노인장기요양서비스 전달체계의 평가 및 개선방안: 재가서비스를 중심으로
Evaluation and policy issues in Long-term care service delivery system for the elderly: centered on home care services
선우덕; 정순둘; 양찬미
노인장기요양서비스 전달체계; 요양등급; 등급판정도구
노인장기요양보험서비스를 이용하는 대상자 및 그 가족과 서비스를 공급하는 재가서비스기관을 대상으로 서비스전달체계의 내용을 각 부문별로 평가하여 현행 체계상 미흡한 부분을 파악하고, 이를 개선하는데 도움을 줄 수 있는 방안 제언
This research report was written to suggest improvements of sub-system for delivering care services in long-term care insurance for the elderly. The research method mainly was the opinion survey targeted at care users and their family care-givers and commercial care providers. Long-term care services aim at improving and maintaining independent functional abilities (effectiveness issue) as well as financial stabilization (efficiency issue). The present long-term care service delivery system is divided into administrative and executive parts. The results of research are as follows. Generally speaking, care users and their family care-givers, or care providers had higher expression for executive parts, while in administrative parts was lower appraisal expressed than the average level. Firstly, the appraisal for needs assessment process including the determination of care level was lower, composed of visiting examiner's expertise, appropriateness of needs assessment items, etc. Secondly, the appraisal for issues in relation to care worker also was lower because there are lots of problems in training, care technic, their providing care quantity, etc. Thirdly, in the type of care benefit, day-care service was appraised high relatively from perspectives of improvement of ADLs and service utilization. Fourthly, in the type of facility operation, services delivered by free-standing facilities was appraised high relatively from various perspectives of delivery system. Fifthly, in the type of facility-operating body, appraisal by non-profit facility was high from perspectives of determination process of care level, while for-profit facility had higher appraisal for service utilization. Sixthly, in the type of facility-located area, and care level and income level of users, there were higher appraisals from urban-located facilities, and those with the second care-level, and higher income brackets respectively about care delivery system. Policy issues can be suggested that care-level assessment process be reviewed and examined closely. Besides, the objective tools measuring care service quality and reinforcement way of care worker's professionality and facility-operation standards be developed.
Abstract 요 약 제1장 서론 제1절 연구의 배경 및 목적 제2절 연구의 내용 및 방법 제2장 사회복지서비스 전달체계의 개관 제1절 사회복지서비스 전달체계의 정의 제2절 사회복지서비스 전달체계의 유형 제3절 사회복지서비스 전달체계의 평가기준 제4절 선행연구 제3장 현행 장기요양서비스 전달체계의 개관과 평가방식 제1절 노인장기요양서비스 전달체계의 정의와 평가기준 제2절 노인장기요양서비스 전달체계의 효과적 평가방법 제4장 장기요양서비스 전달체계 평가를 위한 조사분석 및 시사점 제1절 조사방법 제2절 분석결과 제5장 주요국가의 장기요양서비스 전달체계의 실태와 평가 제1절 독일 제2절 일본 제6장 장기요양서비스 전달체계의 비용효율적 개선방안 제1절 장기요양서비스 전달체계의 평가요약 제2절 제도개선과제 제7장 결론 참고문헌 부록