• 한국노년학
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• 제29권1호
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• pp.149-175
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• 2009

본 연구는 제도 시행 초기인 2008년 10월 현재 여러 부분에서 동시다발적으로 발생하는 노인장기요양보험 재가서비스의 다양한 문제점과 원인을 파악하여 분석한 후, 그에 대한 개선방안을 마련하는 데 목적이 있다. 연구방법은 크게 선행 연구된 2차 자료를 분석하는 문헌조사와 관련 전문가를 대상으로 하는 서베이 조사방식을 통해 진행되었다. 자료의 분석은 길버트와 스펙트의 정책분석틀에 근거하여 대상자체계, 급여(서비스)체계, 재정체계, 전달체계의 영역으로 구분하여 분석하였다. 본 연구를 통해 도출된 노인장기요양보험 재가서비스의 문제점은 첫째, 대상자체계에서는 가입대상자와 서비스 대상자의 불일치, 수요자 추계의 문제점 및 등급판정 관련 문제 등이 있으며, 둘째, 서비스 체계에서는 서비스 인력의 전문성 결여, 방문요양기관 인력기준 완화로 인한 서비스 질 저하, 서비스 이용시간 제한의 불합리성 및 방문요양 수가의 등급별 균등지급의 문제가 있는 것으로 나타났다. 셋째, 재정체계에서는 본인부담금과 비급여항목으로 인한 이용자 부담과중, 기존운영비 지원 기관에 대한 지원중단으로 인한 서비스의 사각지대 발생 및 구조조정 및 파트타임 증가로 서비스 질 저하 문제가 나타났으며, 마지막으로 전달체계에서는 서비스의 질 관리체계 미비, 재가장기요양기관 남설로 인한 과다 경쟁, 영리적 운영으로 인한 서비스 공공성과 질저하, 대상자 모집의 어려움으로 인한 운영난 및 요양보호사 교육기관 난립으로 인한 과다배출과 부실교육 등의 문제가 있는 것으로 조사되었다. 이상의 결과에 근거하여 다음과 같이 제언하였다. 첫째, 장기적으로 가입자와 서비스 대상자를 일치시킬 필요가 있다. 둘째, 공단직원의 전문성 향상 및 인력충원이 필요하며, 셋째, 등급외자에 대한 효율적 서비스 연계, 넷째, 체계적인 요양보호사 관리시스템 구축 및 서비스 표준지침서 개발, 다섯째, 서비스 내용과 절차에 관한 일부 법규의 수정이 필요하며, 여섯째, 본인부담금의 일부 조정도 필요하다. 일곱째, 노인복지법에 의한 재가시설에 운영비를 지원해야 하며, 여덟째, 관리감독 기관의 모니터링 시스템 강화 및 서비스 제공 기관과 서비스 인력에 대한 평가 체계 마련, 그리고 마지막으로 기관설치 기준의 강화가 필요하다.

• 보건행정학회지
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• 제24권1호
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• pp.56-70
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• 2014

Background: Korea shows rapid population aging and increase in healthcare service use and expenditure. Also, this would be accelerated because of the baby boomers who will be 65 years old and more in 2020. Chronic disease is another reason that increases the use of healthcare service and expenditure of the middle- and old-aged households. Catastrophic health expenditure (CHE) is the index which can indicate the households' burden of health spending. Despite the importance, there are few studies on CHE of middle- and old-aged households and especially no panel study yet. This is the reason that this study is carried out. Methods: This study used 3-year data from the Korea Welfare Panel Study conducted from 2009 to 2011. We defined CHE if a household's health expenditure is equal or greater than the threshold value if income remaining after subsistence needs has been met. We used 4 different threshold values which are 10%, 20%, 30%, and 40%. In order to look at the households which experienced CHE, we conducted panel logit analysis after correspondence analysis and conditional transition probability analysis. Results: This study showed three notable results. First, there has been a difference among age groups, which implies that the older people are, the more easily they can experience CHE. Second, the households with no private insurance are shown to have a higher CHE occurrence rate. Lastly, there has been a significant difference among the kinds of chronic diseases. The households which have cancer, cerebrovascular disease, and heart disease have a higher CHE occurrence rate. However, the households with diabetes have no significant effects to CHE occurrence. Also, hypertension has a negative effect to the occurrence. Conclusion: With the results, it can be implied that elderly people with chronic disease are more needed in medical coverage and healthcare. Also, private insurance can play its role in protecting households from CHE. Therefore, it needs to conduct studies on CHE especially about different age groups, private insurance, and chronic disease.

