제1장 서론 ················································································· 1
1. 연구의 배경 및 목적 ····························································· 1
2. 연구의 범위 및 방법 ····························································· 3
1) 연구의 범위 ······································································· 3
2) 연구의 방법 ······································································· 3
3. 연구수행절차 ··········································································· 4
제2장 부산시 보건소 기능 및 현황 ····································· 5
1. 보건소 기능 설정 ··································································· 5
1) 보건소 업무 변화 ····························································· 5
2) 보건소 기능 재분류 ························································· 7
2. 보건소 현황 ············································································ 9
1) 외부환경 ············································································ 9
2) 내부환경 ·········································································· 15
3) 타 시・도 보건조직 및 인력 ········································ 24
3. SWOT분석 ············································································ 28
1) 강점 ·················································································· 28
2) 약점 ·················································································· 28
3) 기회 ·················································································· 29
4) 위협 ·················································································· 30
4. 전략과제 ················································································ 31
제3장 보건소 기능․조직 재설계를 위한 조사 ··················· 35
1. 분석방법 ················································································ 35
2. 설문조사 결과 ······································································· 36
1) 응답자 일반사항 ····························································· 36
2) 보건소 조직혁신을 위한 문제해결 및 중요기능 ········ 37
3) 보건소 조직개편 방안 ···················································· 40
4) 시사점 ·············································································· 42
3. 면담조사 결과 ······································································· 43
1) 보건소 실무진 ································································· 43
2) 민간보건의료기관 ··························································· 44
3) 시사점 ·············································································· 44
4. 보건소 기능 재설계 ····························································· 45
1) 기능재설계를 위한 필요사항 ········································ 45
2) 기능재설계 ······································································ 46
제4장 부산시 보건소 직무분석 ··········································· 49
1. 직무분석 방법 ······································································· 49
2. 직무분석 결과 ······································································· 50
1) 기능별 직무 분석 ··························································· 50
2) 부서별 직무 분석 ··························································· 55
제5장 부산시 보건소 조직 혁신방안 ································· 59
1. 보건소 조직구조 재설계 ······················································ 59
1) 기본방향 ·········································································· 59
2) 조직구조 개편(안) ·························································· 60
2. 적정인력 산정 ······································································· 63
1) 인력 산정 ········································································ 63
2) 보건소 조직(안)에 대한 인력 배치 ······························ 66
3. 효율적인 운영을 위한 Action Plan ································· 69
1) 효율적 운영방안 ····························································· 69
2) 보건소의 효율적인 운영을 위한 Action Plan ·········· 74
제6장 결론 및 정책제언 ······················································· 75
1. 결론 ························································································ 75
2. 정책제언 ················································································ 77
1) 권한 증진 ········································································ 77
2) 효율적 운영 ···································································· 80
3) 전문성 향상 ···································································· 82
