농어촌 영향평가 전문평가 : 평생학습정책/응급의료정책
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(2) 연구 담당. 마 상 진 연 구 위 원 조 미 형 부연구위원 한 영 광 연 구 원. 연구 총괄, 제1부 평생학습정책 제2부 응급의료정책 설문조사, 사례조사.
(3) i 머 리 말. 농어촌 영향평가는 특정 정책이 농어촌 주민의 분산 거주, 불리한 접근성 등 농어촌 특성과 농어촌의 경제 경관 문화 등에 미치는 영향을 고려하여 추진되 도록 하는 제도이다. 농어촌 영향평가는. 」. 「농어업인 삶의 질 향상 및 농어촌지. 역 개발촉진에 관한 특별법 관련 9개 부처와 광역단위 지방자치단체에 의해. 추진되는 자체평가와 삶의 질 위원회가 결정한 정책 사업에 대하여 전문지원 기관에서 실시하는 전문평가가 있다.. 2011년에 처음 실시된 농어촌 영향평가 전문평가 결과는 해당 부처의 사업 개선의 중요한 자료가 되었다. 올해의 농어촌 영향평가 전문평가는 교육과학기술부의 ‘평생학습정책’, 보건 복지부의 ‘응급의료정책’에 대하여 수행되었다. 도․농간의 생활여건과 관련하 여 가장 기본이 되는 두 가지 정책군에 대해 관련 정책에 대한 분석과 더불어,. ․. 도 농간의 격차 실태와 그 원인으로서의 지역요인이 작용 여부를 분석하고. ․. 있다. 그리고 도 농간의 격차 해소를 위한 추진 과제를 제시하고 있다. 아무쪼 록 이 연구에서 제시한 방안들이 농어촌 주민의 평생학습참여율 제고와 응급 의료여건 관련자들의 업무 개선뿐 아니라 관련 정책의 발전에 도움이 되는 기 초자료로 활용되기를 바란다.. 이 연구는 수행과정에서 많은 이의 도움을 받았다. 평생학습정책과 관련한. 정책자료를 제공한 국가평생교육진흥원의 통계 담당자, 변종임, 홍숙희 선생. 님, 과제 개발에 도움을 주신 공주대학교의 양병찬 교수님께 감사드린다. 응급 의료체계 관련 자료를 제공해 준 중앙응급의료센터 윤한덕 센터장님과 장한석 선생님, 과제 진행에 도움을 주신 보건복지부 이미연 선생님과 한국보건사회연 구원 김동진 박사님께 연구진을 대신하여 감사를 드린다.. 2012. 12. 한국농촌경제연구원장 이 동 필.
(4)
(5) iii 요. 약. ○ 이 연구는 ‘삶의 질 향상 위원회’가 선정한 2개 정책(평생학습정책, 응급의료. 정책)을 대상으로 정책 설계 및 시행 과정에서 농어촌에 끼칠 수 있는 차별적 영향에 대해 심층적으로 분석하고 정책 대안을 제시하는 데 목적이 있다.. ○ 농어촌 영향평가(전문평가)는 ‘정책 관련 현황 및 선행연구 분석 → 정책 내용 분석 및 성과목표 확인 → 정책의 도농 간 성과 차이 분석 → 농어촌 인지적 관점에서 정책의 문제점 분석 → 정책의 개선과제 도출’ 등의 과정 에 따라 실시되었다.. [평생학습정책]. ○ 관련 현황 및 선행연구 분석: 농어촌의 평생학습대상자는 도시에 비해 상대 적으로 고령이면서 농어업 종사인구가 많고, 저학력이고, 경제활동참여의 계절적 편차가 심하다. 농어촌의 평생학습시설이 도시에 비해 매우 열악할. 뿐만 아니라, 농어촌에 대한 공공부문의 투자와 민간부문의 관련 자원 역시 도시에 비해 적다.. ○ 관련 정책 분석: 평생학습정책을 통해 추진되는 주요 사업으로는 평생학습 도시 지원사업, 대학평생교육 지원사업, 성인문해교육 지원사업, 소외계층 평생교육 프로그램 지원사업 등이 있고, 이러한 평생학습정책 사업의 원활. 한 추진을 위한 지원조직으로 중앙차원에는 국가평생교육진흥원, 지역차원 에는 광역단위 평생교육진흥원, 기초단위 평생학습관이 있다. 제 2차 계획. 의 경우 당초 평생교육진흥기본계획에서 계획했던 만큼의 투자는 이루어지 지 못하였다. 국가적 단위의 평생학습 인프라 구축에 비해 지역차원의 평생 교육활성화와 관련한 예산 투입이 다소 미흡하였다..
