• 제목/요약/키워드: Personal assistance service for persons with disabilities

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장애인활동 지원제도에 관한 한·일 비교 -장애인의 자기결정권 보장을 중심으로- (Comparative Study on the Personal Assistance System for Persons with Disabilities in South Korea and Japan -Focusing on Self-Determination of People with Disabilities -)

  • 이미정
    • 재활복지
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    • 제17권4호
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    • pp.1-26
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    • 2013
  • 사회가 발전함에 따라 장애복지정책도 장애인의 권리를 보장하기 위한 방향으로 발전하고 있으며 활동보조서비스는 장애인들의 자기결정권을 보장하는 주요 제도이다. 이번 연구의 목적은 한국의 장애인활동 지원제도의 발전방안을 모색하기 위해 한국과 일본의 제도를 비교분석하기 위한 것이다. 비교분석은 신청 자격기준, 정보제공, 지원내용(서비스의 양과 종류 및 지급기관), 이의 신청 제도, 경제적 부담능력 등과 같은 제도 현황을 중심으로 비교분석하였다. 조사 결과에 따르면 한국의 활동지원제도는 이용자의 필요욕구 보다는 행정 중심적으로 이루어지고 있었으며 서비스 시간과 서비스 유형이 개인의 활동지원 필요성에 의하여 이루어 지고 있지 못한 상태에 있었다. 반면, 일본의 활동지원제도는 자립생활의 이념에 맞춰 제공되고 있으며 자기결정권과 서비스 선택권에 의해 서비스가 계획되고 제공되고 있었다. 한국의 장애인활동 지원제도의 발전을 위해서는 첫째, 활동지원제도는 자립생활의 이념에 맞춰 제공되어야 한다. 이는 활동지원서비스의 이념이 장애인의 자기결정권과 선택권을 기초로 하고 있기 때문이다. 둘째, 신청 자격기준, 정보제공, 지원내용, 이의 신청 제도, 경제적 부담능력 등을 분석한 결과 한국의 장애인활동 지원제도는 전반적으로 재검토가 필요하다. 셋째, 한국의 활동지원제도의 효율성 및 정착을 위해 일본제도와 같이 상담지원(사례관리)체계의 도입이 필요하다. 이는 사례관리체계를 통해 활동지원의 양과 서비스 유형이 체계화되면서 장애인들의 사회참여의 기회가 확대될 것이기 때문이다.

장애인활동지원서비스제도의 노동시장 참여에 대한 정책효과 (The effect of policy on Korean personal assistance service for persons with disabilities of labor market participation)

  • 김송숙;김유민;나가연;백승희;이근철
    • 한국융합학회논문지
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    • 제12권4호
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    • pp.267-274
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    • 2021
  • 본 연구는 장애인활동지원제도가 정책효과로서 수급자 가구원의 노동시장 참여를 촉진시켰는지에 대해 평가하고자 한국복지패널 6차(2011년)과 12차(2017년)자료를 이용하였다. 연구대상은 성향점수매칭 중 Caliper matching을 이용하여 제도를 이용한 실험집단 64명과 이용하지 않은 통제집단 344명을 선정하였다. 집단간 특성차이는 카이제곱검정을 이용하였고, 제도 전후의 정책효과를 추정하기 위해 단순이중차이분석과 이중차이 다중회귀분석을 실시하여 제도의 노동시장 참여에 대한 영향을 파악하였다. 연구결과 장애인활동지원제도는 이용자 가구원의 노동시장 참여에 대한 유의한 차이가 나타나지 않았다. 이는 제도 이용자의 수의 적음으로 인한 낮은 통계적 검정력과 불완전한 매칭 그리고 장애인 활동지원사의 서비스만으로는 장애인 자립에 한계가 있기 때문으로 생각한다. 따라서 제도의 효과를 나타내기 위해 전문화된 서비스와 장애인과 부양가구원의 요구에 맞는 제도가 실시되어야 할 것이다.

충남지역 지체장애인의 이동권 실태 및 개선방안 연구 (The Status of Mobility Disadvantaged Persons with Physical Disabilities & Suggested Improvements in Chungnam)

