보고서 정보
주관연구기관 |
한국보건사회연구원 Korea Institute for Health and Affairs |
보고서유형 | 최종보고서 |
발행국가 | 대한민국 |
언어 |
한국어
|
발행년월 | 2013-10 |
주관부처 |
여성가족부 Ministry of Gender Equality & Family(MOGEF) |
등록번호 |
TRKO201600013288 |
DB 구축일자 |
2016-12-17
|
초록
▼
Ⅰ. 서론
제1절 연구의 배경 및 목적
가. 연구배경 및 목적
□ 2013년에 수행되는 특정성별영향분석평가 과제중 하나로 성별영향분석평가틀에
기초하여 노인장기요양보험제도를 검토하고 개선방안 모색
□ 노인장기요양보험제도 서비스 대상자인 노인과 서비스 제공자(요양보호사)의 성별특성을 반영함으로써 공적보호서비스 제공에 있어 성평등 실현
□ 노인장기요양보험제도의 성별 형평성 검토
ㅇ 성인지적 관점에서 노인장기요양 대상자 선정절차의 적절성 검토
ㅇ 성인지적 관점에서 서비스 제공 환경 검토 및 개선방
Ⅰ. 서론
제1절 연구의 배경 및 목적
가. 연구배경 및 목적
□ 2013년에 수행되는 특정성별영향분석평가 과제중 하나로 성별영향분석평가틀에
기초하여 노인장기요양보험제도를 검토하고 개선방안 모색
□ 노인장기요양보험제도 서비스 대상자인 노인과 서비스 제공자(요양보호사)의 성별특성을 반영함으로써 공적보호서비스 제공에 있어 성평등 실현
□ 노인장기요양보험제도의 성별 형평성 검토
ㅇ 성인지적 관점에서 노인장기요양 대상자 선정절차의 적절성 검토
ㅇ 성인지적 관점에서 서비스 제공 환경 검토 및 개선방안 도출
ㅇ 성인지적 관점에서 요양보호사 처우‧역할 개선방안 및 인력양성방안 모색
□ 노인장기요양보험제도의 성별 요구도 차이 및 구현 실태 검토
ㅇ 서비스대상자(노인‧가족)와 제공자(요양보호사)의 욕구 및 서비스 제공과정에서의 문제점 파악
ㅇ 성인지적 관점에서 노인장기요양급여의 적절성 검토
□ 성인지적 관점에서 관련 법령 및 사업지침 개선안 도출
나. 연구의 필요성
□ 급격한 고령화와 더불어 가족‧사회의 구조적 변화 및 가치관의 변화 등으로 인해 노인돌봄 문제가 중요 정책과제로 대두
ㅇ 2008년 7월 노인장기요양보험제도의 도입되었으며, 노인장기요양보험제도 인정자수(등급 외 포함)는 2008년 214,480명→ 2009년 286,907명→2010년 315,994
명 → 2011년 478,446명 → 2012년 495,445명 등으로 지속적으로 증대하여 왔으며 향후도 장기요양서비스 수요는 증가할 것으로 추계되고 있음.
□ 제1차와 2차 저출산고령사회기본계획이나 제1차 장기요양기본계획의 경우 주요
검토내용과 추진방향 모색에 있어 성인지적 관점이 반영되어 있지 못하여 성별
특화된 욕구에 대한 제도 보완 필요
ㅇ 등급인정자, 노인장기요양보험 신청행태, 등급별 급여내용, 등급구성에 있어서
성별 차이 발생
□ 저임금의 장기요양서비스 제공자의 대부분이 여성인 상황
ㅇ 급여 제공자 측면에서 장기요양기관에 종사하는 요양보호사의 91.6%가 재가시설에 근무하며, 대다수의 인력은 중년여성으로 저임금을 받고 있음.
ㅇ 이는 돌봄노동의 가치평가가 낮고 부정적인 사회인식이 팽배한 것에 기인
Abstract
▼
The purpose of this study is assess gender impact on Long-term Care
Insurance. Long-term Care Insurance, introduced in July 2008, aims to
supports older persons who cannot perform regular daily activities due to
old age or geriatric disease, thus improving old age health and stable living,<
The purpose of this study is assess gender impact on Long-term Care
Insurance. Long-term Care Insurance, introduced in July 2008, aims to
supports older persons who cannot perform regular daily activities due to
old age or geriatric disease, thus improving old age health and stable living,
and reducing the burden of family. By analyzing Long-term Care
Insurance in terms of gender equity and gender sensitiveness, the quality of
long-term care services and the social status of home helpers would be
enhanced. Also, the burden of family caregivers, who are mainly female including
wives, daughters, and daughter-in-laws, would be reduced.
