{"id":4426,"date":"2018-03-16T14:32:01","date_gmt":"2018-03-16T05:32:01","guid":{"rendered":"http:\/\/health.re.kr\/?p=4426"},"modified":"2018-03-16T14:33:42","modified_gmt":"2018-03-16T05:33:42","slug":"4426","status":"publish","type":"post","link":"http:\/\/health.re.kr\/?p=4426","title":{"rendered":"\uc758\ub8cc \uc7ac\uc815 \ub35c \uc4f0\uace0, \uad6d\ubbfc \uac74\uac15 \uc9c0\ud0a4\ub294 \ube44\uacb0?"},"content":{"rendered":"

\uc758\ub8cc \uc7ac\uc815 \ub35c \uc4f0\uace0, \uad6d\ubbfc \uac74\uac15 \uc9c0\ud0a4\ub294 \ube44\uacb0?<\/span><\/h1>\n

[\uc11c\ub9ac\ud480 \uc5f0\uad6c\ud1b5\u901a] \uc758\ub8cc \uc774\uc678\uc758 \ubcf5\uc9c0\ub3c4 \uac74\uac15\uc5d0 \ub3c4\uc6c0 \ub41c\ub2e4<\/span><\/h1>\n
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\uc624\ub85c\ub77c (\uc2dc\ubbfc\uac74\uac15\uc99d\uc9c4\uc5f0\uad6c\uc18c \ud68c\uc6d0)<\/div>\n
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\uc804 \uc138\uacc4\uc801\uc73c\ub85c \uc758\ub8cc\ube44\uac00 \ube60\ub974\uac8c \ub298\uc5b4\ub098\ub294 \uc911\uc774\ub2e4. \uc0c8\ub85c\uc6b4 \uc758\ub8cc\uae30\uc220 \ub3c4\uc785, \uc778\uad6c \uace0\ub839\ud654, \uc758\ub8cc\uc11c\ube44\uc2a4\uc5d0 \ub300\ud55c \uc218\uc694 \uc99d\uac00 \ub4f1\uc774 \uadf8 \uc6d0\uc778\uc73c\ub85c \uc9c0\ubaa9\ub418\uace0 \uc788\ub2e4. \uacbd\uc81c\ud611\ub825\uac1c\ubc1c\uae30\uad6c(OECD)\ub294 \ud604\uc7ac \uacbd\ud5a5\ub300\ub85c \uc758\ub8cc\ube44 \uc0c1\uc2b9\uc774 \uc9c0\uc18d\ub41c\ub2e4\uba74 21\uc138\uae30 \uc911\ubc18 \ubb34\ub835 \uadf8 \ube44\uc6a9\uc744 \ub354\ub294 \uac10\ub2f9\ud560 \uc218 \uc5c6\uac8c \ub420 \uac83\uc774\ub77c \uacbd\uace0\ud558\uae30\ub3c4 \ud588\ub2e4(\u261e\uad00\ub828 \uc790\ub8cc : \ubcf4\uac74\uc758\ub8cc\uccb4\uacc4 \uc7ac\uc815\uc758 \uc9c0\uc18d\uac00\ub2a5\uc131<\/a>).<\/p>\n

\ud55c\uad6d \uc0c1\ud669\ub3c4 \ud06c\uac8c \ub2e4\ub974\uc9c0 \uc54a\ub2e4. \uac74\uac15\ubcf4\ud5d8\uc758 \uc9c0\uc18d\uac00\ub2a5\uc131\uc5d0 \ub300\ud55c \uc758\ubb38\uc774 \uc81c\uae30\ub418\uba74\uc11c, \ud5a5\ud6c4\uc758 \uc7ac\uc815 \ucd94\uacc4, \ube44\uc6a9 \uc99d\uac00 \uc694\uc778 \uc2ec\uce35 \ubd84\uc11d \ub4f1 \uc5ec\ub7ec \uac00\uc9c0 \uc5f0\uad6c\uac00 \uc9c4\ud589 \uc911\uc774\ub2e4. \ud558\uc9c0\ub9cc \uc774\ub807\ub2e4 \ud560 \ub300\ucc45\uc740 \ub098\uc624\uc9c0 \uc54a\uace0 \uc788\ub2e4. \uc5b4\ub5bb\uac8c \ud574\uc57c \uc6b0\ub9ac\ub294 \uac74\uac15\uc774\ub77c\ub294 \uac00\uce58\ub97c \ucd94\uad6c\ud558\uba74\uc11c\ub3c4 \uc758\ub8cc\ube44 \uc9c0\ucd9c\uc744 \uc801\uc815 \uc218\uc900\uc73c\ub85c \uc720\uc9c0\ud560 \uc218 \uc788\uc744\uae4c?<\/p>\n