(6) iv. ○ 정책의 도농 간 성과차이 분석: 대도시, 중소도시 주민에 비해 농어촌 주민. 의 평생학습 참여율, 평생학습 참여시간, 평생학습비, 평생학습관련 정보탐 색시도율 모두 낮았다. 이러한 도농간 차이는 주민들의 개인특성(성별, 연. 령, 학력, 혼인상태, 소득수준, 직업 등)에 의해 발생하기도 하지만, 이들 요 인과는 독립적으로 도시와 농어촌이라는 지역 요인의해 발생하고 있었다.. ○ 농어촌 인지적 관점에서 정책의 문제점 분석: 동일 조건으로 정책 사업이 추진 시 도시에 비해 농어촌에 불리할 수밖에 없는 주요 특성이 무엇인지 농어촌 인지적 관점에서 평생학습정책의 문제점을 분석한 결과 평생학습정 책은 농어촌 영향평가에서 고려하고 있는 농어촌 특성 중에서도 불리한 서 비스 접근성, 공공 성 등의. / 민간 자원의 부족, 그리고 농어촌 평생학습대상의 특수 관점에서 구체적인 문제를 가지고 있었다.. ○ 정책 개선과제 도출: 농어촌 주민의 평생학습참여 확대를 위해, 농어촌 인지 적 관점에서 제기된 문제점의 극복과 관련하여, ① 농어촌에 적합한 평생 학습 추진체계 구축, ② 농어촌 주민의 삶의 질 향상을 위한 평생학습 사업 실시, ③ 대상자별 특성화된 평생교육사업 실시 등을 추진과제로 제안하였다. [응급의료정책]. ○ 관련 현황 및 선행연구 분석: 응급의료취약지역 지원이 확대되고, 지리성 접 근성이 개선되고 있지만, 농어촌지역의 응급의료서비스는 아직 저조한 수 준이었다.. ○ 관련 정책 분석: 응급의료정책은 응급의료체계를 기준으로 병원전 단계에 해당하는 환자 이송 관련 사업과 병원 단계로 응급의료센터·기관 서비스로 구분하여 살펴보았다. 정책의 성과 목표는 단위면적당 구급차 수, 구급차. 현장도착시간, 현장에서 응급의료기관 이송시간, 응급의료기관의 법정기준 충족률, 교통사고 사망률 등으로 측정하였다..