• 예술인문사회 융합 멀티미디어 논문지
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• 제9권8호
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• pp.569-576
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• 2019

본 연구는 재가요양보호사의 직무스트레스와 이직의도와의 관계에서 직업의식 매개효과를 검증하고, 그 결과를 기초하여 재가요양보호사의 이직의도를 감소시키려는 목적으로 수행하게 되었다. 연구대상은 서울·경기지역에서 일하고 있는 재가요양보호사 447명을 대상으로 하였다. 연구목적을 위해 자료분석은 SPSS 통계패키지를 활용하여 기술분석과 상관관계 분석 및 다중공선성 확인 후 매개효과를 검증하였다. 분석결과 첫째, 재가요양보호사가 연령이 낮고, 월가구소득이 높을수록 이직의도가 높을 것으로 나타났다. 둘째, 재가요양보호사가 직무스트레스를 높게 인식할수록 이직의도가 높아지는 것으로 나타났다. 셋째, 직업의식이 높을수록 이직의도는 낮게 나타났다. 넷째, 재가요양보호사의 직무스트레스는 직업의식을 부분 매개하여 이직의도에 통계적으로 유의미한 영향을 주는 것으로 나타났다. 이상의 결과를 토대로 재가요양보호사의 이직을 예방하고 노인돌봄 서비스의 질을 향상시키기 위한 임상적·정책적 실천에 대한 제언을 하였다.

• 보건행정학회지
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• 제18권3호
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• pp.110-127
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• 2008

Expenditures on pharmaceuticals of different concepts were estimated and their functional, financing and providers' breakdowns were examined in line with the OECD's System of Health Accounts (SHA) manual. This study also shows the way such estimates are made. The results are then analyzed particularly from the international perspective. Data from both Household Survey by the National Statistical Office and the National Health and Nutritional Survey by the Ministry of Health and Welfare of Korea were used to estimate pharmaceutical expenditures that. are financed by out-of-pocket payments of the household, while national health insurance data etc. were used for estimation of pharmaceutical expenditures that are financed by public funding sources. The 'per capita expenditure on pharmaceutical/medical non-durables' in Korea stood at 380 US$ PPPs, less than the OECD average of 443 US$ PPPs in 2006, but its share of the per capita health expenditure of 25.9% noticeably outnumbered the OECD average of 17.1%, due partly to low per capita health expenditure as a denominator of the ratio. This indicates that Koreans tend to spend less on health care than an OECD average, while tending to spend more on pharmaceuticals than on other health care services, much like the pattern found in relatively low income countries. An international pharmaceuticals pricing mechanism is most likely responsible for such a tendency. In addition, it is to be noted that the percentage comes down to 21.0%, when expenditures on both medical non-durables and herbal medicine, which is locally quite popular among the elderly, have been excluded.

• 디지털융복합연구
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• 제18권6호
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• pp.443-450
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• 2020

본 연구는 과학을 주제로 한 공공서비스 기관들 중, 상대적으로 가장 넓은 지역을 관할하고 있는 국립과천과학관의 지역순회프로그램 활성화 방안을 모색하고자 시작되었다. 국립과천과학관은 상설전시 프로그램 이외에도 지리적, 환경적 이유로 과학관을 직접 방문하기 어려운 소외지역 주민들을 위해 2018년부터 경기, 강원도 지역에서 순회프로그램을 시행하고 있으나 문화, 노인복지, 교육 등 타 분야에 비해 인지도와 효과가 미비한 실정이며 관련 연구도 전무한 실정이다. 연구 방법으로는 최근 3년 이내에 1회 이상 국립과천과학관의 지역순회프로그램 현장을 직접 방문한 경험이 있는 문화기획자 및 스텝, 과학&문화콘텐츠 전문가, 관련학과 교수 등 총 12명을 대상으로 3차에 걸쳐 FGI를 실시하였다. 연구결과로는 첫째 매우 특별한 체험의 기회 둘째 소수의 기쁨 셋째는 재미는 없지만 학습형 공연 등 총 3가지 상위 의미 단위와 5가지 하위 의미 단위로 도출되었다. 이는 과학에 대한 흥미성 제고, 직접 체험의 기회 확대 등 긍정적 효과는 돋보이나 체계적 홍보계획 필요, 전문예술인을 통한 콘텐츠의 질적 수준 보완 등 개선이 시급한 요소들이 도출되었다.

• 기본간호학회지
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• 제15권3호
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• pp.274-283
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• 2008

Purpose. The purpose of the study was to identify the factors, which predict care burden perceived by caregivers of elders with dementia. Methods: The participants in this descriptive survey were 92 caregivers who used one of six daycare centers located in Incheon. The data were collected by questionnaires composed of items on general characteristics of the elders and caregivers, care burden, caregiver fatigue, and functional status of the elders. Results: General characteristics of the elders associated with care burden were age, gender, religion, and the presence of a spouse. Features of caregivers related to care burden were education, relationship with elderly, amount of rest, intention to care, monthly family income, and perceived family economic status. There were significant correlations among care burden, fatigue of caregiver and functional status of the elders. In stepwised multiple regression analysis, significant influencing factors were identified as caregiver fatigue, functional status of the elders, intention to care, relationship with the elders, amount of rest and elder's gender. Those variables explained 46% of variance of care burden. Conclusion: Functional status of elders and amount of rest were significant predictors and are supported by other previous studies. Future interventions for caregivers need to be focused on the slowing down of functional status of elders and increasing of number and length of caregiver's rest periods.

