Sihn Kyu Hwan, Seo Hong Gwan
Department of Medical History & Medical Ethics, Inje University.
Uisahak. 2002 Jun;11(1):85-110.
Modern hospital in Korea was the space of competition and comprise among different forces such as the state power and social forces, imperialism and nationalism, and the traditional and modern medicine. Hospital in the Japanese colonialism was the object of control for establishing the colonial medical system. Japanese colonialism controlled not only the public hospital but also the private hospital which had to possess more than 10 infectious beds in the isolation building by the Controlling Regulation of Private Hospital. In fact, the private hospital had to possess more than 20 beds for hospital management. As a result, its regulation prevented the independent development of the private hospital. But because the public hospital could not accommodate many graduates of medical school, most of them had to serve as practitioner. Although some practitioners had more than 20 beds in their clinics, they were not officially included in the imperial medicine. By concentrating on the trend of the number of beds in the hospital, this paper differs from most previous studies of the system of hospital, which have argued that the system of hospital was converted the public-centered hospital system under the colonial medical system into the private-centered hospital system under the U. S. medical system after the Liberation in 1945. After Liberation, medical reformers discussed arranging the public and the private hospital. Lee Yong-seol, who was a Health-Welfare minister, disagreed the introduction of the system of state medicine. Worrying about the flooding of practitioners, he did not want to intervene the construction of hospital by state power. Because the private hospital run short of the medical leadership and the fundamental basis, the state still controlled the main disease in the public health and the prevention of epidemics. This means the state also played important part in the general medical examination and treatment. The outbreak of Korean War in 1950 reinforced the role of state. The leadership of the public hospital verified the trend of the quantity of beds. The number of beds in the private hospital exceeded that of the public hospital in 1966 for the first time. Futhermore, the number of beds in the public hospital doubled that of private hospital in the new general hospital of 1950s. This means the system of hospital after the Liberation was not converted the public-centered hospital system into the private-centered hospital system, but maintained the public-centered hospital system until 1960s.
韩国的现代医院是一个竞争空间，由国家权力与社会力量、帝国主义与民族主义以及传统医学与现代医学等不同力量构成。日本殖民统治时期的医院是建立殖民医疗体系的管控对象。日本殖民统治不仅控制公立医院，还通过《私立医院管制条例》控制私立医院，规定私立医院在隔离楼必须拥有10张以上传染病床位。实际上，私立医院为了医院运营必须拥有20张以上床位。结果，这项规定阻碍了私立医院的独立发展。但由于公立医院无法容纳众多医学院毕业生，他们大多只能成为开业医生。尽管一些开业医生的诊所拥有20张以上床位，但他们并未被正式纳入帝国医学体系。本文关注医院床位数量的趋势，这与以往大多数关于医院体系的研究不同，以往研究认为1945年解放后，殖民医疗体系下以公立为主的医院体系转变为美国医疗体系下以私立为主的医院体系。解放后，医疗改革者讨论了公立和私立医院的安排。曾任卫生福利部长的李永燮反对引入国营医学体系。由于担心开业医生泛滥，他不想让国家权力干预医院建设。由于私立医院缺乏医疗领导力和基础条件，国家仍控制着公共卫生中的主要疾病和疫情防控。这意味着国家在一般医疗检查和治疗中也发挥着重要作用。1950年朝鲜战争的爆发强化了国家的作用。公立医院的主导地位证实了床位数量的趋势。1966年，私立医院的床位数首次超过公立医院。此外，20世纪50年代新建的综合医院中，公立医院的床位数是私立医院的两倍。这意味着解放后的医院体系并没有从以公立为主的医院体系转变为以私立为主的医院体系，而是在20世纪60年代之前一直维持着以公立为主的医院体系。
