디지털융복합연구 (Journal of Digital Convergence)

  • 제18권12호
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  • Pages.389-399
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  • 2020
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  • 2713-6434(pISSN)
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  • 2713-6442(eISSN)
한국디지털정책학회 (The Society of Digital Policy and Management)
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비공식 돌봄자를 위한 정책 지원 비교 연구: 미국과 영국 최근 정책 동향 고찰 중심으로

Policy Supports for Informal Caregivers: Focusing on Policy Changes in the United States and United Kingdom

  • 이용주 (동덕여자대학교 보건관리학과)
  • Rhee, YongJoo (Dept. of Health Sciences, Dongduk Women's University)
  • 투고 : 2020.10.04
  • 심사 : 2020.10.20
  • 발행 : 2020.12.28
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초록

지역사회 내의 노인의 독립적 생활을 지원하기 위하여, 미국과 영국은 오래 전부터 비공식 돌봄자에 대한 지원을 정책적으로 마련하였다. 본 연구는 최근 미국의 가족 돌봄자 지원법(The Recognize, Assist, Include Support and Engage, RAISE)과 영국의 돌봄자법 2014(Carer Act 2014)를 바탕으로 새로운 정책적 전략과 이에 관련한 문서를 분석하여 비공식 돌봄자를 위한 정책을 검토하여 국내 시사점을 찾고자 하였다. 미국의 경우는 가족 비공식 돌봄자의 역할을 확대하여 신약개발 및 치료방법 개발에 일정 부분 개입을 시켜 환자와 돌봄자 중심의 가정의로 환경 모델을 기획하고 있다. 무엇보다, 영국은 노동시장에서의 돌봄자 지원정책을 심화하였다. 근무하는 비공식 돌봄자를 다각적 방법으로 지원하는 것이 노동시장에서 경제적으로 효율적이라는 실증적 연구와 연계하여 근거 중심의 지원 정책을 시도하고 있었다. 재정적 지원, 직접 서비스 제공, 유연 근무, 권익 보장이라는 네 범주 안에서 지원되는 미국과 영국의 비공식 돌봄의 지원정책은 돌봄의 가치 인정과 돌봄자의 건강권과 인권에 대한 보장이라는 근본적인 합의를 토대로 이루어졌다. 현재 국내에서 장기요양정책과 노인복지 정책에서 제공되고 있는 비공식 돌봄자에 정책적인 지원들이 근거를 중심으로 지원된다면, 지역사회 내의 통합적인 돌봄 체계의 실질적인 효과가 있으리라 본다.

Diverse official policies in community are available for caregivers to take care of the elderly in the US and the UK. This study aims to examine the recent changes in government supports based on The Recognize, Assist, Include Support and Engage (RAISE) in the US, and those by Carer Act 2014 in the UK, to take any good lessons for Korean policy. Caregivers will play a new role to develop innovative treatment for patient-centered care. The UK strengthens to provide various efforts for working carers while assuring economic efficiency in labor market with empirical evidence. The major four ways to support carers were developed agreed with the acknowledge of caregiving value and their human right; financial support, direct services for carers, flexible work time, and advocacy. Korean supports policies for carers in long-term care and social welfare will be more effective in community care system if more evidence based policies are prepared.

