• 한국주거학회논문집
• /
• 제25권2호
• /
• pp.99-107
• /
• 2014

This study attempts to provide implications for developing more efficient and effective community-based support system with AIP perspective for the elderly in Korea. The main purpose of this study is to analyze Japan's community-based integrated care system that respond to the concept of aging in place (AIP) and its cases. In Japan, they have offered Community-Based Service since 2005, and the advanced system which include integrated support categories and consolidated community/local resources will started in 2015 by The revision of Long-term Care Insurance policy, 2012. The result of policy analysis and case studies are as follows: 1) The suggestion for ideal support system model promoted a relationship of multiple agents include private sectors even resident and senior and specified responsibility sharing, 2) the system proposed Not only health and medical care support, living care and residence are also addressed as a comprehensive support. and 3) the amount of available community resource is different by each local government, but the effort to get the understanding of community residents and to connect with a potential community resource is also essential aspect to set effective community-based support system.

• 대한통합의학회지
• /
• 제12권3호
• /
• pp.179-188
• /
• 2024

Purpose : The home-visiting exercise guidance service is a component of the community-based integrated care policy in District J of Busan Metropolitan City. This study aims to investigate the effects of the service provided by physical therapists on depression, pain, and balance among the elderly. Methods : Three elderly individuals were selected as study participants. Depression was assessed using the beck depression inventory (BDI) and the short geriatric depression scale-Korea (SGDS-K). Pain was evaluated using the visual analog scale (VAS). Balance was assessed using the berg balance scale (BBS), functional reach test (FRT), and timed up and go test (TUGT). The evaluation data were compared by averaging the values from the first and eighth sessions. Additionally, the overall satisfaction with the home-visiting exercise guidance service was surveyed. Results : In the depression assessment, the beck depression inventory score decreased (by 16.67±5.69 points), and the short geriatric depression scale score decreased (by 4.67±2.52 points). The visual analog scale score for pain decreased (by 2.67±0.58 points). In the balance assessment, the berg balance scale score increased (by 7.67±2.52 points), the functional reach test distance extended (by 4.67±0.58 cm), and the timed up and go test time decreased (by 5.33±0.58 s). Overall satisfaction with the home-visiting exercise guidance service was high (4.26±0.14 points). Conclusion : The home-visiting exercise guidance service received high satisfaction ratings from the participants. It was effective in reducing depression and pain while improving balance, potentially reducing fall risk factors among the elderly. These findings suggest that the home-visiting exercise guidance service, delivered by physical therapists, could significantly enhance the quality of life for elderly individuals by addressing issues related to depression, pain, and fall prevention within the community. Consequently, it is recommended that this service be continued and expanded as part of government policy.

• 보건행정학회지
• /
• 제29권1호
• /
• pp.1-3
• /
• 2019

Suicide is a major problem in Korean health care and a serious social problem. In Korea, 12,463 people (24.3 per 100,000) lost their lives due to suicide in 2017. Although the government has established three National Comprehensive Plan of Suicide Prevention (2004, 2009, 2016), and National Action Plan of Suicide Prevention (2018), the suicide rate is still high. The suicide rate of the elderly is especially high. This is due to the economic vulnerability of the elderly in Korea. Therefore, in order to prevent suicide in Korea, mental health care approach and social welfare approach should be integrated. The intervention of preventing suicide of suicide attempters should include social welfare services as well as mental health program and should be based on community. There are many health problems, including prevention of suicide, which can not be solved only by the efforts of health care. Many health problems are social problems and the integrated approach is needed to solve them. In order to solve many health care problems and improve health, integrated approach of health, social science, and humanities is needed.

• 농촌의학ㆍ지역보건
• /
• 제48권3호
• /
• pp.189-204
• /
• 2023

Objectives: The goals of this study are to exploring critical factors and methods to improve Korean Community Care through the cases of GyeongsangNamdo. Methods: For this study, we performed in-depth interviews with 90 people involved in Community Care services of 6 regions, and the collected data were analyzed. The collected data were analyzed utilizing NVivo12. In the end, we reconfirmed the process through Topic Modeling analysis. Results: We conducted descriptive statistics and qualitative data analysis collected through surveys and in-depth interviews. In the case of qualitative analysis, we extracted principle codes (Need, Lack, Absence), and sorted the contents into sub-categories. The response rate of 'Need to strengthen capabilities' was the highest, 'Need to communicate and share information' was the second, and 'Need for integrated operation and a control tower' was the third. Conclusion: As a result, we find the critical factors to improve Community Care. Based on them, we should conduct follow-up researches to propose concrete methods to apply to diverse regions.