\ucd5c\uadfc <\uce90\ub098\ub2e4 \uc758\uc0ac\ud611\ud68c\uc9c0(Canadian Medical Association Journal)>\uc5d0 \ub354\ud134(Dutton)\uc744 \ube44\ub86f\ud55c 4\uba85\uc758 \uacf5\uacf5\uc815\ucc45 \uc5f0\uad6c\uc790\ub4e4\uc774 \uac8c\uc7ac\ud55c \ub17c\ubb38\uc740 \uc774\uc640 \uad00\ub828\ud55c \uc2e4\ub9c8\ub9ac\ub97c \ubcf4\uc5ec\uc900\ub2e4(\u261e\uad00\ub828 \uc790\ub8cc : \uce90\ub098\ub2e4 \uc8fc\uc815\ubd80\uc758 \uc0ac\ud68c\ubcf5\uc9c0 \ubc0f \ubcf4\uac74\uc758\ub8cc \uc9c0\ucd9c\uc774 \uac74\uac15\uacb0\uacfc\uc5d0 \ubbf8\uce58\ub294 \uc601\ud5a5<\/a>). \uadf8\ub3d9\uc548\uc758 \ub17c\uc758\uac00 \uc8fc\ub85c \uac74\uac15\ubcf4\ud5d8\uc774\ub098 \ubcf4\uac74\uc758\ub8cc\uccb4\uacc4 \uc548\uc5d0\uc11c\uc758 \uc9c0\ucd9c \ud6a8\uc728\ud654\uc5d0 \ucd08\uc810\uc744 \ub9de\ucdc4\ub358 \uac83\uacfc \ub2ec\ub9ac \uc774 \uc5f0\uad6c\ub294 \ubcf4\uac74\uc758\ub8cc \uc601\uc5ed\uc744 \ub118\uc5b4 \uc0ac\ud68c\ubcf5\uc9c0\ub97c \uc544\uc6b0\ub974\ub294 \ubcc0\ud654\uac00 \ud544\uc694\ud558\ub2e4\uace0 \uc8fc\uc7a5\ud55c\ub2e4. \uadf8 \uae4c\ub2ed\uc740 \ubb34\uc5c7\uc77c\uae4c?<\/p>\n