(7) v. ○ 정책의 도농 간 성과차이 분석: 구급차 수는 인구 수 기준에 비해 단위면적 당 수의 농어촌이 매우 적은 것으로 나타났다. 환자 이송 관련 구조구급시 간에 대해서 응급의료체계에서 제시한 ‘전국 어디서나. ·. 30분 내 응급의료서. 비스 수혜가능’ 이라는 목표 수준에 못 미치는 읍 면 지역이 아직도 절반 정도에 이르렀다. 군 지역 응급의료기관은 숫자에 있어서도 절대적으로 적. 을 뿐 아니라, 이들 대부분이 법정기준을 충족하지 못하는 것으로 나타났. 다. 또한 응급의료체계의 성과를 대변하는 지표 중 하나인 교통사고 사망률 은 농어촌지역이 도시지역에 비해 3배가량 높은 것으로 나타났다.. ○ 농어촌 인지적 관점에서 정책의 문제점 분석: 동일 조건으로 정책 사업이 추진 시 도시에 비해 농어촌에 불리할 수밖에 없는 주요 특성이 무엇인지 농어촌 인지적 관점에서 평생학습정책의 문제점을 분석한 결과 응급의료정 책은 농어촌 영향평가에서 고려하고 있는 농어촌 특성 중에서도 불리한 서 비스 접근성, 낮은 인구밀도와 소수의 정책 수혜자, 그리고 농어촌 응급의 료기관의 영세성 등의 관점에서 구체적인 문제를 가지고 있었다.. ○ 정책 개선과제 도출: 농어촌 주민의 응급의료체계 개선을 위해, 농어촌 인지 적 관점에서 제기된 문제점의 극복과 관련하여, ① 지역주민의 응급처지 교육을 통해 일차 반응자 역할 강화, ② 구급차 업그레이드, 응급구조사 1급 및 간호사 구급차 동승 등 전문응급서비스 강화, ③ 보건소·보건지소·보건 진료소 의료진과의 연계, ④ 농어촌 인지적 관점에서의 자료 확보 등을 추 진과제로 제안하였다..
(8) vi ABSTRACT. Rural Proofing on Life-long Learning Policy and Emergency Medical Service Policy. This study was to investigate the discriminative effects between rural and urban area of major central government policies(Life-long Learning Policy and Emergency Medical Service Policy) and to suggest improvement measures in terms of rural perspective. For the purpose, this study employed following 5 phases: related statistics and research reviewing; policy analysis and performance target identifying; performance gap analyzing between rural and urban area; problem finding in terms of rural perspective(low accessability, low population density, small and isolated businesses, agriculture-based economic activity, lack of public resource, human and social capital shortage); and improvement measures developing. This study suggested three measures for the life-long learning policy of Ministry of Education, Science and Technology: rural implementation system for life-long learning establishment; project introduction for quality of life improvement through life-long learning; promotion of life-long learning specified for rural minorities. Also, following four measures for the emergency medical service policy of Ministry of Health and Welfare were put forward: education of first responders; improvement to the advanced life support; collaboration with the medical team in community health centers; producing rural statistics.. Researchers: Sang-Jin Ma, Mihyoung Cho, and Young-kwang Han Research period: 2012. 5. - 2012. 12. E-mail address: msj@krei.re.kr.
(9) vii 차. 례. 제1장 서 론 ········································································································1 1. 연구 배경 ······································································································ 1 2. 연구 목적 ······································································································ 4 3. 연구 방법 ······································································································ 4 제1부 평생학습 정책. 제2장 농어촌의 평생학습 관련 기본현황과 선행연구 ·······························13 1. 평생학습의 개념과 역사 ············································································ 13 2. 농어촌 평생학습 대상자 분석 ··································································· 17 3. 농어촌 평생학습 인프라 실태 ··································································· 26 4. 농어촌 평생학습 관련 연구 동향 ····························································· 30 5. 관련 현황 및 선행연구의 시사점 ····························································· 44 제3장 평생학습 정책 현황 ··············································································47 1. 추진배경 및 경과 ······················································································· 47 2. 비전 및 목표 ······························································································· 50 3. 추진 주체와 체계 ······················································································· 52 4. 투입예산 ······································································································ 56 5. 주요 사업 ···································································································· 58 6. 성과지표 ······································································································ 64 7. 정책 시사점 ································································································· 69 제4장 평생학습 성과의 도농간 차이와 원인․요구 분석 ·························71.