This study consists of seven parts. The first part reviews related discussions
regarding health status of older persons, care-giving burdens, and
working conditions of care workers. The second part points out the achievements
and challenges of Long-term Care Insurance during last 6 years.
The third part reviews current changes and policy issues regarding
long-term care services in OECD countries, in particular in Germany and
Japan.
The fourth part assesses Long-term Care Insurance based on the framework
of gender impact assessment. Survey data and Long-term Care
Insurance data are used for this purpose. According to the analyses, women
is underrepresented in the process of decision-making. Only around
20% of committee members are women. This points out the possibilities of
gender bias and unsensitiveness to gender issues in the decision making
process. Also the data analyses report that men and women have different
needs and resources in terms of long-term care services. In addition to
that, the percentage of those who are assessed Level A, B, and C, those
cannot receive long-term care benefits, is higher among women than men.
These findings points out the need to be sensitive to gender differences.
The fifth part analyzes the nationwide data set (Living Profiles and
Welfare Needs of Older Persons 2011) to answer to the question whether
there are gender differences in functional status among older persons.
Other issues of concern include whether more women tend to apply for
long-term care benefits more actively than men under the condition of
same functional status.
Along with these quantitative analyses, qualitative approach is introduced
to explore the interests and difficulties of formal and informal
caregivers. Focus group interview are conducted 4 times. Participants of
FGI are home helpers, administrative staffs, and directors of long-term
care facilities. 20 persons, who are family members, older persons with
functional limitations, home helpers, and NGO activists, are invited to face
to face interview.
The sixth part conducts and analyses a mail survey. The purpose of the
mail survey is to find out concrete working conditions in terms of gender
equity and difficulties by gender of care providers and care receivers. 33
facilities are selected to present diversity of long-term care facilities. 297
home helpers working at 33 facilities answered to the questionnaire.
Questionnaire is developed based on the main findings from FGI, interview,
and data analyses. Main findings of mail survey are following.
Among the facility residents, less than 20% are male older persons. The
characteristics of male older persons are uncontrolled sexual needs and
tendency to solve the problem by physical strength. Female older persons
tend to be compliant. In the case of home helpers, the merits of men are
their physical strength and the disadvantages are their clumsiness in
housekeeping activities. In the case of female, the merits and the disadvantages
are the inverse.
Among home helpers, only 16.7% are male, only one third working at
the current facilities more than 5 years, and majority of them are 40 years
old and over. Among caregiving activities, the most difficult activity is giving
bath-service, followed by support for urination and bowl movement,
diaper change, and postural changes. By characteristics of older persons,
overweight older persons are the most difficult to care followed by the
bedridden.
61.9% of home helpers have experiences of verbal abuse, 34.6% of physical
abuse, and 29.2% of sexual harrassment. In addition, 68.0% answered
that their health deteriorated after working as home helper. Back pain,
shoulder pain, and chronic fatigue are among the main symptoms. They
answered that the low wage and low social status of home helpers are the
main reasons of feminization of caregiving labor force.
Lastly, policy suggestions are made to enhance gender equity and gender
sensitiveness in Long-term Care Insurance. First of all, policy measures to
provide gender equitable services such as 1) increase the opportunities of
male older persons live in nursing home when they want; 2) provide support
for Level A, Level B, Level C who have functional limitations but can
not receive Long-term Care Insurance benefits(majority of them are female
older persons); 3) strengthen preventive approach by linking public health
screening service at 66 years old and Long-term Care Insurance data set; 4)
provide user-friendly service user support including oral explanation.
Secondly, policy measures are suggested to 1) improve working conditions
of home helpers; 2) make regulations to protect human rights of home
helpers; 3) provide more diverse tools to support caregiving activities; 4)
provide consulting and resolve grievances by arranging focal point such as
‘support center for home helpers’, Lastly, policy efforts to increase gender-
sensitiveness of Long-term Care Insurance through education and decision-
making process are urgent. Also, future data production will need to
be more gender-sensitive. In addition to that social campaign regarding
the social importance of caregiving activities can enhance the social status
of home helpers.
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