4) 신뢰 제고 ········································································ 83
Abstract ···················································································· 88
참고문헌 ·················································································· 91
부록 ·························································································· 94
1. 타 시・도 조직도 ···························································· 94
2. 전문인력의 면허 또는 자격의 종별에 따른 최소배치기준
(2015.11.19.시행예정) ···················································· 97
3. 설문지 ··············································································· 99
<표 Ⅱ-1> 시・도별 노인비중 ······················································ 9
<표 Ⅱ-2> 특・광역시별 평균수명 ············································ 10
<표 Ⅱ-3> 특・광역시별 출산율 ················································ 10
<표 Ⅱ-4> 특・광역시별 사망원인별 연령표준화 사망률 ······· 11
<표 Ⅱ-5> 지역보건기관 현황 ···················································· 15
<표 Ⅱ-6> 부산시 보건소 조직체계 ·········································· 17
<표 Ⅱ-7> 부산시 보건기관 직급별 인력현황 ························· 20
<표 Ⅱ-8> 부산시 보건소장, 행정과장 직렬 현원 ·················· 20
<표 Ⅱ-9> 부산시 보건기관 직능별 인력현황 ························· 21
<표 Ⅱ-10> 부산시 보건소 비정규직 현황 ······························· 22
<표 Ⅱ-11> 타 시・도 보건조직 분석(인구규모・지역별) ······ 26
<표 Ⅱ-12> 시・도별 보건소 공무원 인력 ······························· 27
<표 Ⅱ-13> 부산시 보건 조직의 SWOT 분석 ························· 31
<표 Ⅲ-1> 설문지 구성 ····························································· 36
<표 Ⅲ-2> 보건소 조직혁신을 위해 해결해야 할 내부문제 ··· 37
<표 Ⅲ-3> 보건소의 중요기능 ···················································· 38
<표 Ⅲ-4> 보건소 기능별 필요 정도 ······································· 40
<표 Ⅲ-5> 보건소의 조직개편 방안 ·········································· 41
<표 Ⅲ-6> 면담조사 결과(실무진) ·············································· 43
<표 Ⅲ-7> 면담조사 결과(민간보건의료기관장) ······················· 44
<표 Ⅲ-8> 보건소 기능재설계를 위한 필요사항 ······················ 45
<표 Ⅳ-1> 보건의료서비스 기능 직무분석 ······························· 50
<표 Ⅳ-2> 진료 기능 직무분석 ·················································· 52
<표 Ⅳ-3> 위생 기능 직무분석 ·················································· 53
<표 Ⅳ-4> 지도・관리 기능 직무분석 ····································· 53
<표 Ⅳ-5> 의료복지 기능 직무분석 ·········································· 54
<표 Ⅳ-6> 조사・연구 기능 직무분석 ······································· 54
<표 Ⅳ-7> 일반 행정 및 지원 기능 직무분석 ························· 55
<표 Ⅳ-8> 부서별 직무분석 ························································ 56
<표 Ⅳ-9> 서비스실 소요 평균 인력 ········································ 57
<표 Ⅴ-1> 조직구조 재설계 기본방향 ······································· 59
<표 Ⅴ-2> 회귀분석 결과표(25만명 미만) ································ 65
<표 Ⅴ-3> 회귀분석 결과표(25만명 이상) ································ 65
<표 Ⅴ-4> 구・군별 적정인력 산출 및 적정인력 대비 현재 정원
비교 ············································································· 66
<표 Ⅴ-5> 조직개편안(Ⅰ)의 인력배치(안) ································ 67
<표 Ⅴ-6> 조직개편안(Ⅱ)의 인력배치(안) ································ 68
<표 Ⅴ-7> 보건소 기능에 따른 인구규모별 조직・인력주) ··· 68
<표 Ⅵ-1> 규정 변경(안) ··························································· 78
<그림 Ⅰ-1> 부산시 보건소 조직진단 프로세스 ······················ 4
<그림 Ⅱ-1> 보건소 업무의 시대적 변화 ································· 6
<그림 Ⅱ-2> 보건소 기능의 재분류 ············································· 8
<그림 Ⅱ-3> 부산시 음주율(2013년) ········································· 12
<그림 Ⅱ-4> 부산시 비만율(2013년) ········································· 13
<그림 Ⅱ-5> 부산시 구강건강율(2013년) ································· 14
<그림 Ⅱ-6> 부산시 구강 미충족치료 비율 및 원인(2012년) 14
<그림 Ⅱ-7> 부산시 보건복지 항목별 예산 ····························· 16
<그림 Ⅱ-8> 부산시 보건소의 인력 변화(1990~2013) ··········· 19
<그림 Ⅲ-1> 응답자 직급 ··························································· 36
<그림 Ⅲ-2> 응답자 직능 ··························································· 36
<그림 Ⅲ-3> 보건소 기능 재설계 ·············································· 47
<그림 Ⅴ-1> 보건소 조직구조 개편안(Ⅰ) ································ 61
<그림 Ⅴ-2> 보건소 조직구조 개편안(Ⅱ) ································ 62
<그림 Ⅴ-3> 적정인력 산정방법 ················································ 64
<그림 Ⅴ-4> 인력배치 방법 ························································ 67
<그림 Ⅴ-5> 보건소의 효율적인 운영을 위한 Action Plan · 74
<그림 Ⅵ-1> 감염병 관리위원회 구성(안) ································ 84
<그림 Ⅵ-2> 정책제언 ································································· 86