(10) viii. ······································································································ 71 도농간 평생학습 성과지표 차이 ······························································· 72 도농간 평생학습 성과차이 원인 분석 ····················································· 78 농어촌 주민의 평생학습 관련 요구 ························································· 87 분석결과 요약 ····························································································· 90 제5장 평생학습 정책 개선과제 ······································································91 1. 농어촌 인지적 관점에서의 문제점 ··························································· 91 2. 정책개선과제 ····························································································· 100 1. 2. 3. 4. 5.. 분석개요. 제2부 응급의료 정책. 제6장 응급의료 정책 현황 ············································································117 1. 추진배경 ···································································································· 117 2. 목표 및 추진과제 ····················································································· 118 3. 추진주체 및 체계 ····················································································· 120 4. 투입예산 ···································································································· 124 5. 주요 사업 ·································································································· 125 제7장 응급의료 관련 현황과 선행연구 ······················································127 1. 응급의료 정책 추진 현황 ········································································ 127 2. 농어촌 지역 응급의료체계 현황 ····························································· 130 3. 선행연구 고찰 ··························································································· 144 제8장 응급의료 정책 관련 성과 지표의 도농 간 비교 ···························153 1. 분석 개요 ·································································································· 153 2. 응급의료체계 관련 성과지표의 도농간 비교 ········································ 155.
(11) ix. 제9장 응급의료 정책의 문제점 및 개선방안 ·············································161 1. 농어촌 인지적 관점의 문제점 ································································· 161 2. 정책 개선 과제 ························································································· 167 ···································································································· 173 부록2: 농어촌 영향평가 소개 ········································································· 189 부록3: 외국의 농어촌 영향평가 사례 ···························································· 192 부록1: 질문지. 참고 문헌. ··········································································································· 199.
(12) x. 표 차 례 제1장 표 표 표. 1-1. 1-2. 1-3.. 제2장 표 표 표 표 표 표 표 표 표 표 표 표 표 표 표 표 표. 2-1. 2-2. 2-3. 2-4. 2-5. 2-6. 2-7. 2-8. 2-9. 2-10. 2-11. 2-12. 2-13. 2-14. 2-15. 2-16. 2-17.. ·· 7 응급의료서비스 이용환자 조사 응답자의 일반적 특성 ················ 9 응급의료서비스 이용환자 조사 장소별 응답자 분포 ···················· 9 농어촌 주민의 평생학습/응급의료 실태조사 응답자 일반 특성. ․. ···················································· 14 지역규모별 평생학습대상 인구변화 ·············································· 17 성별 평생학습대상자 ······································································· 18 연령별 평생학습대상자 ··································································· 18 학력별 평생학습대상자 ··································································· 19 경제활동상태별 평생학습대상자 ···················································· 20 평생학습대상자의 경제활동종사분야(산업기준) ··························· 21 지역규모별 65세 이상 노인인구 비중 ·········································· 23 지역규모별 65세 이상 노인인구의 학력 ······································ 23 지역규모별 65세 이상 노인인구의 경제활동상태 ······················· 24 지역규모별 65세 이상 노인인구의 경제활동분야 ······················· 25 지역별 평생교육기관 개황 ····························································· 26 지역규모 및 연도별 평생교육 기본개황(2007～2011) ················ 27 지역별 평생교육기관 특성별 현황 ················································ 27 지역별 평생교육 주제별 프로그램 현황 ······································· 28 지역별 평생교육 프로그램 주제별 학습자 현황 ························· 28 지역별 평생교육기관 설립별 현황 ················································ 28 교육 훈련과 평생학습의 차이.