키워드

참고문헌

  1. Statistics Korea. (2019). Statistics for Elderly 2019. Statistics Korea (online) /kostat.go.kr/portal/korea/kor_nw/1/1/index.board?bmode=read&aSeq=377701
  2. National Health Insurance Service. (2019). Long Term Care Insurance Statistical Yearbook 2018: (online) https://www.nhis.or.kr/menu/boardRetriveMenuSet.xx?menuId=F332a.
  3. H. Kim & S. Kwon. (2012) Projection of demand and expenditure for services under long-term care insurance for the elderly in Korea, The Korean Journal of Health Economics and Policy. 18(3), 29-51. DOI 210.101.116.18/kiss9/download_viewer.asp
  4. E. J. Han. J. S. Lee. S. Y. Park. & A. J. You. (2016). A report for long-term care benefit use by the type of benefits in long-term care among long-term care beneficiaries. Wonju, Korea: National Health Insurance Service. DOI: 10.17000/kspr.26.3.201909.93
  5. World Health Organization. (2002). Active ageing: a policy framework. World Health Organization: Geneva, Switzland. p. 1-60. DOI: https://apps.who.int/iris/bitstream/handle/10665/67215/WHO_NMH_NPH_02.8.pdf;jsessionid=A183A47C0731C41D9137442EC90D848C?sequence=1
  6. Y. W. Lee. & S. H. You. (2018). Elderly Care. 2nd Edition. Seoul. Korea: Kwechook Publisher.
  7. Office for National Statistics. (2020). Changes in the Older Resident Care Home Population between 2001 and 2011, (online) : https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/ageing/articles/changesintheolderresidentcarehomepopulationbetween2001and2011/2014-08-01.
  8. N. Muramatsu. R. L. Hoyem. H. Yin. & R. T. Campbell. (2008). Place of death among older Americans: does state spending on home- and community-based services promote home death? Med Care, 46(8): 829-38. DOI : 10.1097/MLR.0b013e3181791a79.
  9. R. W. Johnson. & A.T. Lo Sasso. (2006). The Impact of elder care on women's labor supply. Inquiry, 2006. 43(3): 195-210. DOI: 10.5034/inquiryjrnl_43
  10. M. K. Kim. E. J. Han. H. Y. Lee. S. W. Lee. & A. J. You. (2018). A study to develop better system of family benefit in long-term care. Wonju, Korea: National Health Insurance Service. DOI: http://210.178.135.44/search/detail/CATXAZ000000040750
  11. N. J. Yang. & I. H. Choi. (2013). The impact of Korean long-term care insurance system on family caregivers: Focusing on Family caregivers arrangements. Korean Journal of Social Welfare Studies, 44(3): 31-56. DOI : 10.16999/kasws.2013.44.3.31
  12. S. Yeandle. (2016). Caring for our carers: an international perspective on policy developments in the UK. Juncture, 23(1): 57-62. DOI : 10.1111/j.2050-5876.2016.00896.x.
  13. National Alliance for Caregiving and AARP Public Health Institute (2015), Caregiving in the U.S. AARP Public Policy Institute: Bethesda, Maryland, United States. DOI :10.15585/mmwr.mm6907a2.
  14. L. Feinberg. & A.H., Houser (2012). Assessing Family Caregiver Needs: Policy and Practice Considerations AARP Public Policy Institute: Washington DC, United States. https://www.caregiving.org/wp-content/uploads/2020/05/AARP-caregiver-fact-sheet.pdf
  15. L. Feinberg. (2013). Keeping up with the Times: Supporting Family Caregivers with Workplace Leave Policies. AARP Public Policy Institute: Washington DC, United States. https://www.aarp.org/content/dam/aarp/research/public_policy_institute/ltc/2013/fmla-insight-keeping-up-with-time-AARP-ppi-ltc.pdf
  16. J. C. Williams, R. Devaux. P. Petrac. & L. Feinberg. (2012). Protecting family caregivers from employment discrimination. AARP Public Policy Institute: Washington DC, United States. https://www.aarp.org/content/dam/aarp/research/public_policy_institute/health/protecting-caregivers-employment-discrimination-insight-AARP-ppi-ltc.pdf
  17. C. H. Van Houtven., et al. (2019). Comprehensive Support for Family Caregivers: Impact on Veteran Health Care Utilization and Costs. Medical Care Ressearch Review, 76(1), 89-114. DOI: 10.1177/1077558717697015.
  18. U. S. Congress (2018). Public Law 115-119 115th Congress. U.S. Government Publishing Office: Washington DC., the United States. 1-5. https://acl.gov/sites/default/files/about-acl/2018-10/PLAW-115publ119%20-%20RAISE.pdf
  19. Family Caregiver Alliance (2006). Caregiver Assessment: Principles, Guidelines, and Strategies for Change: San Francisco. the United States: National center on Aging. https://www.caregiver.org/sites/caregiver.org/files/pdfs/v1_consensus.pdf
  20. L. Bangerter & K. O'Malley (2020). RAISE Family Caregivers Act: Progress Toward a National Strategy to Support Family Caregivers. Administration for Community Living: Washington DC. the United States. National center on Aging. https://acl.gov/sites/default/files/RAISE_SGRG/RAISE%20Family%20Caregiver%20Act_Progress%20Report_23%20April%202020.pdf。
  21. Administrtation for Community Living. (2020). RAISE Family Caregiving Advisory Council. (online): https://acl.gov/.