\uc5f0\uad6c\uc9c4\uc740 \uc6b0\uc120 \uac74\uac15\uc744 \uc704\ud55c \uc815\ubd80 \uc9c0\ucd9c\uc774 \ud611\uc18c\ud55c “\ubcf4\uac74\uc758\ub8cc”\uc5d0\ub9cc \ud55c\uc815\ub418\ub294 \uac83\ubd80\ud130\uac00 \uc798\ubabb\uc774\ub77c\uace0 \ubcf4\uc558\ub2e4. \uc774\ub4e4\uc740 \uad50\uc721, \uace0\uc6a9, \uc18c\ub4dd, \uc8fc\uac70 \ub4f1 “\uac74\uac15\uc758 \uc0ac\ud68c\uc801 \uacb0\uc815\uc694\uc778\ub4e4(social determinants of health)”\uc5d0 \uc601\ud5a5\uc744 \ubbf8\uce58\ub294 \uc0ac\ud68c\ubcf5\uc9c0\uc9c0\ucd9c\ub3c4 \uc911\uc694\ud55c \uac74\uac15\uc9c0\ucd9c\ub85c \ubcf4\uc544\uc57c \ud55c\ub2e4\uace0 \ud310\ub2e8\ud588\ub2e4. \uadf8\ub9ac\uace0 \uc815\ubd80\uac00 \uac74\uac15\uc744 \uc758\uc2dd\uc801\uc73c\ub85c \uc5fc\ub450\uc5d0 \ub450\uace0 \uc0ac\ud68c\ubcf5\uc9c0 \ubd80\ubb38\uc5d0 \ud22c\uc790\ud558\uc9c0\ub294 \uc54a\ub294\ub2e4\ub294 \uc810\uc5d0 \uc8fc\ubaa9\ud558\uc5ec \uc5f0\uad6c\ub97c \uc218\ud589\ud588\ub2e4. \uc5f0\uad6c\uc9c4\uc740 \uce90\ub098\ub2e4 \uc8fc(province) \uc815\ubd80\ub4e4\uc774 \ubcf4\uac74\uc758\ub8cc \ub300\ube44 \uc0ac\ud68c\ubcf5\uc9c0\uc5d0 \ud22c\uc790\ud558\ub294 \uc608\uc0b0 \uc218\uc900\uc774 \uc8fc\ubbfc\uc758 \uac74\uac15\uacfc \uad00\ub828 \uc788\ub294\uc9c0 \ud30c\uc545\ud558\uace0\uc790 \ud588\ub2e4. \uc774\ub97c \uc704\ud574 9\uac1c \uc8fc \uc815\ubd80\uc758 \uc9c0\ub09c 30\ub144 \ub3d9\uc548 (1981~2011\ub144) \uc7ac\uc815 \uc9c0\ucd9c \uc790\ub8cc\ub97c \uc218\uc9d1\ud558\uace0, \ud68c\ud53c \uac00\ub2a5\ud55c \uc0ac\ub9dd\ub960, \ud3c9\uade0\uc218\uba85, \uc601\uc544\uc0ac\ub9dd\ub960 \ub4f1\uc758 \uac74\uac15\uc9c0\ud45c\ub97c \uce21\uc815\ud588\ub2e4. \uadf8\ub9ac\uace0 \uc120\ud615\ud68c\uadc0\ubd84\uc11d\uc744 \ud1b5\ud574 \uc774\ub4e4\uc758 \uc5f0\uad00\uc131\uc744 \uac80\ud1a0\ud588\ub2e4.<\/p>\n

\ubd84\uc11d \uacb0\uacfc, \ubcf4\uac74\uc758\ub8cc \uc9c0\ucd9c 1\ub2ec\ub7ec \ub300\ube44 \uc0ac\ud68c\ubcf5\uc9c0 \uc9c0\ucd9c\uc774 1\uc13c\ud2b8 (\uc989, 1\ub2ec\ub7ec\uc758 1\/100) \uc99d\uac00\ud560 \ub54c\ub9c8\ub2e4 \ud1b5\uacc4\uc801\uc73c\ub85c \uc758\ubbf8 \uc788\ub294 \uac74\uac15 \ud5a5\uc0c1\uc774 \uad00\ucc30\ub418\uc5c8\ub2e4. \uc608\ucee8\ub300 \ud68c\ud53c \uac00\ub2a5\ud55c \uc0ac\ub9dd\ub960\uc740 0.1% \uac10\uc18c\ud588\uace0 \ud3c9\uade0\uc218\uba85\uc740 0.01% \ub298\uc5b4\ub0ac\ub2e4. \uc601\uc544\uc0ac\ub9dd\ub960\uc740 \ud1b5\uacc4\uc801\uc73c\ub85c \uc758\ubbf8 \uc788\ub294 \uad00\ub828\uc131\uc744 \ubcf4\uc774\uc9c0 \uc54a\uc558\ub2e4. \uc6d0\ud654\ub85c \ud658\uc0b0\ud574\ubcf4\uba74 \ub300\ub7b5 \ubcf4\uac74\uc758\ub8cc \uc9c0\ucd9c \ucc9c \uc6d0 \ub2f9 \uc0ac\ud68c\ubcf5\uc9c0 \uc9c0\ucd9c\uc774 \uc2ed \uc6d0 \ub298\uc5b4\ub0a0 \ub54c\ub9c8\ub2e4 \uac74\uac15 \uc218\uc900 \ud5a5\uc0c1\uc774 \uac00\ub2a5\ud55c \uc148\uc774\ub2e4. \uc989, \ubcf4\uac74\uc758\ub8cc \ub300\ube44 \uc0ac\ud68c\ubcf5\uc9c0 \uc9c0\ucd9c\uc774 \uc18c\ud3ed\uc73c\ub85c\ub9cc \uc99d\uac00\ud574\ub3c4 \uac74\uac15 \uacb0\uacfc\uac00 \ub098\uc544\uc9c4\ub2e4\ub294 \uac83\uc744 \uc54c \uc218 \uc788\ub2e4.<\/p>\n

