• 한국사회복지학
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• 제69권1호
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• pp.33-57
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• 2017

본 연구는 한국의 장기요양서비스 제도적 맥락 속에서 발생한 시장화와 공존하고 있는 공공성의 관점에서 요양보호사의 근로조건이 서비스 질에 미치는 효과를 실증분석 하였다. 기존 연구들은 사회서비스의 낮은 생산성과 시장화로 가중된 저임금노동시장의 문제가 서비스 질 저하를 가져온다고 추론한 것이지, 근로조건과 서비스 질의 두 변수간의 인과관계를 규명한 것이 아니다. 본 연구의 노인장기요양서비스 제도적 맥락에서 본 요양보호사의 근로조건과 서비스 질과의 이론적 관련성은 Daly와 Lewis(2000)의 돌봄의 통합적 접근을 통해 조망하였다. 자료는 전국에 있는 노인장기요양시설을 소유권을 중심으로 비비례층화표집하여 248개 조직에 대한 설문조사를 통해 수집하였고, 이를 다시 인터넷 자료와 병합하였다. 분석결과, 요양보호사의 근로조건 가운데 3개 영역에서 임금수준이 높을수록, 부가급여가 존재할수록, 교육 및 훈련을 지원할수록 서비스 질이 높은 것으로 나타났다. 이는 정부가 규제하는 노동시장정책과 평가제도상의 최소기준을 넘어서는 조직의 규범적 차원에서의 근로조건과 보상체계가 장기요양서비스 질에 긍정적인 영향을 미치고 있다는 것을 보여준다.

• 한국측량학회지
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• 제37권1호
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• pp.29-42
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• 2019

본 연구는 공공시설의 질적인 측면의 확대를 위해 SNS (Social Network Service) 데이터를 활용하여 이용자 중심의 공공시설 선호요인을 도출하고, 이를 공급측면과 수요측면에서 정량화시키는 방법을 제안하였다. 선호요인 도출을 위해 토픽모델링 중 하나인 LDA (Latent Dirichlet Allocation)를 활용하였으며, 공급요인인 개별시설별로 매력도지수를 산출하였다. 또한 수요자 입장에서 서비스체감 정도를 측정하기 위해 공간접근성을 분석하였는데, 2SFCA (2-Step Floating Catchment Area) 방법을 활용하여 앞서 제안한 공공시설 매력도지수를 적용할 수 있도록 하였다. 실험은 서울시 공공도서관을 대상으로 진행하였다. 연구결과 공공도서관에 대한 선호요인으로 주변 환경, 시설 및 이용규모, 문화 프로그램, 육아, 장서 및 자료현황의 5가지 주제가 추출되었으며, 주변 환경이나 육아관련 주제는 새롭게 도출된 선호요인으로 선행연구와 차별성이 있다. 각 도서관별로 매력도지수를 산출한 결과 송파도서관, 정독도서관, 남산도서관의 매력도지수가 높게 나타났으며, 송파도서관은 육아요인에서 정독도서관과 남산도서관은 주변 환경요인에서 좋은 평가를 받고 있는 것으로 나타났다. 각 동별 공간접근성은 공공도서관이 많이 몰려있는 서울 중심부의 접근성이 좋은 편이며, 외곽지역으로 갈수록 줄어드는 것으로 보였다. 본 연구에 제안한 기법을 통해 이용자 중심의 공공시설 평가 및 정책의사 결정에 도움을 줄 것으로 기대한다.