• 보건행정학회지
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• 제28권3호
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• pp.217-221
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• 2018

Korea Institute for Family Planning (KIFP) was established on July 1, 1971 (Law 2270) and Korea Health Development Institute (KHDI) was established on April 19, 1976 (Law 2857). Korea Institute for Population and Health (KIPH) was formed through the merger of KIFP and KHDI (Act 3417) on July 1, 1981. Korea Institute for Health and Social Affairs (KIHASA), the former KIPH, was renamed KIHASA on December 30, 1989 (Law 4181) with its additional function of research in social security. It was transferred on January 29, 1999 to the Office of State Affairs Coordination pursuant to the Law on the Establishment, Operation and Promotion of State-Sponsored Organizations (Law 5733). Annually it conducts approximately 50 short- and long-term research projects to accumulate a wide range of research experience. Also it studies and evaluates the primary issues of national health services, health and medical industries, social insurance, social security, family welfare, and population. it conducts joint research projects and active information exchange programs with related domestic and international organizations through seminars and conferences. It executes specific research and development projects according to the government's requests. it educates and trains people domestically and abroad by disseminating a wide-range of information on health and social affairs. it conducts national household surveys on areas of fertility, health and medical care of the disabled, the elderly, and low-income earners. The mid- and long-term research goals of KIHASA should be established and managed systematically. A new organization such as 'Center for Policy Evaluation' is needed to enhance research abilities and experiences. Able research personnels should be recruited and current researchers should try to develop their abilities.

• 한국농촌간호학회지
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• 제9권2호
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• pp.59-70
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• 2014

Purpose: The present study was to done ascertain variables related to health-related quality of life (HRQOL) and their related factors in elders from urban or rural areas. Methods: Data were collected from raw material of the 2009 community health survey. Participants were 2,140 elders. Health related quality of life (HRQOL) was measured using EQ-5D. Data were analyzed with SPSS 13.0. Results: Mean EQ index score for urban elders was $0.78{\pm}0.23$, Mean EQ index score for rural elders was $0.82{\pm}0.16$. Rural elders had significantly higher EQ-5D index value compared to urban elders. The urban elder HRQOL model accounted for 33.6% of the variance due to depression, age, stress perception. The rural elder HRQOL model accounted for 23.5% of the variance due to exercising walking, skipping breakfast, depression in that order. In comparison, depression, skipping breakfast, livelihood, arthritis, stress perception, hours of sleep and age are strongly associated with HRQOL in both groups. Conclusion: Results indicate that significant differences in HRQOL between elders from the two areas and thus, confirm claims that welfare services for elders should be provided with consideration of the different needs of elders in the two areas, and in particular for addressing depression in elders.

• 한국가정과교육학회지
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• 제23권4호
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• pp.105-124
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• 2011

본 연구는 고령화사회에 대비하기 위하여 인문계와 가사 실업 전문계 고등학생을 대상으로 기술 가정, 가정과학, 인간발달 수업 시간에 자신의 노후를 성공적으로 준비하기 위한 실천적 문제 중심 수업과 강의식 수업을 적용하고, 그 효과를 알아보는데 목적이 있다. 이를 위해 인문계 고등학교와 가사 실업 전문계 고등학교의 정규 교과목 수업 시간에 실험집단은 실천적 문제 중심으로 총 5차시의 수업을 실시하고, 비교집단에는 강의식으로 총 5차시의 수업을 실시하였다. 그리고 실험집단과 비교집단의 사전-사후검사를 분석하여 교수법의 차이, 학교계열의 차이를 알아보았으며, 교수법과 학교계열에 따라 노인에 대한 이해 변인과 노후생활 준비 변인에 차이가 있는지를 알아보았다. 이러한 연구 목적을 달성하기 위해 인문계 고등학교 4개교, 가사 실업 전문계 고등학교 2개교를 임의표집 하여 총 41학급, 1,263명을 대상으로 하였으며, 2009년 10월부터~2010년 11월까지 총 9명의 교사가 실험집단과 비교집단에 각각 수업을 실시하였다. 자료분석과 통계처리는 SPSS 12.0프로그램을 이용하여 평균과 표준편차, t-검증, 공분산분석을 실시하였다. 인문계와 가사 실업 전문계 고등학생을 대상으로 노후 준비를 위한 가정과 수업을 적용한 결과, 가사 실업 전문계 보다는 인문계에서, 강의식 수업보다는 실천적 문제 중심 수업이 고등학생들의 노인에 대한 이미지, 노인에 대한 지식, 자녀로부터의 부양의식, 노후생활준비도, 노인복지서비스 필요도를 향상시키는데 더 효과가 있는 것으로 나타났다. 이에 따라 실천적 문제 중심 노후 준비 교육의 후속연구로서, 고등학생의 노후준비교육을 일반화 할 수 있도록 보다 많은 학교에서 기술 가정, 가정과학, 인간발달의 정규 교과목 수업에 적용하고 그 효과를 검증하는 연구가 실시되기를 바라며, 고령화 사회에 대한 교육적 대응으로 노후생활 준비교육은 새로운 교육과정에서도 지속적으로 반영되어야 할 것을 제언하였다.