\ubbf8\uad6d\uc744 \ube44\ub86f\ud558\uc5ec \ub2e4\ub978 \uc5ec\ub7ec \ub098\ub77c\ub4e4\uc5d0\uc11c\ub3c4 \uc774\ub97c \ub4b7\ubc1b\uce68\ud558\ub294 \ube44\uc2b7\ud55c \uc5f0\uad6c\uacb0\uacfc\ub4e4\uc774 \ubc1c\ud45c\ub418\uace0 \uc788\ub2e4. \uc9c0\ub09c 1\uc6d4 <\ubbf8\uad6d\uc608\ubc29\uc758\ud559\uc9c0>\uc5d0\ub294 OECD 20\uac1c \uad6d\uac00\ub97c \ub300\uc0c1\uc73c\ub85c \uad50\uc721\uacfc \uadfc\ub85c\ubb34\ub2a5\ub825(incapacity)\uc5d0 \ub300\ud55c \uc815\ubd80\uc9c0\ucd9c \ud655\ub300\uac00 \ud3c9\uade0 \uc218\uba85 \ud5a5\uc0c1\uacfc \uad00\ub828 \uc788\ub2e4\ub294 \ub17c\ubb38\uc774 \uc2e4\ub838\ub2e4(\u261e\uad00\ub828 \uc790\ub8cc : \uace0\uc18c\ub4dd \uad6d\uac00\ub4e4\uc758 \uc0ac\ud68c\uc815\ucc45\uc9c0\ucd9c\uacfc \uae30\ub300 \uc218\uba85<\/a>).<\/p>\n

\uc0ac\ud68c\ubcf5\uc9c0 \uc9c0\ucd9c\uc744 \uc5b4\ub5bb\uac8c \uc815\uc758\ud560 \uac83\uc778\uc9c0\uc5d0 \ub300\ud574 \uc5f0\uad6c\ub9c8\ub2e4 \ub2e4\uc18c \ucc28\uc774\uac00 \uc788\uc9c0\ub9cc, \uc804\ubc18\uc801\uc73c\ub85c \uc0ac\ud68c\ubcf5\uc9c0 \ubd80\ubb38\uc5d0 \ub300\ud55c \uc9c0\ucd9c(\uc989, GDP \ub300\ube44 \uc0ac\ud68c\ubcf5\uc9c0 \uc9c0\ucd9c, \ubcf4\uac74\uc758\ub8cc \ub300\ube44 \uc0ac\ud68c\ubcf5\uc9c0 \uc9c0\ucd9c \ub4f1) \uc99d\uac00\ub294 \ud3c9\uade0\uc218\uba85, \uc601\uc544 \uc0ac\ub9dd\ub960, \ube44\ub9cc, \uc2ec\uadfc\uacbd\uc0c9 \ub4f1 \uac74\uac15\uc9c0\ud45c\ub4e4\uc758 \uc720\uc758\ubbf8\ud55c \uac1c\uc120\uc744 \uac00\uc838\uc624\ub294 \uac83\uc73c\ub85c \ub098\ud0c0\ub09c\ub2e4.<\/p>\n