  22. P. Z. Cacchione. (2019). The Recognize, Assist, Include, Support and Engage (RAISE) Family Caregivers Act. Clinical Nursing Research 28(8), 907-910. DOI: 10.1177/1054773819876130
  23. H. J. Noh. (2020). Family and Informal Caregiver Support Program in the United States: Review of Programs by Administration for Community Living(ACL). Global Social Welfare Review. 12, 29-38. DOI: 10.1080/10522158.2016.1218399
  24. National Alliance for Caregiving. (2019). Paving the path for family-centered design: a national report on family caregiver roles in medical product development. Washington DC. the United States: National Alliance for Caregiving. https://www.caregiving.org/wp-content/uploads/2020/05/NAC_LEAD-Coalition_Paving-the-Path_Report_May-2019.pdf DOI; 10.1123/
  25. Y. J. Rhee. S. I. Jun. & S. E. Choi. (2015). Concepts and Applications of Patient-Reported Outcomes & Quality of Life Measure: Practical Recommendations for Korean Journal Health Technology Assessment. 3(1), 48-58. DOI : 10.34161/johta.2015.3.
  26. M. Y. Jun. (2020). Informal Caregivers Supporting System in UK. Global Social Welfare Review. 12, 17-27. DOI:10.1525/sp.2002.49.4.455
  27. J. Marczak. (2017). The Care Act 2014 in England. Zdrowie Publiczne i Zarzadzace. 15(3), 232-241. DOI: 10.4467/20842627OZ.17.023.7803
  28. N. Brimblecombe et al. (2018). Unpaid care in England: future patterns and potential support strategies. London. the United Kingdom: London School of Economics and Political Science. https://www.lse.ac.uk/cpec/assets/documents/Economics-of-caring-2018.pdf
  29. N. Brimblecombe et al. (2018). Review of the international evidence on support for unpaid carers. Journal of Long-Term Care, 25-40. DOI: 10.21953/lse.
  30. J. Twigg. (1989). Models of carers: how do social care agencies conceptualise their relationship with informal carers? Journal of social policy, 18(1). 3-66. DOI : 10.1017/S0047279400017207.
  31. J. E. Yu. et al. (2019). A study for economics for caregiving. Sejong Korea: Korea Institute for Health and Social Affairs. http://prism.go.kr/homepage/entire/retrieveEntireDetail.do;jsessionid=BD49A693BF4E6D824CF6E7E084EE1D92.node02?cond_research_name=&cond_research_start_date=&cond_research_end_date=&research_id=1351000-201900272&pageIndex=59&leftMenuLevel=160.
  32. E. J. Han. J. S. Lee. S. Y. Park. & S. He. Park (2016). Evaluation report for family counselling pilot project among long-term care beneficiaries. 1-298. Wonju, Korea: National Health Insurance Service. http://lib.nhis.or.kr/search/detail/CATTOT000000031816.
  33. J. E. Yu. (2019). Recent Changes and Challenges in National Dementia Policy in Korea Social Welfare Forum. 276, 6-18. https://www.kihasa.re.kr/web/publication/periodical/view.do?menuId=48&tid=38&bid=19&aid=432&ano=2
  34. Wittenberg, R., B. Hu, and R. Hancock (2018), Projections of demand and expenditure on adult social care 2015 to 2040. discussion papers (DP2944). Personal Social Services Research Unit, Economics of Health and Social Care Systems Policy, London, UK. DOI : http://eprints.lse.ac.uk/88376/
  35. Y. K. Lee. (2018). Current Status of and Barriers to Home and Community Care in the Long-term Care System Policy Review. 259, 77-89. https://www.kihasa.re.kr/web/publication/periodical/view.do?menuId=48&tid=38&bid=19&aid=415&ano=6.
  36. E. J. Han. R. I. Whang. S. Y. Park. & J. S. Lee. (2019). Comparison of caregiving burdens among family members by the type of benefits in long-term care. Korea Social Policy Review. 26(3), 93-118. DOI : 10.17000/kspr.26.3.201909.93.
  37. B. Cass. et al. (2014). The challenge of caring, now and in the future: learning from across the world. Leeds England: University of Leeds. DOI : org/10.5255/UKDA-SN-7205-1.
  38. J. E. Yu. et al. (2018). Policy Review for Demented Older People and Family Caregivers. Sejong Korea: Korea Institute for Health and Social Affaires. http://repository.kihasa.re.kr/handle/201002/31310
  39. J. E. Yu. et al. (2018). A Report for Nono Care. 1-232. Sejong Korea: Korea Institute for Health and Social Affairs. https://www.humanrights.go.kr/site/program/board/basicboard/view?menuid=001003001004001&pagesize=10&boardtypeid=16&boardid=7604479
  40. National Advocacy Agency for Persons with Disabilities. (2020). (online) http://www.naapd.or.kr/index.php.
  41. I. Choi. Kim. Y. A. Lee. & S. Park. (2014). Family caregiving in ageing society: evaluation of current support system and policy implications: Seoul. Korea. Korean Women's Development Institute. https://www.kwdi.re.kr/publications/reportView.do?p=52&idx=114688
  42. M. Kim. (2018). A Study on Supports for Work-Family of Caregivers of the Elderly. The Journal of Korean Long term Care. : 6(1), 80-119. DOI : 10.32928/TJLTC.6.1.4.