• 한국콘텐츠학회논문지
• /
• 제21권3호
• /
• pp.761-770
• /
• 2021

본 연구는 초등아동을 위해 학교 정규교육시간 이외의 시간에 마을에서 제공하는 돌봄서비스가 아동이 행복한 일상생활을 보장하는 돌봄, 즉 아동권리가 실현되는 정책으로 실현되고 있는지 현황과 개선점을 살펴보고자 한다. 방과후 돌봄은 생존권과 보호권은 물론 창의적인 교육활동과 주체적인 시민성장을 지원하는 통합적 방법으로서 중요하며, 코로나 상황을 맞아 공공의 역할이 더욱 강조되고 있다. 따라서 온종일돌봄 정책 중학교밖 돌봄의 주축이 되는 다함께돌봄 정책을 아동권리 관점에서 분석하였다. 분석결과, 보호자의 역할을 대신하는 보호권에 초점이 맞추어져 아동의 4대 권리를 충분히 보장하는 포괄적 정책으로서 한계점이 있었다. 안전한 돌봄공간 마련도 중요하지만 마을의 다양한 자원을 돌봄 콘텐츠로 적극 활용하여 놀면서 배우는 아동의 선택권 확대를 위한 정책설계가 부족하다. 이를 위한 공공의 역할은 서비스의 양적확대와 더불어 내용적 공공성인 책임성, 공정성, 민주성, 공익성을 담보하기 위한 보완이 요청된다. 다함께 돌봄 정책은 아직 실행초기인 정책으로, 아동권리 관점을 반영하여 유연한 공적돌봄 체계로 발전할 수 있는 정책 개선방향을 제언하였다.

• 한국콘텐츠학회논문지
• /
• 제19권3호
• /
• pp.441-456
• /
• 2019

본 연구의 목적은 노인대상 통합적 케어 프로그램의 구성 요소와 효과를 탐색하고, 이러한 프로그램에서 다학제팀의 일원으로 활동하는 사회복지사의 역할을 기술하는 것이다. 연구를 위해 신속 체계적 문헌고찰을 실시하였으며, 데이터베이스 검색과 수기 검색을 단계적으로 진행하였다. 주요 연구결과는 다음과 같다. 첫째, 노인대상 통합적 케어 프로그램의 주요 요소는 케이스매니지먼트, 개별케에플랜, 서비스 특성, 클라이언트 욕구중심, 환자교육, 자기관리로 나타났다. 둘째, 참여노인의 케어경험과 건강 및 경제적 측면에서, 결과가 혼합되어 있긴 하지만, 대조군에 비해 프로그램 참여노인에게 어느 정도 긍정적인 효과가 나타났다. 셋째, 통합적 케어 프로그램의 다학제팀에서 사회복지사는 케이스매니저, 케어매니저, 케어코디네이터, 그리고 직접 서비스 제공자의 역할을 수행하고 있는 것으로 나타났다. 연구결과를 바탕으로 노인대상 통합적 케어를 준비하기 위해 필요한 교육과 정책에 대한 제언을 하였다.

• Journal of Preventive Medicine and Public Health
• /
• 제52권3호
• /
• pp.200-204
• /
• 2019

On September 12, 2018, President Jae-In Moon announced the Comprehensive Plan for Lifelong Care for People with Developmental Disabilities, with representatives from the associated government branches (Ministry of Health and Welfare, Ministry of Education, and Ministry of Employment and Labor) in attendance. The goals of this plan are to provide health, medical, rehabilitative, special education, and social welfare services according to the life-stages of the affected individuals; to reduce parental pressure; to promote social interventions; and to enhance community-level participation in order to create a 'welfare society in harmony.' However, in order for the plan to succeed, additional efforts must be made in the following areas. First, an epidemiological survey is needed to understand the scale, prevalence, and incidence of developmental disabilities and to establish an evidence base to support policy development. Second, accurate definitions of developmental disabilities must be established in order to avoid policy discrimination based on impairment type and age. Third, personal evaluations to assess disabled individuals' unmet needs and customized service designs to deliver those needs are required. Fourth, the plan must fulfill the goals of accessibility and fairness that the government intends to provide. Fifth, the government should consider an integrated financial support system and to propose a detailed plan for monetary distributions. Finally, an integrated system that links health, medical, employment, educational, and welfare services must be constructed.