• 가정과삶의질연구
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• 제19권4호
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• pp.49-68
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• 2001

The purpose of this study was 1) to review communal housing in the UK, 2) to consider the policy implications for elderly communal housing in Korea. The research methods used were 1) literature review about communal housing and related policy in the UK 2) field survey in the UK 3) interpretative suggestion for the proper policy implication to develope communal housing for the elderly in Korea. Sheltered housing in the UK had been developed as communal housing for the elderly with special needs since the 1970s. The type of sheltered housing were category 1 and category 2. Very sheltered housing with more facilities and meal services was added in 1980s. Sheltered housing was evaluated as the most humanistic solution for older people in the UK in 1980s. Because of the policy of moving institutional care to community care, sheltered housing became less in demand because of more options for older people including being able to stay in their own home. So new completion of sheltered housing by registered social landlords reduced saliently. Sheltered housing already totalled over half million units in which 5% of all elderly over 65 still lived and a small quantity of private sector for sale schemes emerged in the 1990s. The reason why the residents moved to sheltered housing was for sociable, secure, and manageable living arrangements. In general the residents were satisfied with these characteristics but dissatisfied with the service charge and quality of meals, especially in category 2.5 schemes. The degree of utilisation of communal spaces and facilities depended on the wardens ability and enthusiasm. Evaluation of sheltered housing indicated several problems such as wardens duty as a \"good neighbour\" ; difficult-to-let problems with poor location or individual units of bedsittiing type with shared bathroom ; and the under use of communal spaces and facilities. Some ideas to solve these problems were suggested by researchers through expanding wardens duty as a professional, opening the scheme to the public, improving interior standards, and accepting non-elderly applicants who need support. Some researchers insisted continuing development of sheltered housing, but higher standards must be considered for the minority who want to live in communal living arrangement. Recently, enhanced sheltered housing with greater involvement of relatives and with tied up policy in registration and funding suggested as an alternative for residential care. In conclusion, the rights of choice for older people should be policy support for special needs housing. Elderly communal housing, especially a model similar to sheltered housing category 2 with at least 1 meal a day might be recommended for a Korean Model. For special needs housing development either for rent or for sale, participation of the public sector and long term and low interest financial support for the private sector must be developed in Korea. Providing a system for scheme managers to train and retrain must be encouraged. The professional ability of the scheme manager to plan and to deliver services might be the most important factor for the success of elderly communal housing projects in Korea. In addition the expansion of a public health care service, the development of leisure programs in Senior Citizens Centre, home helper both for the elderly in communal housing and the elderly in mainstream housing of the community as well. Providing of elderly communal housing through the modified general Construction Act rather than the present Elderly Welfare Act might be more helpful to encourage the access of general people in Korea. in Korea.

• 대한건축학회논문집:계획계
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• 제34권12호
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• pp.65-76
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• 2018

Due to the rapid demographic and structural changes, Korea has faced a variety of social issues and quickly entered the aged society since the 2000s. In order deal with this reality, diverse types of welfare policies are emerging in the society as a whole. The government began to supply domestic public silver housing in 2016 to provide against the quickly growing aged society and now, the government is planning to supply approximately 50,000 housing by 2022 for quantitative growth of aged society, by selecting 1st and 2nd designated areas for the project additionally. This public retirement(silver) housing combines 'space' with 'service'. The lower floors are a public silver welfare Facilities and the upper floors are a housing spaces. This type of housing is to deal with requirements of rental housing residents by combining physical space with supporting service. Based on barrier-free design, the complex and unit house have safety handles and alarm bells in the bathroom, undulating washstands, bathroom sliding doors, corridor safety handles, and emergency safety exit lamps in each housing unit so the aged and the disabled can use easily and conveniently. Also, hand rails are installed and stepped pulleys are removed to promote convenience. Currently, the government is planning to increase the supply, focusing on low-income groups, such as beneficiaries of national basic livelihood and the working poor. Recognizing that the public retirement(silver) housing project is at its early stage, this study examined satisfaction, based on evaluations of real residents. This study aimed to obtain more empirical research data and apply them to public retirement(silver) house space analysis. For analysis, this study targeted Wirye public retirement(silver) housing and Magnolia public retirement(silver) housing that are in operation, and literature review, previous research review, and field survey were conducted to examine the present state. Using the questionnaires consisting of four large classification items; Block Layout, Housing Unit, Welfare Facilities, and Barrier-free Design, and sub-details, a survey was conducted to analyze residents' satisfaction. In conclusion, it is anticipated that this study would serve as basic research data about public retirement(silver) housing to increase continuously in future by analyzing public retirement(silver) housing spaces, on the basis of the analyzed data.