(13) xi 표 표 표 표 표 표. 2-18. 2-19. 2-20. 2-21. 2-22. 2-23.. 제3장 표 표 표 표 표 표 표 표 표 표 표. 3-1. 3-2. 3-3. 3-4. 3-5. 3-6. 3-7. 3-8. 3-9. 3-10. 3-11.. 제4장 표 표 표 표 표 표 표. 4-1. 4-2. 4-3. 4-4. 4-5. 4-6. 4-7.. ․. ···················································· 29 지역별 사무직원 현황 및 평생교육사 배치 현황 ······················· 29 지역별 연도별 평생교육사 배치 비율 ·········································· 29 도시형과 농촌형 평생학습도시 운영 모델 비교 ························· 31 지역유형별 인구구성, 주요산업, 기반자원 차원에서 차이점 ····· 32 지역유형별 평생학습 문제와 요구 ················································ 33 지역별 교 강사 최종학력 현황. ·············································· 55 평생교육진흥기본계획의 영역별 투자계획 ··································· 56 평생교육 관련 예산투입 실적(교육과학기술부 중심) ················· 57 평생교육진흥기본계획상의 정책영역별 주요 추진 과제 ············ 58 지역규모별 평생학습도시 지정현황 ·············································· 59 평생학습도시 지원사업 투여 예산 ················································ 60 대학 평생교육 활성화 지원사업 예산투입 ··································· 61 성인문해교육 지원사업 투입예산 ·················································· 63 소외계층 평생교육 프로그램 투입예산과 프로그램 현황 ·········· 64 평생교육진흥기본계획상의 성과지표 ············································ 65 한국 성인의 평생학습 실태에서의 지표와 조사항목 ·················· 68 평생학습 주요 주체별 기능과 구성. ․. ································ 72 지역규모별 무형식학습 참여율 ······················································ 73 지역규모별 평생학습 참여시간 ······················································ 74 지역규모별 평생학습 참여자의 연평균 1인당 교육비 ················ 75 지역규모별 평생학습 정보탐색 관련 현황 ··································· 75 농어촌 주민의 평생학습 참여율 ···················································· 76 농어촌 주민의 평생학습 시간과 학습비용 ··································· 77 지역규모별 평생학습(형식 비형식) 참여율.
(14) xii 표 표 표 표 표 표 표 표 표 표 표 표 표. 4-8. 4-9. 4-10. 4-11. 4-12. 4-13. 4-14. 4-15. 4-16. 4-17. 4-18. 4-19. 4-20.. 제5장 표 표 표 표 표. 5-1. 5-2. 5-3. 5-4. 5-5.. 제6장 표 표 표. 6-1. 6-2. 6-3.. ······························· 78 분석에 사용된 변인의 기초통계 ···················································· 79 평생학습 참여에 대한 Logit 분석 ················································· 81 무형식학습 참여에 대한 Logit 분석 ············································· 82 평생학습 참여시간에 대한 Tobit 분석 ········································· 83 평생학습 비용에 대한 Tobit 분석 ················································· 84 정보탐색시도율에 대한 logit 분석 ················································ 85 정보탐색성공율에 대한 logit 분석 ················································ 86 평생학습 참여장애 요인 (중복응답) ············································· 87 농어촌 주민들이 평소 자주 이용하는 학습기관 ························· 88 농어촌 주민들이 선호하는 교육시설/방식 ···································· 89 지역규모별 평생학습(비형식) 참여 경험 ······································ 89 농어촌 주민의 평생학습 내용 요구 ·············································· 90 도농간 평생학습 성과 차이 원인 분석 설계. ·················· 94 가구소득(연간 소득) 변화 동향 ····················································· 99 농촌진흥기관에서 운영하는 농업인대학 현황 ··························· 107 강화군 농업대학 향토자원개발과 교과목 편성 사례 ················ 108 고산향 교육공동체 세부 활동 ······················································ 111 농어촌서비스기준 주요 항목의 이행실태 점검 결과. ······················ 123 응급의료기금 현황 ········································································· 125 응급의료기금 사업 현황 ······························································· 126 응급의료기관별 역할 및 현황(2012년 8월 기준). 제7장 표. 7-1.. 구급서비스 이용 경험의 도농간 비교. ········································ 131.
