parents and professionals to neonatal BCG vaccination in light of recent UK policy changes: a questionnaire study. BMC Infect Dis 2007;7:82 https://doi.org/10.1186/1471-2334-7-82
  39. Groom AV, Cheek JE, Bryan RT. Effect of a national vaccine shortage on vaccine coverage for American Indian/Alaska Native children. Am J Public Health 2006;96(4):697-701 https://doi.org/10.2105/AJPH.2004.053413
  40. Horlick GA, Beeler SF, Linkins RW. A review of state legislation related to immunization registries. Am J Prev Med 2001;20(3):208-213 https://doi.org/10.1016/S0749-3797(00)00309-3
  41. Hull BP, Lawrence GL, MacIntyre CR, McIntyre PB. Is low immunisation coverage in inner urban areas of Australia due to low uptake or poor notification? Aust Fam Physician 2003;32(12):1041-1043
  42. Humiston SG, Szilagyi PG, Iwane MK, Schaffer SJ, Santoli J, Shone L, et al. The feasibility of universal influenza vaccination for infants and toddlers. Arch Pediatr Adolesc Med 2004;158(9):867-874 https://doi.org/10.1001/archpedi.158.9.867
  43. Lamagni TL, Davison KL, Hope VD, Luutu JW, Newham JA, Parry JV, et al. Poor hepatitis B vaccine coverage in injecting drug users: England, 1995 and 1996. Commun Dis Public Health 1999;2(3):174-177
  44. Lee GM, Santoli JM, Hannan C, Messonnier ML, Sabin JE, Rusinak D, et al. Gaps in vaccine financing for underinsured children in the United States. JAMA 2007;298(6):638-643 https://doi.org/10.1001/jama.298.6.638
  45. Linkins RW, Feikema SM. Immunization registries: the cornerstone of childhood immunization in the 21st century. Pediatr Ann 1998;27(6):349-354 https://doi.org/10.3928/0090-4481-19980601-09
  46. Loewenson PR, White KE, Osterholm MT, MacDonald KL. Physician attitudes and practices regarding universal infant vaccination against hepatitis B infection in Minnesota: implications for public health policy. Pediatr Infect Dis J 1994;13(5):373-378 https://doi.org/10.1097/00006454-199405000-00008
  47. Lu L, Jin SG, Yu JJ, Ze WY, Ling LY, Wang SL, et al. Study on the cost of expanded programme on immunization in areas with diffent economic levels. Zhonghua Liu Xing Bing Xue Za Zhi 2004;25(8):684-687
  48. Madan TN. Community involvement in health policy; socio-structural and dynamic aspects of health beliefs. Soc Sci Med 1987;25(6):615-620 https://doi.org/10.1016/0277-9536(87)90086-4
  49. Mascarenas A, Salinas J, Tasset-Tisseau A, Mascarenas C, Khan MM. Polio immunization policy in Mexico: economic assessment of current practice and future alternatives. Public Health 2005;119(6):542-549 https://doi.org/10.1016/j.puhe.2004.08.020
  50. Matsumura T, Nakayama T, Okamoto S, Ito H. Measles vaccine coverage and factors related to uncompleted vaccination among 18-month-old and 36-month-old children in Kyoto, Japan. BMC Public Health 2005;5:59 https://doi.org/10.1186/1471-2458-5-59
  51. Moran K, Maaten S, Guttmann A, Northrup D, Kwong JC. Influenza vaccination rates in Ontario children: implications for universal childhood vaccination policy. Vaccine 2009;27(17):2350-2355 https://doi.org/10.1016/j.vaccine.2009.02.017
  52. Ritvo P, Wilson K, Willms D, Upshur R, Goldman A, Kelvin D, et al; CANVAC Sociobehavioural Study Group. Vaccines in the public eye. Nat Med 2005;11(4 Suppl):S20-S24 https://doi.org/10.1038/nm1220
