care
; migrant worker
; long-term care
; personal assistance services
Publication Year
2021
Publisher
Korea Institute for Health and Social Affairs
Abstract
이 연구는 국내 돌봄서비스의 외국인 종사자 현황을 분석하고 정책적 개선안을 도출하는 것을 목적으로 한다. 이를 위해 돌봄서비스 외국인 종사자 관련 선행연구 및 제도를 고찰하고 돌봄서비스의 외국인 종사자 현황, 유입 구조 및 노동경험 등을 분석하였다. 돌봄 영역의 내국인 수급의 어려움으로 인해 외국인 종사자들이 유입되고 있다. 비제도권 돌봄 영역에서 외국인 종사자의 비중이 높으나, 제도권 돌봄 영역에서는 외국인 종사자의 비중이 아직 미미한 수준이다. 한국어가 가능한 중국동포 등이 주로 일하고 있기에 서비스 제공이 불가하지는 않으나 언어 및 문화 차이로 인한 어려움도 일부 나타나고 있다. 돌봄 영역은 중고령의 여성 이주자에게 선택 가능한 주요 일자리이며, 특히 제도화된 영역은 선택할 수 있는 다른 산업의 직업에 비해 괜찮은 근로조건의 일자리인 것으로 파악되었다. 돌봄 영역의 외국인 종사자 활용을 논의하기에 앞서 돌봄노동시장 개선을 우선으로 고려해야 할 것이며, 적정 수준의 서비스를 제공할 수 있는 외국인 종사자가 돌봄 현장에서 차별이나 배제 없이 일할 수 있도록 관련 정책을 개선하는 방향으로 나아갈 필요가 있다.
This study is intended to analyze the status of foreign care workers in South Korea and to draw a policy improvement with an aim of understanding the structure and current state of migrant work in the care services. First, it examines the structure that has an inflow of foreign workers under the care policy and labor market system. Second, it figures out the present status of foreign care workers focusing on the care for the elderly and persons with disabilities, and analyzes the characteristics of foreign workers in formal and informal sectors of the care services. Third, it seeks a policy improvement related to foreign care workers. For this, this study has identified the status of foreign care workers and the relevant system as focusing on the long-term care system, nursing hospital care giving service, and personal assistance services for persons with disabilities and carried out a qualitative analysis of care work by foreign workers by area. First, it has examined the regulations on foreign care worker. According to Korea’s immigration policy, people such as overseas Koreans — mainly Korean Chinese —, permanent residents, and marriage-based immigrants can work in the field of care services. Additionally, employment of foreign workers including overseas Koreans, permanent residents, marriage-based immigrants is allowed according to the guidelines for long-term care services and personal assistance services for persons with disabilities. Meanwhile, since there is no regulation regarding the recruitment of nursing hospital caregivers, overseas Koreans, permanent residents, and marriage-based immigrants can work in nursing hospitals as a caregiver according to the regulation of immigration policy. Second, the share of foreign care workers in the care services was estimated based on the second data analysis and the survey on institutions. According to the data about the COVID-19 -related state, about 6% of the total long-term care facilities (facility-based long-term care institutions) employ one or more foreign workers, and the analysis result of the data related to social service e-voucher shows that 0.9% of the personal assistance service workers for persons with disabilities are estimated to be foreigners. In the case of the caregivers in nursing hospitals, which are the informal sector outside the long-term care services, administrative data shows that 46% of the caregivers in nursing hospitals are foreigners. Meanwhile, this study carried out a survey targeting long-term care institutions and centers for personal assistance services for persons with disabilities. Among the long-term care institutions that responded to the telephone contact for the survey, 5.1% of them said that they hired foreign care workers. According to the findings on survey, both long-term care institutions and centers employing foreigners for personal assistance for persons with disabilities naturally hired them during the recruitment due to vacancies, and more than half of institutions and centers said that they would be willing to hire foreigners in the future. Most of the foreign care workers in the long-term care institutions and centers for personal assistance for persons with disabilities were Korean Chinese. They were mostly middle-old aged females, which is a characteristic similar with that of Korean care workers. According to the estimation based on the second data analysis and survey on the institutions by this study, the share of foreign care workers was low in the formal care sector, while the share was relatively higher in the informal care sector. Third, in-depth interviews were conducted on care workers in long-term care, nursing hospital caregivers, and personal assistance service workers for persons with disabilities, and Focus Group Interviews(FGI) were carried out on directors or managers in long-term care institutions, managers in the centers for personal assistance services for persons with disabilities, and family members of the patients in nursing hospitals. Foreign care workers flew into the care services mainly from informal care sectors as a caregiver, expanding their scope of work in the field of care services. However, occupational hierarchies in this field of care work was not distinctly shown, because foreign care workers consider their preference like wages, working hours, working environment, job description, etc. for choosing their jobs such as nursing hospital caregiver, live-in caregiver, care worker in long-term care facility, care worker in home-based long-term care, and personal assistance service worker for persons with disabilities. Due to a lack of local Koreans for the recruitment of care workers, foreigners are naturally flowing in. Care service work is a job available to the aged migrant females in the limited scope of occupation, and care work in the formal sector (long-term care services and personal assistance services) is a relatively stable job that protects fundamental labor right. Foreign care workers respond to discrimination or unreasonable demands by quitting the jobs or just enduring the problems. According to the results of survey on the institutions, in-depth interviews, and FGI, the demand for foreign workers in the care services is expected to continue in the future. The analysis of migrant care work in Korea reveals that foreign workers are flowing into this field where Koreans are hardly employed due to its relatively poor working conditions. Insufficiency of the care services in formal sectors is linked with the increase of foreign workers in informal care services outside the system. Foreign care workers are exposed to heavy workload, emotional labor, and poor working environment, which reflects defects of the existing care work. Since the fundamental reason for difficulty in hiring Koreans in the care services is the poor working conditions and low recognition for the job, care service working conditions and its improvement need to be preferentially considered before discussing the policy regarding foreign care workers. Policy improvement concerning the labor protection to comply with favorable working conditions is also required in the informal sector. Considering the policy in regard to foreign care workers, there is a need to discuss improvement plans to encourage the foreign workers with qualifications and skills work without discrimination or exclusion in the field of care work.
Table Of Contents
Abstract 1 요약 7
제1장 서론 29 제1절 연구의 배경 및 목적 31 제2절 연구의 내용 및 방법 34
제2장 선행연구 검토 41 제1절 돌봄과 이주에 관한 연구 43 제2절 한국 돌봄 영역의 외국인 관련 연구 검토 54
제3장 돌봄서비스와 외국인 종사자 관련 제도 59 제1절 노인·장애인 대상 돌봄서비스 61 제2절 돌봄 영역의 외국인 종사자 관련 제도 82
제4장 돌봄서비스의 외국인 종사자 현황 93 제1절 돌봄서비스 외국인 종사자 통계 95 제2절 돌봄서비스 제공기관의 외국인 종사자 현황 102
제5장 돌봄서비스 외국인 종사자의 유입 구조와 노동경험 119 제1절 연구 방법 121 제2절 장기요양기관의 외국인 요양보호사 131 제3절 요양병원의 외국인 간병인 171 제4절 장애인활동지원사업의 외국인 활동지원사 208 제5절 소결 245
제6장 결론 및 정책 제언 257 제1절 주요 연구 결과 259 제2절 정책적 제언 265