• 한국사회정책
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• 제24권4호
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• pp.113-150
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• 2017

본 연구는 노동자가 업무 이외의 이유로 아프게 되면, 노동시장에서 어떻게 고용 불안정성을 경험하고 또 빈곤화를 경험하는지 분석한다. 특히 아픈 노동자에 대한 한국 사회보장제의 소득보장 기능을 분석하고, 상병수당이 부재한 한국 복지국가의 특수성이 아픈 노동자의 빈곤화에 미치는 영향에 주의를 기울이며 사례 연구를 실시했다. 연구 결과, 아픈 노동자들은 상병으로 고통을 경험해도 일단 '아파도 참는다'. 특히 불안정 노동을 하는 비정규직 노동자들은 아프면 몸을 회복할 수 있는 휴직을 누릴 수 있는 여지가 없이 실직을 경험하게 된다. 그리고 아파서 실직을 경험하게 되어도 소득 감소분을 채우기 위해 더 불안정한 노동이라도 지속하는 경향이 있었다. 그 과정에서 가족 등 주변 사회적 자원이 무너지는 양상도 보이면서, 빈곤화의 경로를 밟는 것이 관찰됐다. 상병과 실업이라는 복합적인 위기에 처한 노동자를 위한 사회보장제도에도 사각지대가 확인됐다. 산재를 겪은 노동자들은 산업재해 신고를 기피하는 사업주 탓에 제도의 혜택에서 벗어나기도 하였고 또 상병으로 실직한 노동자를 고용주가 '자발적 실업'으로 신고하여 실업수당에도 배제됐다. 본 연구는 노동자의 상병으로 인한 일자리 불안정화와 빈곤화 과정을 구체적으로 확인하는 연구로 의의가 있다. 또한 상병수당의 부재와 아픈 노동자의 관계가, 상병수당을 포함하여 한국 소득보장제에 어떠한 학술적, 정책적 함의를 가지는지 고찰했다.

• 보건행정학회지
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• 제30권3호
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• pp.286-300
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• 2020

In 2019, the Seoul metropolitan government established its own 'Seoul-type paid sick leave project'. Although the central government had to introduce such a system, which is also called sickness benefits, it was not implemented. In order to understand the process by which the Seoul government has implemented such a policy, this study used Kingdon's multiple streams framework. As a result, in the problem stream, it was found that the economic burden of sickness has been considered only in terms of medical expenses in the past of Korea. Then Songpa's three women and Middle East respiratory syndrome incidents raised awareness of the necessity of the sickness benefit system in 2014 and 2015. In the political stream, several social affairs such as national health insurance huge surpluses and the 2017 presidential election opened policy window. At that time, Seoul Mayor actively promoted sickness benefits as a policy entrepreneur. In the policy stream, the sickness benefit system has gained new attention through political events. To summary, these three streams flowed separately and then they assembled around huge political affairs. As a result, it was confirmed that Kingdon's model is the most effective theory than any other models in analyzing the health care policy decision process in Korea.

• 보건행정학회지
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• 제29권2호
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• pp.112-129
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• 2019

Currently, the South Korean Government does not provide sickness benefits from the National Health Insurance, which is different from most other Organization for Economic Cooperation and Development countries. The sickness benefit guarantees a part of lost income due to injuries or diseases. The purpose of this study is to propose a sickness benefit scheme for South Korea. To this end, we compare health care systems, sickness benefit schemes, and delivery systems of those in Germany, Japan, and Sweden, focusing on the seven categories: management authority, object, level of payment, duration of payment, qualification requirements, connection with paid sick leave of workplace, and financial resources, and as to delivery system, the six categories: the number of procedures, transferring document between institutions, whether or not utilizing electronic reporting system, applicant, and administrative convenience. Based on the implications derived from the case study, we propose the sickness benefit scheme and its delivery pathway and other details for South Korea. This study is first to propose the sickness benefit for health insurance in Korea with its level of details. More studies should follow with case studies of other countries, as well as productive debates to build a feasible and sustainable sickness benefit system in South Korea.

• 대한간호학회지
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• 제31권5호
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• pp.858-870
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• 2001

Purpose: This study was to compare changes in health behaviors, motivational factors, cardiovascular risk factors, and functional status (SIP) after implementing the 6-month motivation-enhancing program to institutionalized elderly women. Methods: Sixty-four elderly women participated. Face to face interviews with blood sampling and anthropometric assessment were conducted at the pretest, 10 weeks and 6 months during the program. Results: 1. The program participants showed significantly better health behaviors over 6 months. The mean motivational level was also significantly improved, especially for perceived benefits, perceived barriers, and emotional salience. 2. The mean of cardiovascular risk factors for the participants was 21.8 at the level of low to moderate risk. After completing the program, total risk score was significantly decreased to 18.7 at 10 weeks, and further to 17.7 at 6 months. A significant reduction was also found in HDL and LDL-cholesterol levels, blood pressure, obesity, inactivity, and stress. 3. The functional status (SIP) was 11% at the baseline and significantly changed in positive direction at 10 weeks(M=9.3) and at 6 month(M=6.3). The significant improvement was also found in physical and psychosocial dimensions and sleep/rest dimension. Conclusion: The motivation enhancing program was effective to reduce cardiovascular risks and to improve the functional status of institutionalized elderly women by motivating them to perform better health behaviors.