  53. Rivera A, Orengo JC, Rivera AL, Rodríguez C, Calderon E, Rullan J, et al; Centers for Disease Control and Prevention (CDC). Impact of vaccine shortage on diphtheria and tetanus toxoids and acellular pertusars vaccine coverage rates among children aged 24 months-Puerto Rico, 2002. MMWR Morb Mortal Wkly Rep 2002;51(30):667-668
  54. Robertson SE. Research and development within the Expanded Programme on Immunization: the first five years. Geneva, World Health Organization, unpublished document WHO/EPI/GEN/93.10, 1993
  55. Rosenbaum S. The public-private dynamics of national immunization policy. Am J Prev Med 2000;19(3 Suppl):19-20 https://doi.org/10.1016/S0749-3797(00)00214-2
  56. Santibanez TA, Santoli JM, BarkerkeE. Differential effects of the DTaP and MMR vaccine shortages on timeliness of childhood vaccination coverage. Am J Public Health 2006;96(4):691-696 https://doi.org/10.2105/AJPH.2004.053306
  57. Semali IA, Tanner M, de Savigny D. Decentralizing EPI services and prospects for increasing coverage: the case of Tanzania. Int J Health Plann Manage 2005;20(1):21-39 https://doi.org/10.1002/hpm.794
  58. Siddiqi N, Khan A, Nisar N, Siddiqi AE. Assessment of EPI (expanded program of immunization) vaccine coverage in a peri-urban area. J Pak Med Assoc 2007;57(8):391-395
  59. Shin T, Kim CB, Ahn YH, Kim HY, Cha BH, Uh Y, et al. The comparative evaluation of expanded national immunization policies in Korea using an analytic hierarchy process. Vaccine 2009;27(5):792-802 https://doi.org/10.1016/j.vaccine.2008.10.075
  60. Stampi S, Ricci R, Ruffilli I, Zanetti F. Compulsory and recommended vaccination in Italy: evaluation of coverage and non-compliance between 1998-2002 in Northern Italy. BMC Public Health 2005;5:42-49 https://doi.org/10.1186/1471-2458-5-42
  61. Steinglass R. Global eradication of polio. JAMA 2009;301(2):161-162 https://doi.org/10.1001/jama.2008.913
  62. Strebel PM, Henao-Restrepo AM, Hoekstra E, Olive JM, Papania MJ, Cochi SL. Global measles elimination efforts: the significance of measles elimination in the United States. J Infect Dis 2004;189(1 Suppl):S251-S257 https://doi.org/10.1086/378092
  63. Streefland PH. Public doubts about vaccination safety and resistance against vaccination. Health Policy 2001;55(3):159-172 https://doi.org/10.1016/S0168-8510(00)00132-9
  64. Taylor JA, Darden PM, Brooks DA, Hendricks JW, Baker AE, Wasserman RC. Practitioner policies and beliefs and practice immunization rates: a study from Pediatric Research in Office Settings and the National Medical Association. Pediatr 2002;109(2):294-300 https://doi.org/10.1542/peds.109.2.294
  65. Torun SD, Bakirci N. Vaccination coverage and reasons for non-vaccination in a district of Istanbul. BMC Public Health 2006;6:125 https://doi.org/10.1186/1471-2458-6-125
  66. van den Hof S, Meffre CM, Conyn-van Spaendonck MA, Woonink F, de Melker HE, van Binnendijk RS. Measles outbreak in a community with very low vaccine coverage, the Netherlands. Emerg Infect Dis 2001;7(3 Suppl):593-597 https://doi.org/10.3201/eid0703.010343
  67. Vernon JG. Immunisation policy: from compliance to concordance? Br J Gen Pract 2003;53(490):399-404
  68. Vitek CR. Diphtheria. Curr Top Microbiol Immunol 2006;304:71-94 https://doi.org/10.1007/3-540-36583-4_5
  69. White F, Shima E. Influenza vaccination in Alberta, 1978: physician compliance with recommendations. Can Med Assoc J 1980;123(5):347-348