  • 최윤영;양정빈;김자영
    • 융합정보논문지
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    • 제11권4호
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    • pp.130-136
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    • 2021
  • 본 연구는 충남에 거주하는 지체장애인의 이동권 현황을 파악하여, 이들의 이동권을 향상시킬 수 있는 방안을 제시하고자 한다. 이를 위해 2단계에 걸쳐 설문지를 개발하였으며, 일반적 특성, 외출 및 이동현황, 저상버스 및 장애인 콜택시 사용현황, 서비스 개선사항, 광역이동지원센터 관련 문항으로 구성되었다. 연구대상은 충남에 거주하는 지체장애인으로 총 219명이 참여하였다. 조사 결과 응답자 중 54.6%는 매일 외출하였으며, 17.0%는 거의 외출을 하지 않았다. 53.4%의 응답자만 홀로 외출이 가능했으며, 외출하지 않는 주된 이유로는 계단과 대중교통의 불편함을 꼽았다. 응답자 중 26.9%는 저상버스를, 71.1%는 장애인 콜택시를 이용했으며, 이를 위해 각각 66.57분, 42.65분 동안 기다린 것으로 나타났다. 78.7%는 광역지원센터가 필요하다고 한 반면, 49.8%만이 센터를 인지하고 있었다. 연구결과에 기초하여 이동권 향상 방안으로 특별교통수단의 확대, 지체장애인의 보행환경 개선, 광역이동지원센터 기능 활성화 등에 대해 논의하였다.

농촌(農村) 주민(住民)들의 의료필요도(醫療必要度)에 관(關)한 연구(硏究) (A Study Concerning Health Needs in Rural Korea)