• 한국한의학연구원논문집
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• 제18권2호
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• pp.65-89
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• 2012

Objective : In order to investigate and improve public Korean medical health service satisfaction level, this study was designed. Method : A questionnaire has been conducted on 212 patients who received treatments at six public health centers in the northern part of Gyeongbuk during 15 days between Sep. 24 and Oct. 8, 2011. Result : 1. An Investigation on the usage of herbal clinics in public health centers reveals that 63.7% have received three times or more medical treatments previously and 61.8% have had their illness treated at other medical institutions. In regard to illness 32.1% have had arthritis or muscle aches. 50.9% have taken insurance medication after having had treatments at the public health centers. 66% have assessed acupuncture and moxa cautery the most satisfying. 2. To a question regarding whether herbal health treatment costs higher than that of physician's, the highest response at 31.6% is 'No'. And to a question regarding whether herbal medicines administered at public health centers have more side effects than that of physician's, the highest response at 39.6% is 'No'. 3. To a question regarding whether herbal treatment of public health centers has little effect against acute disease, 48.1% of responses are 'Fair'. To a question regarding whether herbal treatments, when compared with physician's treatments, boost better recovery of patients, 48.1% of responses are 'Fair'. To a question regarding whether herbal medicine is unscientific, when compared with that of western medicine, 38.2% of responses are 'Fair', To a question regarding whether herbal medicine has faster effect on disease than western medicine, 41.0% of responses are 'Fair'. To a question regarding whether herbal medicine is more effective on disease prevention and promotion of health than disease treatment, 38.2% of responses are 'Fair'. And to a question regarding whether the lack of various types of physical therapy devices in herbal medicine, when compared with western medicine causes inconvenience in herbal treatment, 42.0% of responses are 'Fair'. Those responses take up highest portion at each questionnaire. 4. A comparative study between herbal treatments and physician's treatments has also been conducted. To questions regarding which one of the two considering types of disease is the better, responses are the latter accounted for 43.9% against 'Cancer', the latter accounted for 45.3% against 'Endocrine disorders', the former accounted for 30.7% against 'Psychiatric disorders', the latter accounted for 38.2% gainst 'Otolaryngological(ENT) disease', the former accounted for 47.6% against 'Post traumatic stress disorder', and the former accounted for 52.4% against 'Muscle-skeletal disease'. 5. An investigation on frequency of patients' visits via (p<0.05) of subjects show a statistically significant difference. 6. First, an investigation on frequency of reasons of medical treatments reveal that age, occupation, monthly income, and insurance type (p<0.05) of subjects show a statistically significant difference. Secondly, an investigation on frequency of subjects taking insurance medicines after herbal health treatments reveal that monthly income (p<0.05) of subject shows a statistically significant difference. 7. First, an investigation on frequency of a claim that herbal treatments of public health center does not have great effect on acute disease reveals that age, education, and insurance type (p<0.05) of subjects show a statistically significant difference. Secondly, an investigation on frequency of analysis that herbal treatments has faster effect on disease compared with western treatments reveals that education level, religion, monthly income, and insurance type (p<0.05) of subjects show a statistically significant difference. 8. When herbal clinics of public health centers and general herbal medicine institutions are compared, a survey on additional treatments that herbal clinics need the most reveals that education level, monthly income, and insurance type (p<0.05) of subjects show a statistically significant difference. Secondly, an investigation on frequency of subjects who want various forms of herbal medicines reveals that occupation and insurance type (p<0.05) of subjects show a statistically significant difference. Conclusion : In order to improve efficiency of treatments and enhance patient's satisfaction level, this study suggests measures such as providing a differentiated acupuncture treatments as a whole, streamlining an reception procedure, adopting more elaborated computer system for a patient to get proper medical attention, standardizing a treatment duration in order for a maximum result, keeping regular office hours, and optimizing a consultation time for a patient.