• 농촌의학ㆍ지역보건
• /
• 제48권4호
• /
• pp.262-274
• /
• 2023

본 연구는 달구벌건강주치의사업에 참여하고 있는 기관의 실무자와 서비스 이용자들의 경험을 토대로 질적연구를 통하여 보건의료·복지 서비스의 통합적인 지원의 성과와 개선방안을 살펴 보았다. 분석 결과 달구벌건강주치의사업은 의료취약계층의 복합적 수요 해결에 효과적이었다. 의료와 복지 사각지대에서 삶의 희망을 잃어버리고 의료와 복지서비스 이용에 대한 두려움을 가진 이용자들에게 신속 간단한 대상자 선정과 자원연계를 통한 통합적 서비스 제공으로 복합적 수요 해결과 삶에 대한 긍정적인 태도 회복, 삶의 질 개선에 기여하였다. 달구벌건강주치의사업은 대상자 의뢰기관부터 서비스 제공기관까지 공공뿐 아니라 민간기관이 참여하는 포괄적 네트워크를 구축하였으며, 대구의료원을 중심으로 5개 상급종합병원의 참여로 경증부터 최중증까지 대상자의 중증도에 적합한 치료를 지원하는 모형을 구축함으로써 의료혜택에서 소외된 대상자를 적극적으로 발굴하고 실제 이들의 건강 문제를 해결함으로써 건강 형평성을 개선한 것으로 파악된다.

• 농촌의학ㆍ지역보건
• /
• 제49권2호
• /
• pp.132-145
• /
• 2024

본 연구는 국내 의료기관 중심 보건의료·복지통합 서비스 활성 방안을 모색하기위하여 대구의료원 달구벌건강주치의사업, 삼척의료원 301 네트워크 사업, 부산의료원 3 for 1 사업 을 프로그램 논리모형을 적용하여 사례 비교하였다. 상황적 측면에서 세 사업 모두 보건의료·복지 서비스의 분절과 의료사각지대 문제를 해결하기 위해 고안되었으며, 투입 요소 중 인력은 모두 다학제 팀 구성 현황은 유사하였으나 구체적인 구성 분야, 채용 규모, 고용 형태, 에서는 기관별 차이가 있었다. 예산을 지원받는 재원 출처의 차이로 각 사업은 지역사회와 협력하고 지원하는 방식과 향후 방향성에서의 차별성도 확인할 수 있었다. 산출은 수혜대상자 수와 진료 건수에 차이가 있었으며, 투입인력 또는 운영비 대비실인원 수, 수혜대상 1인당 사업비 비교시 다른 결과를 확인하였다. 의료기관 중심의 보건의료·복지 통합제공체계의 설계 시 우선적으로 권고하는 상황은 안정적인 기금마련 기전을 확보하고 이에 합당한 대상자와 서비스 전달체계를 구축하라는 것이다. 또한, 의료기관 내 사례관리 전담기구로서 각 부문의 활동을 연계할 수 있도록 위탁이 아닌 전담부서 설치, 적정 규모의 채용, 안정적 고용 체계가 필요하며, 민·관 협력 및 경증부터 중증까지 제공할 수 있는 포괄적 제공체계 구축을 제안한다. 이를 통해 의료기관 중심보건의료복지 통합 서비스 제공 사업은 지역사회에서 풀리지 않는 난제였던 보건의료 서비스 강화와 촘촘한 연계를 가능하게 함으로 궁극적인 지역사회 건강안전망 역할 강화를 기대한다.

• 농촌의학ㆍ지역보건
• /
• 제19권2호
• /
• pp.159-173
• /
• 1994

Since the establishment of health centers in the 1960s, the centers have been played an important role in providing basic health care for the people. Although the health centers made a great effect to prevent diseases and promote the health status of the people for the last three decades, the function of health centers should be strengthened to meet the health care need of individual, family and community. Over the last ten years, there have been great changes and developments in health related environments, such as population size and age, rapid urbanization, up-grading of the educational level, increase of income, health care demand for promotive health care measures and practical measures for chronic diseases and also practicing healthy life. According to the great changes in health related environments, the health centers should be reformed. The following policy options are recommended as a summary; First, the function of health centers should be converted from providing basic health services into promotive and preventive health care services, to meet changing needs of people. Second, the health center personnel should be reinforced for their competency to provide a qualitative services to people and also the operation of health center should be reactivated. Third, a close linkage of health centers with the private sector is an essential requirement for the operation of the health care delivery system within a health district in order to improve the health status of people. Fourth, type of manpower mix, scope of organization and health care program should be varied, based on the health care needs of people, geographical characteristics and size of population etc. Fifth, a comprehensive health care delivery system should be developed, for maintaining healthy life style of people and also the health and welfare services should be integrated in order n ensure an effective service.