• 한국문헌정보학회지
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• 제58권2호
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• pp.363-384
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• 2024

본 연구는 텍스트마이닝 기법을 중심으로 빅데이터 분석을 활용하여 대전시 공공도서관에 대한 이용자의 인식과 경험을 살펴보고자 수행되었다. 이를 위하여 첫째, 소셜미디어에 나타난 이용후기 데이터를 수집하여 대전시 공공도서관에 대한 이용자들의 전반적인 인식과 평가를 탐색하였다. 둘째, 온라인 뉴스 기사 분석을 통해 사회적으로 논의되고 있는 현안을 파악하였다. 분석 결과, 첫째로 어린이 동반 이용자 비중의 높다는 것과 다음으로 LDA 분석을 통한 토픽이 '문화행사/프로그램', '자료 이용', '물리적 환경 및 시설', '도서관 서비스'의 네 가지 분류로 나타난다는 것, 마지막으로 뉴스기사 데이터에 도서관 및 복합문화공간 추가 건립과 도서관 협력 체계 구축에 대한 키워드가 핵심적으로 등장한다는 것을 확인하였다. 이를 바탕으로 지역 균형을 고려한 공공도서관 건립과 육아 및 보육 기관과의 업무협약을 통한 사회적 육아공동체 네트워크 조성을 제안하였다. 본 연구를 활용하여 대전시 공공도서관의 정책적·사회적 흐름을 알아보고 지역사회 수요를 반영하는 공공도서관 운영을 데이터에 기반하여 실행할 수 있기를 기대한다.

• 대한간호학회지
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• 제26권4호
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• pp.768-781
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• 1996

The problem of care of patients and families with Alzheimer's disease has become a conscious raising social policy issue in Korea. The government of the Republic of Korea has become cognizant of the situation and has begun searching for ways to remedy it. Thus, there is a need for a comprehensive under-standing of the situation in which patients and their families are struggling and the enormous problems of care. With a realization of the urgent need, this study was done to investigate the situation and the care needs of families with patients with Alzheimer's Disease, and to compare the effectiveness of services utilized by the families in terms of cost and effects on patient's conditions and on family live. The Subjects for the study were 29 families with hospitalized patients, 25 families utilizing hospital outpatient clinics, 14 families utilizing day care facilities, and 16 families with homebound patients. A total of 84 families were interviewed by four trained interviewers using structured and semistructured questionnaires. The data produced from these interviews included : the patient's stage of Alzheimer's disease, patient's bizarre behavior, hours spent on patient care per day, family burden and quality of life, direct and indirect costs encountered in the care of patients, and the families' evaluation of the effectiveness of the services received. The data were analyzed to determine the relationships between family charactersistics, patient's conditions and services utilization. The effectiveness of each of the service entities was assessed through families evaluation and hoped for service and comparisons were made between services in terms of the cost-effectiveness ratios. After initial comparison of cost-effectiveness ratios, further analysis was done to compare between groups for incremental effectiveness for each incremental unit of cost to determine the most cost-effective service entities. The findings of the study are as fellows : 1. The choice of living arrangement and the types of services are a function of the stage of Alzheimer's condition and the economic status of the family. 2. Comparision of the cost of care showed that most expenses were encountered in by families with hospitalization, families using outpatient services, and families using day care services in that order. The least expense was involved in the care of homebound patients. The economic burden felt by families was in the same order as expenses. 3. The average number of hours spent on daily patient care was 9.9 hours for the outpatient clinic users, 9.7 hours for homebound patients, and 5.4 hours for day care users. 4. There were significant differences in the patient's conditions (CDRL), bizarre behaviors and the families's burden by living arrangement and /or types of service. However, no significant difference was found between groups in the family's quality of life. 5. The families rated the services of day care center as most effective for the care of the patients and families, except for a few families who had experienced some improvement in the patient's conditions. The outpatient clinic users expressed psychological comforts mainly in that the patient was being taken care of. For those hospitalized patients, families expressed the comfort of being relieved of the burden of care and that the patient is being professionally cared for. Form the analysis of the costs, hours of patient care, patient's bizarre behaviors, family's quality of life and burdens, and family's evaluation of services, it is concluded that up to the mid stage of Alzheimer's condition, the utilization of day care center services is found to be the most cost-effective, and toward the end stage of the Alzheimer's disease, it is hoped that there will be a establishment of long term or short term in-patient facilities for the protection of patients and preservation of the integrity of families for less cost. Thus. it was concluded that the family centered system of care is the most effective for Korea with systematic support systems developed for the care of patients and their families according to the needs of families as the patient's condition deteriorates.