• Safety and Health at Work
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• 제13권3호
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• pp.350-356
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• 2022

Background: Although sick leave is a complex phenomenon, it is believed that there is potential for prevention at the workplace. However, little is known about this potential and what specific measures should be implemented. The purpose of the study was to identify perceived reasons to take work-related sick leave and to suggest preventive measures. The study was completed before the COVID-19 pandemic emerged, and the risk factors identified may have been amplified during the pandemic. Methods: An in-depth cross-sectional survey was conducted across a randomly selected sample of hospital nurses in Norway. The national sample comprised 1,297 nurses who participated in a survey about their sick leave during the previous 6 months. An open-ended question about perceived reasons for work-related sick leave was included to gather qualitative information. Results: Among hospital nurses, 27% of the last occurring sick leave incidents were perceived to be work-related. The most common reasons were high physical workload, high work pace, sleep problems, catching a viral or bacterial infection from patients or colleagues, and low staffing. Conclusions: Over a quarter of the last occurring sick leave incidents among Norwegian hospital nurses are potentially preventable. To retain and optimize scarce hospital nursing resources, strategies to reduce work-related sick leave may provide human and financial benefits. Preventive measures may include careful monitoring of nurses' workload and pace, optimizing work schedules to reduce the risk of sleep problems, and increasing staffing to prevent stress and work overload.

• 보건행정학회지
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• 제28권3호
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• pp.202-209
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• 2018

Health care has two different facets. One is commodity and another is a right of human being. Health care as a commodity is utilized by demand approach in market. Demand is determined by economic factors such as price and income. From the last third of the 19th century until the early 1920s, priority of sickness insurance was replacing the income that workers lost as a result of illness and injury. By the 1920s, the capacity of applied biological and medical science was remarkably developed. Development of medical science stimulated the cost of medical care, and the burden of increased medical care cost required new role of medical care security system. In 1942, Beveridge report was published in United Kingdom, and health care was considered as a right of human being. In 1948, United Nations declared heath care as a right in the Universal Declaration of Human Right. In most countries introduced new medical care security policy based on health care as a right. The viewing health care as a commodity must be shifted toward need based care as a right. Need were understood to rest on demographic, epidemiological, scientific, and medical knowledge factors. Bring needed care to the population could best be achieved institutionally by a hierarchy of provider organizations, guided by planning bodies, which would provide comprehensive benefits. In Korea, health care in social health insurance (SHI) is considered as a commodity not a right. However, health policies under SHI must be need approach based on health care as a right. Mismatch between health policies and ideology of SHI made big troubles. It is important to realize ideology of SHI for good health policies.

• 사회복지연구
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• 제48권1호
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• pp.5-21
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• 2017

본 연구는 OECD 국가의 장애인 고용정책이 장애인 고용률에 미치는 영향이 무엇인지 알아보고자 하였다. 연구대상은 장애인의무고용제 또는 차별금지제도를 실행하고 있는 OECD 10 개국이며, 2000년부터 2011년까지 12개년 시계열 자료를 분석에 활용하였으며, 이러한 시계열 횡단자료(time-series cross-sectional data)를 분석하기 위한 방법으로 패널수정 표준오차(PCSE) 분석을 사용하였다. 그 결과, 통제변수 중에는 실업률, 장애인 출현율 및 장애급여(현금)지출비율이 장애인 고용률에 영향을 미치는 것으로 나타났다. 장애인 고용정책요인 중에서는 차별금지제도 적용범위와 직업재활제도의 전달체계 유형이 장애인 고용률에 영향을 미치는 것으로 나타났는데, 차별금지제도 적용범위가 넓을수록 장애인 고용률이 높고, 장애인 특화 기관을 운영하는 국가가 일반 기관을 운영하는 국가보다 장애인 고용률이 높은 것으로 나타났다. 이에 따라 적용범위가 넓은 일반적 차별금지제도를 도입하고 장애인의 고용에 대한 욕구와 서비스에 전문성을 갖는 장애인 특화형 전달체계가 장애인 고용률 향상에 더 효과가 있는 것으로 판단된다.