\uc774\ub7ec\ud55c \uc5f0\uad6c\uacb0\uacfc\ub294 \ub2e4\uc74c\uacfc \uac19\uc740 \uc8fc\uc7a5\uc5d0 \ud798\uc744 \uc2e4\uc5b4\uc900\ub2e4. \uc815\ubd80\uac00 \uac74\uac15\uc744 \uc704\ud55c \uc9c0\ucd9c\uc744 \uc758\ub8cc\uc5d0 \ud55c\uc815\ud558\uc9c0 \uc54a\uace0 \uc0ac\ud68c\ubcf5\uc9c0\ubd80\ubb38\uc73c\ub85c \uc804\ud658, \ud655\ub300\ud560 \ub54c \uc7ac\uc6d0\uc758 \uc9c0\uc18d\uac00\ub2a5\uc131\uacfc \uac74\uac15 \ud5a5\uc0c1 \ubaa8\ub450\ub97c \ub3c4\ubaa8\ud560 \uc218 \uc788\ub2e4\uace0 \ub9d0\uc774\ub2e4. \ubb3c\ub860 \uc758\ub8cc\ube44\ub294 \uc9c8\ubcd1\uc758 \uce58\ub8cc\uc640 \uc608\ubc29\uc5d0\uc11c \ud544\uc218\uc801\uc778 \uc9c0\ucd9c\uc774\ub2e4. \uadf8\ub7ec\ub098 \uadf8\uc5d0 \ud22c\uc785\ub418\ub294 \ube44\uc6a9\uc774 \ud55c\uc5c6\uc774 \ub298\uc5b4\ub09c\ub2e4\uace0 \ud574\uc11c \ubc18\ub4dc\uc2dc \uadf8\ub9cc\ud07c\uc758 \uac74\uac15\ud5a5\uc0c1\uc73c\ub85c \uc774\uc5b4\uc9c0\ub294 \uac83\uc740 \uc544\ub2c8\ub2e4. \ubc18\uba74 \uc0ac\ud68c\uc815\ucc45\uacfc \uc0ac\uc5c5\ub4e4\uc5d0 \ub300\ud55c \uc9c0\ucd9c\uc740 \uc880\ub354 \uadfc\ubcf8\uc801\uc778 \ucc28\uc6d0\uc5d0\uc11c \uc778\uad6c\uc9d1\ub2e8\uc758 \uac74\uac15\uc218\uc900\uc5d0 \uc601\ud5a5\uc744 \ubbf8\uce58\ub294 \uc704\ud5d8\uc694\uc778 \ubd84\ud3ec\ub97c \ubcc0\ud654\uc2dc\ud0ac \uc218 \uc788\uae30 \ub54c\ubb38\uc5d0 \ubcf4\ub2e4 \ud6a8\uacfc\uc801\uc778 \ud22c\uc790\uc77c \uc218 \uc788\ub2e4.<\/p>\n

\uae09\uc99d\ud558\ub294 \ubcf4\uac74\uc758\ub8cc\ube44\uc5d0 \ub300\ud55c \ud68d\uae30\uc801 \ub3cc\ud30c\uad6c\uac00 \uc5c6\ub294 \uc0c1\ud669\uc5d0\uc11c \uc774\ub7ec\ud55c \uc5f0\uad6c \uacb0\uacfc\uac00 \uac16\ub294 \uc758\ubbf8\ub294 \ud06c\ub2e4. \uc65c\ub0d0\ud558\uba74 \ud604\uc7ac \uc81c\uc548\ub418\uace0 \uc788\ub294 \uc7ac\uc815\uc808\uac10 \ubc29\uc548\ub4e4\uc740 \uac74\uac15\uacb0\uacfc\uc5d0 \ub300\ud55c \uace0\ub824 \uc5c6\uc774 \uc8fc\ub85c \ube44\uc6a9 \uc808\uac10 \uac00\ub2a5\uc131\uc5d0\ub9cc \ucd08\uc810\uc744 \ub450\ub294 \ubc18\uba74, \uc774 \uc5f0\uad6c\ub294 \uc778\uad6c\uc9d1\ub2e8\uc758 \uac74\uac15\uc218\uc900\uc744 \ud5a5\uc0c1\uc2dc\ud0a4\uba74\uc11c \ube44\uc6a9\uc744 \uc808\uac10\ud560 \uc218 \uc788\ub294 \ubc29\ud5a5\uc744 \uc81c\uc2dc\ud558\uace0 \uc788\uae30 \ub54c\ubb38\uc774\ub2e4. \uac8c\ub2e4\uac00 \ubcf5\uc9c0\uc9c0\ucd9c\uc740 \uac1c\uc120\uc758 \uc5ec\uc9c0\uac00 \ud070 \uc601\uc5ed\uc774\uae30\ub3c4 \ud558\ub2e4. \uc5f0\uad6c\uc9c4\uc774 \ubd84\uc11d \ub300\uc0c1\uc73c\ub85c \uc0bc\uc558\ub358 30\uc5ec \ub144 \ub3d9\uc548 \uce90\ub098\ub2e4 \uc8fc \uc815\ubd80\uc758 \uc7ac\uc815\uc9c0\ucd9c \ucd94\uc774\ub97c \uc0b4\ud3b4\ubcf4\uba74, 1\uc778\ub2f9 \ud3c9\uade0 \ubcf4\uac74\uc758\ub8cc\ube44 \uc9c0\ucd9c\uc740 \uc57d 2\ubc30 \uc815\ub3c4 \ub298\uc5b4\ub0ac\uc73c\ub098(2000\ub2ec\ub7ec \u2192 4000\ub2ec\ub7ec), \uc0ac\ud68c\ubcf5\uc9c0 \uc9c0\ucd9c\uc740 \uadf8 \uc99d\uac00\ud3ed\uc774 \ub9e4\uc6b0 \ubbf8\ubbf8\ud588\ub2e4 (770\ub2ec\ub7ec \u2192 970\ub2ec\ub7ec)\ud588\ub2e4 (\uadf8\ub9bc1 \ucc38\uc870).<\/p>\n