• 보건행정학회지
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• 제26권3호
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• pp.195-206
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• 2016

Background: Concentration of patients to large hospitals is serious problem in Korea. The purpose of this paper is to propose appropriate policy direction to relieve concentration of patients to large hospitals. It is focused on evaluation of the possibility of family doctor system as a policy alternative to relieve concentration of patients to large hospital by empirically analyzing the effect of usual source of care (USC) on large hospitals medical care use. Methods: Korea Health Panel conducted 2009, 2012, 2013 by KIHASA (Korea Institute for Health and Social Affairs) and NHIS (National Health Insurance Service) was used for analysis. For dependent variables, first, the ratio of the amount of using large hospital to total amount of using medical care, and second, the amount of using large hospital are estimated. Independent variables are having an USC and type of USC. Panel analysis was done with above variables. Results: Main results are as follows. First, having an USC increases using large hospital. Second, having a domestic clinic type USC decreases using large hospital and ratio of using large hospital. Third, the effect of domestic clinic type USC is greater in older group, less income group, worse health status group, not having private insurance group, and having chronic disease group. Conclusion: These results show that family doctor program can be a policy alternative to relieve concentration of patients to large hospital. Nonetheless, primary care system in Korea is unsatisfied. It is recommended to reinforce primary care system and family doctor system to relieve concentration of patients to large hospitals.

• 한국노년학
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• 제41권2호
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• pp.197-215
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• 2021

본 연구는 요양시설거주 치매환자들의 삶의 질을 사정하기 위해 개발된 DCM(Dementai Care Mapping)을 활용, 국내 장기요양시설에서의 사람중심케어 실천 정도 및 특성을 탐색하는 것을 목적으로 한다. DCM은 훈련받은 매퍼가 시설거주 치매노인을 관찰 사정하는 도구이지만 본 연구에서는 장기요양 시설 종사자들의 자기보고식 평가척도로 변용하였다. DCM의 개념을 34개의 문항으로 조작화하였으며 브래포드치매팀의 검토를 거쳐 총화평정척도로 만들었다. 본 척도의 신뢰도는 .88로 신뢰할 만 하며, 이를 국내 시설 종사자 343명을 대상으로 설문조사를 실시한 결과 평균점수는 3.77점(5점 척도)으로 나왔다. DCM의 하위카테고리 별 평균 점수는 애착(4.02), 편안함(3.95), 포용(3.89), 정체성(3.67), 주체성(3.41)으로 나타났다. 국내 요양서비스가 대상자의 안전과 편안함에 초점을 맞춘 신체수발에 주력하며 종사자와 대상자간에 애착이 형성되고 있지만, 개별적 케어(정체성)부족이나 대상자의 삶에서 의미있는 활동이 부족한 점(주체성)에서 사람중심케어가 취약함이 드러났다. 한편, DCM척도에 의한 사람중심케어의 특성을 조직 및 개인 특성에 따라 살펴보면, 시설의 규모가 작을수록 사람중심케어 실천이 높으며 공립과 민간시설간의 차이는 없었다. 또한 시설장과 직접 서비스제공자의 사람중심케어 실천이 높으며 경력이 1~2년인 종사자들의 사람중심케어 점수가 높은 것으로 나타났다. 본 연구는 국내 요양서비스에서 사람중심케어의 실천이 필요하며 이를 위한 구체적인 방안으로 유니트케어의 적용, 시설에서 직접 서비스제공자뿐 아니라 간호, 사회복지사등 전 직원을 대상으로 한 사람중심케어 교육 실시를 제언한다. 국내 요양서비스의 질평가에서도 사람중심케어의 관점이 강화돼야 하며 이를 위해 DCM 또는 직접 관찰이 어려운 상황에서는 대안으로 본 연구에서 개발한 한국형DCM척도의 활용을 제언한다.

