韩国长期护理保险制度中不符合条件人员的现状及改善管理研究

Jin-Hee Kwon, Eun-Jeong Han, Jung-Suk Lee, Chong-Yon Park
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引用次数: 1

摘要

为了激活韩国长期护理保险制度与社区服务挂钩计划,我们分析了韩国国民健康保险公团(NHIC)的索赔数据,并对地方政府老年服务部门的收费员工进行了问卷调查。研究对象共81377人,其中57454人被安排参加社区服务。由于身体或心理援助的需要,错过的受试者比安排的人更需要链接程序。对地方政府从业人员的调查结果显示,59.5%的被调查者表示自己的环节服务比例在10%以上到20%以下,54.3%的被调查者表示自己的工作边界不明确。主要链接方式为向地方政府通报主题清单,占91.4%;定期通知其服务链接状态的比例为57.1%,只有7.1%的人在链接后进行了管理。指出了链接过程中存在的困难因素:对方工作负荷过大、资源不足、链接优先级刚性等。考虑到这些结果,激活社区非达标人群服务,可能需要主体的积极参与,需要构建包括国家健康保险公司、地方政府和服务提供者在内的机构协调工作的部分;发展各种服务,以维持或促进不符合条件的人的健康和功能状况;第三部门机构的积极参与,等等。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A study on the present status and improving management of the non-eligible people in Korean long-term care insurance system
To vitalize the link program of Korean long-term care insurance system to community-based services for non-eligible people, we analysed the claim data from the Korean National Health Insurance Corporation (NHIC), and conducted a questionnaire survey to charging employees of elderly service department at local governments. The subjects were all 81,377 people, 57,454 of them were arranged to community-based services. The link program was more necessary among the missed subjects rather than the arranged people due to the need for physical or psychological assistance. By the result of the survey to the local government employees, 59.5% of subjects responded their proportion of link service was over 10% and under 20%, and 54.3% of them responded their job boundary are not clear. Major type of linking was notification the subject list to local government, 91.4%; proportion of periodical notification on the status of their service link were 57.1%, only 7.1% were followed to manage after the link. Difficult factors at the link process were pointed out the overload by other side work, deficiency of resources, rigidity of priority of link, and so on. Considering these results, to vitalize the community-based services to the non-eligible people, it may be essential the active participation of the subjects, construction of parts working in coordination among the institutions including NHIC, local governments, and service providers; development of various services for maintenance or promotion of the non-eligible peoples` health and functional status; and active participation of institutions from the third sector, and so on.
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