(15) xiii 표 표 표 표 표 표 표 표 표 표 표 표 표 표. 7-2. 마을에서 인근 종합병원까지 소요시간(이송시간) ····················· 132 7-3. 119안전센터에서 마을까지 소요시간(반응시간) ························ 132 7-4. 거주 지역 규모에 따른 응급실 방문 시 이용 병원까지 소요시간 비교 · 133 7-5. 병원의 근접성에 따른 응급실 방문 시 이용 병원까지 소요시간 비교 · 134 7-6. 응급실 이용 현황 ·········································································· 135 7-7. 응급실 경유 입원환자의 입원 경로 ············································ 136 7-8. 도농 간 응급실 내원 환자 중 응급증상 환자 비율 비교 ········ 137 7-9. 응급의료시설 지역별 배치 현황 ·················································· 139 7-10. 응급의료기관의 응급실 규모 및 인력 현황 ······························· 140 7-11. 지역규모별 응급의학전문의 수 현황 ·········································· 140 7-12. 전국의 응급의료취약지역 분포 ···················································· 145 7-13. 응급의료지수 평가지표(이진석 등 2007) ··································· 150 7-14. 응급의료체계 평가영역별 평가지표 예시(임정수 등 2007) ····· 151 7-15. 응급의료기본계획(2011-2015)에서 설정한 목표별 측정가능지표 ··· 151. 제8장 표 표 표 표 표 표 표. 8-1. 8-2. 8-3. 8-4. 8-5. 8-6 8-7.. 제9장 표 표 표. 9-1. 9-2. 9-3.. ························································ 154 교통사고 사망률 계산 방식 ························································· 154 단위면적 및 인구 1만 명당 구급차 수 ······································ 155 단위면적당 구급차 수가 적은 지역 ············································ 156 응급의료체계 관련 성과지표. 신고-구급차 현장 도착/현장-응급의료센터 도착 소요시간 비교. 157 도농 간 지역응급의료기관 법정기준 충족률 ······························ 158 도농 간 교통사고 사망률 추이 비교 ········································ 159. ························· 163 응급구조사 업무 범위 비교 ························································· 169 응급의료체계 관련 성과지표별 자료 현황 ································· 171 응급실 의료진 1회 근무 시 담당 환자수 비교.
관련 문서
③ 제1항에 따라 허가를 받아야 하는 행위로서 정비구역의 지정 및 고시 당시 이미 관계 법령에 따라 행위허가를 받았거나 허가를 받을 필요가 없는 행위에 관하여 그
다음에서는 주로 경관 분야를 중심으로 하여 농어촌 어메니티 향상을 위한 정책 추진 동향과
- 이와 더불어 지역 공동체성이 복원되고 이를 바탕으로 농어촌 정책 사업이 추진되어 야 바람직하겠지만, 이러한 기대와는 반대로 국비지원을 통해 지속 가능한 지역
대표적으로 농어촌 소규모 통폐합 정책은 농어촌 교육력 회복 을 위한 장기적ㆍ유기적인 성격의 정책이라기보다는 단기간에 나타날 교육 재정적 효과를 위해
◦주요 조사 내용은 농업인과 도시민의 의식 변화를 지속적으로 파악할 수 있는 고정 문항과 정책 현안 등을 포함한 비고정 문항으로 구성되었음... – ‘주요 농산물
회의 다자성 양자원조의 동향, 주요 공여국의 다자성 양자원조 정책 기조, 한국의 농업 ODA 사업의 목표 등의 다각적인 검토를 통해 다자성 양자원조의 정책 추진
이주를 준비하고 있는 사람들은 기존 마을에서 기존 농어촌 주민들과 함께 어울리 면서 적응하려는 경향이 높아 기존 마을 내 입주 선호도가 상대적으로 높 음..
농어촌 지역에 대한 사업 비중을 설정하고, 농어촌 수혜자 만족도 조사 등을 진행하여 사업의 효과성을 높이기 위한