\uadf8\ub9bc 1.<\/p>\n

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\ud55c\uad6d\uc740 \uc5b4\ub5a8\uae4c. “\ud1b5\uacc4\ub85c \ubcf4\ub294 \uc0ac\ud68c\ubcf4\uc7a5 2016″\uc5d0 \ub530\ub974\uba74 2012\ub144 \ud55c\uad6d\uc758 \uacf5\uacf5\uc0ac\ud68c\uc9c0\ucd9c(Public Social Expenditure; \ub178\ub839, \uc720\uc871, \uadfc\ub85c \ubb34\ub2a5\ub825, \ubcf4\uac74, \uac00\uc871, \uc801\uadf9\uc801 \ub178\ub3d9\uc2dc\uc7a5 \ud504\ub85c\uadf8\ub7a8, \uc2e4\uc5c5, \uc8fc\uac70, \uae30\ud0c0\ub85c \uad6c\uc131\ub428) \uc218\uc900\uc740 GDP\uc758 10.4%\ub85c OECD 30\uac1c \ud68c\uc6d0\uad6d \uc911 \uaf34\ucc0c\uc600\ub2e4. \ucc38\uace0\ub85c OECD \ud3c9\uade0\uc740 21.0%\uc600\ub2e4. \ub610\ud55c \uc9c0\ucd9c \uad6c\uc870\ub97c \uc138\ubd84\ud558\uc5ec \uc0b4\ud3b4\ubcf4\uba74, \ubcf4\uac74\ubd80\ubb38(\uac74\uac15\ubcf4\ud5d8, \uc758\ub8cc\uae09\uc5ec, \ub178\uc778\uc7a5\uae30\uc694\uc591\ubcf4\ud5d8, \uc0b0\uc7ac\ubcf4\ud5d8 \ud3ec\ud568)\uc774 \uc804\uccb4 \uacf5\uacf5\uc0ac\ud68c \uc9c0\ucd9c\uc5d0\uc11c \ucc28\uc9c0\ud558\ub294 \ube44\uc911\uc774 42.8%\ub85c OECD \ud3c9\uade0(29.1%)\ubcf4\ub2e4 \ud6e8\uc52c \ub192\uc558\ub2e4 (\uadf8\ub9bc 2 \ucc38\uc870). \uc989, \uc804\uccb4 \uacf5\uacf5\uc0ac\ud68c\uc9c0\ucd9c \uc218\uc900\uc774 \ub0ae\uc744 \ubfd0 \uc544\ub2c8\ub77c \uadf8\ub098\ub9c8\ub3c4 \ubcf4\uac74\uc758\ub8cc \ubd80\ubb38\uc5d0 \uc9d1\uc911\ub418\uc5b4 \uc788\uc5b4, \ub098\uba38\uc9c0 \uc0ac\ud68c\ubcf5\uc9c0 \ubd80\ubb38\uc5d0 \ub300\ud55c \uc9c0\ucd9c\uc740 \ub9e4\uc6b0 \uc801\ub2e4\ub294 \uac83\uc744 \uc54c \uc218 \uc788\ub2e4.<\/p>\n

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\uadf8\ub9bc 2.<\/p>\n

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