• 지역사회간호학회지
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• 제6권2호
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• pp.259-274
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• 1995

The study is to grasp the problems related to operation of Maternity clinic of public health centers in seoul and needs for public health of community in relation to consumers and providers in order to improve efficiency of community public health for mothers and children. Four pregnancy woman, who receive medical care at the maternity clinic of M public health centers in seoul and understand the purpose of this study, and one nurse who works at the were the objects of this field study. Participating observation and intensive interviews were conducted to collect data. All of them were performed as necessary from time to time since December, 1994, and not during a specific period. Through an data analysis in the order of sector analysis and classification analysis, the data were classified into specific patterns and the results are the following; 1. All of the subjects were using both private hospitals and public clinics, but managing activities prior to delivery were not carried out in accordence with theories for those activities. 2. The subjects showed two types of response to utilizing maternity clinic. they answered that the advantages of the clinic were 'short waiting time for medical treatment', 'medical treatment by female doctors' and 'economical benefit.' Meanwhile, they gave negative response to the problems of 'non-implementation of delivery' 'uncleanness and insufficient facilities', 'limited time of treatment', 'lack of expertise' and 'want of public health education for materity.' 3. Problems related to operation of maternity clinic were 'lack of experts', 'irrational facility structure' and 'absolutely lack budget'. In terms of the status of managing the subjects, 'programs only aimed at attaining the central-government-assigned objects' and 'limited management before and after delivery by non-implementing delivery' were pointed out to be problems. Regarding public health education before delivery and PR relations, 'superficial public health education for maternity' and 'absence of PR programs' were named. In planning and evaluation, 'absence of autonomous planning and evaluation by the clinic itself' was a major problem in operating the clinic. 4. 'Substantial health education and PR', 'supplementation of facilities and eqipment', 'development' and supply of demanded service by the subjects', 'implementation of autonomous programs', and 'reinforcement of supplementary education' were presented as alternatives for efficient opration of maternity clinics.

• 한국산학기술학회논문지
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• 제13권5호
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• pp.1954-1962
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• 2012

최근 유럽과 아시아 사이의 물류 증가는 철도수송에 있어서 사회적/경제적으로 좋은 기회이며, 동시에 커다란 도전이 될 수 있다. 유라시아 대륙에는 다양한 궤간이 존재하고 있다. 이러한 궤간의 차이는 철도에 의한 화물수송시 장애요인중의 하나이다. 궤간 차이를 극복하기 위한 방법은 수송 화물의 유형에 따라 달라질 수 있으며, 국경 지점에 보관 창고 및 환적 설비와 같은 넓은 기반 시설과 많은 운영 인력수요와 같은 철도 수송 시스템의 운영에 많은 영향을 준다. 따라서 철도 수송 시스템의 효율성은 복잡한 하역 및 교환 기술에 관련된 궤간 극복 방법에 매우 의존한다. 본 논문은 궤간 극복 방법에 대한 기술적 평가를 기반으로 수송 시나리오의 효율성을 검토하고, 각 시나리오의 운영에서 요구되는 기술적 요소들을 기술하였다.