  • 이성관;김두희;정종학;정극수;박상빈;최정헌;홍순호;라진훈
    • Journal of Preventive Medicine and Public Health
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    • 제7권1호
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    • pp.29-94
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    • 1974
  • Today most developed countries provide modern medical care for most of the population. The rural area is the more neglected area in the medical and health field. In public health, the philosophy is that medical care for in maintenance of health is a basic right of man; it should not be discriminated against racial, environmental or financial situations. The deficiency of the medical care system, cultural bias, economic development, and ignorance of the residents about health care brought about the shortage of medical personnel and facilities on the rural areas. Moreover, medical students and physicians have been taught less about rural health care than about urban health care. Medical care, therefore, is insufficient in terms of health care personnel/and facilities in rural areas. Under such a situation, there is growing concern about the health problems among the rural population. The findings presented in this report are useful measures of the major health problems and even more important, as a guide to planning for improved medical care systems. It is hoped that findings from this study will be useful to those responsible for improving the delivery of health service for the rural population. Objectives: -to determine the health status of the residents in the rural areas. -to assess the rural population's needs in terms of health and medical care. -to make recommendations concerning improvement in the delivery of health and medical care for the rural population. Procedures: For the sampling design, the ideal would be to sample according to the proportion of the composition age-groups. As the health problems would be different by group, the sample was divided into 10 different age-groups. If the sample were allocated by proportion of composition of each age group, some age groups would be too small to estimate the health problem. The sample size of each age-group population was 100 people/age-groups. Personal interviews were conducted by specially trained medical students. The interviews dealt at length with current health status, medical care problems, utilization of medical services, medical cost paid for medical care and attitudes toward health. In addition, more information was gained from the public health field, including environmental sanitation, maternal and child health, family planning, tuberculosis control, and dental health. The sample Sample size was one fourth of total population: 1,438 The aged 10-14 years showed the largest number of 254 and the aged under one year was the smallest number of 81. Participation in examination Examination sessions usually were held in the morning every Tuesday, Wenesday, and Thursday for 3 hours at each session at the Namchun Health station. In general, the rate of participation in medical examination was low especially in ages between 10-19 years old. The highest rate of participation among are groups was the under one year age-group by 100 percent. The lowest use rate as low as 3% of those in the age-groups 10-19 years who are attending junior and senior high school in Taegu city so the time was not convenient for them to recieve examinations. Among the over 20 years old group, the rate of participation of female was higher than that of males. The results are as follows: A. Publie health problems Population: The number of pre-school age group who required child health was 724, among them infants numbered 96. Number of eligible women aged 15-44 years was 1,279, and women with husband who need maternal health numbered 700. The age-group of 65 years or older was 201 needed more health care and 65 of them had disabilities. (Table 2). Environmental sanitation: Seventy-nine percent of the residents relied upon well water as a primary source of dringking water. Ninety-three percent of the drinking water supply was rated as unfited quality for drinking. More than 90% of latrines were unhygienic, in structure design and sanitation (Table 15). Maternal and child health: Maternal health Average number of pregnancies of eligible women was 4 times. There was almost no pre- and post-natal care. Pregnancy wastage Still births was 33 per 1,000 live births. Spontaneous abortion was 156 per 1,000 live births. Induced abortion was 137 per 1,000 live births. Delivery condition More than 90 percent of deliveries were conducted at home. Attendants at last delivery were laymen by 76% and delivery without attendants was 14%. The rate of non-sterilized scissors as an instrument used to cut the umbilical cord was as high as 54% and of sickles was 14%. The rate of difficult delivery counted for 3%. Maternal death rate estimates about 35 per 10,000 live births. Child health Consultation rate for child health was almost non existant. In general, vaccination rate of children was low; vaccination rates for children aged 0-5 years with BCG and small pox were 34 and 28 percent respectively. The rate of vaccination with DPT and Polio were 23 and 25% respectively but the rate of the complete three injections were as low as 5 and 3% respectively. The number of dead children was 280 per 1,000 living children. Infants death rate was 45 per 1,000 live births (Table 16), Family planning: Approval rate of married women for family planning was as high as 86%. The rate of experiences of contraception in the past was 51%. The current rate of contraception was 37%. Willingness to use contraception in the future was as high as 86% (Table 17). Tuberculosis control: Number of registration patients at the health center currently was 25. The number indicates one eighth of estimate number of tuberculosis in the area. Number of discharged cases in the past accounted for 79 which showed 50% of active cases when discharged time. Rate of complete treatment among reasons of discharge in the past as low as 28%. There needs to be a follow up observation of the discharged cases (Table 18). Dental problems: More than 50% of the total population have at least one or more dental problems. (Table 19) B. Medical care problems Incidence rate: 1. In one month Incidence rate of medical care problems during one month was 19.6 percent. Among these health problems which required rest at home were 11.8 percent. The estimated number of patients in the total population is 1,206. The health problems reported most frequently in interviews during one month are: GI trouble, respiratory disease, neuralgia, skin disease, and communicable disease-in that order, The rate of health problems by age groups was highest in the 1-4 age group and in the 60 years or over age group, the lowest rate was the 10-14 year age group. In general, 0-29 year age group except the 1-4 year age group was low incidence rate. After 30 years old the rate of health problems increases gradually with aging. Eighty-three percent of health problems that occured during one month were solved by primary medical care procedures. Seventeen percent of health problems needed secondary care. Days rested at home because of illness during one month were 0.7 days per interviewee and 8days per patient and it accounts for 2,161 days for the total productive population in the area. (Table 20) 2. In a year The incidence rate of medical care problems during a year was 74.8%, among them health problems which required rest at home was 37 percent. Estimated number of patients in the total population during a year was 4,600. The health problems that occured most frequently among the interviewees during a year were: Cold (30%), GI trouble (18), respiratory disease (11), anemia (10), diarrhea (10), neuralgia (10), parasite disease (9), ENT (7), skin (7), headache (7), trauma (4), communicable disease (3), and circulatory disease (3) -in that order. The rate of health problems by age groups was highest in the infants group, thereafter the rate decreased gradually until the age 15-19 year age group which showed the lowest, and then the rate increased gradually with aging. Eighty-seven percent of health problems during a year were solved by primary medical care. Thirteen percent of them needed secondary medical care procedures. Days rested at home because of illness during a year were 16 days per interviewee and 44 days per patient and it accounted for 57,335 days lost among productive age group in the area (Table 21). Among those given medical examination, the conditions observed most frequently were respiratory disease, GI trouble, parasite disease, neuralgia, skin disease, trauma, tuberculosis, anemia, chronic obstructive lung disease, eye disorders-in that order (Table 22). The main health problems required secondary medical care are as fellows: (previous page). Utilization of medical care (treatment) The rate of treatment by various medical facilities for all health problems during one month was 73 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 52% while the rate of those who have health problems which did not required rest was 61 percent (Table 23). The rate of receiving of medical care for all health problems during a year was 67 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 82 percent while the rate of those who have health problems which did not required rest was as low as 53 percent (Table 24). Types of medical facilitied used were as follows: Hospital and clinics: 32-35% Herb clinics: 9-10% Drugstore: 53-58% Hospitalization Rate of hospitalization was 1.7% and the estimate number of hospitalizations among the total population during a year will be 107 persons (Table 25). Medical cost: Average medical cost per person during one month and a year were 171 and 2,800 won respectively. Average medical cost per patient during one month and a year were 1,109 and 3,740 won respectively. Average cost per household during a year was 15,800 won (Table 26, 27). Solution measures for health and medical care problems in rural area: A. Health problems which could be solved by paramedical workers such as nurses, midwives and aid nurses etc. are as follows: 1. Improvement of environmental sanitation 2. MCH except medical care problems 3. Family planning except surgical intervention 4. Tuberculosis control except diagnosis and prescription 5. Dental care except operational intervention 6. Health education for residents for improvement of utilization of medical facilities and early diagnosis etc. B. Medical care problems 1. Eighty-five percent of health problems could be solved by primary care procedures by general practitioners. 2. Fifteen percent of health problems need secondary medical procedures by a specialist. C. Medical cost Concidering the economic situation in rural area the amount of 2,062 won per residents during a year will be burdensome, so financial assistance is needed gorvernment to solve health and medical care problems for rural people.

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