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日本における認知症政策の変遷 ‒厚生白書・厚生労働白書を題材として‒
高尾眞紀子 ( Takao Makiko ) 한국일본근대학회 2019 일본근대학연구 Vol.0 No.63
本論文においては、日本における認知症政策の変遷を明らかにするため、過去の厚生白書の中から認知症に関係する記述を抽出し、分析を行った。その結果、①1970年に認知症の問題を認識しているのにもかかわらず、80年代半ばに至るまで特段の対策がなされていない、②80年代半ばから痴呆老人対策が始まるが、90年代の介護保険の設計においては認知症対策があまり論じられない、③2000年代半ばから急速に認知症に特化した対策がとられるといった疑問点を見出した。これらの点について、医療や国際動向の観点を踏まえて考察した結果、①については老人医療費の無料化と精神病院への入院が対策となっていたこと、②介護サービスの量的確保が優先で認知症の望ましいケアが確立していなかったこと、③医療や介護のケア技術の進展や国際動向が政策の代替案を広げたことが要因と考えられた。 In this paper, in order to clarify the transition of dementia policy in Japan, the description related to dementia was extracted and analyzed from past Annual Health and Welfare Report. As a result, I found the following question. ①Despite recognizing the problem of dementia in 1970, no special measures have been taken until the mid-1980s,②measures for elderly with dementia began in the mid-1980s, but countermeasures against dementia are not discussed much in the design of long-term care insurance system in the 1990s, ③measures dedicated to dementia have been taken rapidly from the mid 2000’s. Based on the perspective of medical policy and international trends, I examined these points as a result of ① the fact that medical expenses for the elderly were free of charge and hospitalization for psychiatry hospitals was taken as measures, ②The supply of care services is a priority issue and the desired care of dementia has not been established,③ The development of medical care and nursing care technology and international trends expanded alternative policies.
日本の介護保險政策の成果と課題 - 準市場の視点からの評價 -
高尾眞紀子 한국일본근대학회 2017 일본근대학연구 Vol.0 No.57
The Japan`s long-term care insurance system was envisioned in Japan at the mid-1990s, and the frame of the system was formed led by the Ministry of Health and Welfare, the law was established in 1997. As a result of long-term care insurance, the quantity of service supply increased, the users were able to select services, the quality of services were improved by competition, and innovation was promoted and that the burden of family care has been reduced. On the other hand, an increase in fiscal burden and lack of care workforce is a major issue. Looking at long-term care insurance in Japan from the viewpoint of “quasi-market”, although issues remain in neutrality of care managers and in evaluating quality of services, conditions for success have been dealt with to some extent. In addition, if we look at the outcome of long-term care insurance with four evaluation criteria of efficiency, responsiveness, choice, equity, it seems to be improving in comparison with the previous system. Toward reform of the long-term care insurance system there is a conflicting argument between “the principle of market group” seeking more thorough market mechanism and “the regulation reinforcement group” for user protection. Assuming universalism, institutional design of “quasi-market” is required to promote innovation through competition, to improve quality and improve efficiency.
어머니-교사 간의 의사소통 어려움과 태도가 어머니의 유아교육공동체 인식에 미치는 영향
고미진(Ko, Mi-Jin),정계숙(Chung, Kai-Sook) 한국유아교육·보육복지학회 2017 유아교육·보육복지연구 Vol.21 No.4
본 연구는 어머니-교사 간의 의사소통 어려움과 의사소통 태도가 어머니의 유아교육공동체 인식에 미치는 영향력을 살펴보는데 목적이 있다. 이를 위해 대구와 부산에 소재한 유아교육기관에 자녀를 보내고 있는 어머니 167명을 대상으로 설문조사를 실시하였고, 회수된 자료는 연구문제에 따라 상관분석 및 회귀분석을 실시하였다. 본 연구의 결과를 살펴보면 다음과 같다. 첫째, 어머니의 의사소통 어려움과 태도는 유아교육공동체 인식과 유의미한 상관관계가 있는 것으로 나타났다. 둘째, 어머니의 의사소통 어려움, 태도가 유아교육공동체 인식에 미치는 상대적 영향력을 알아본 결과, 의사소통 태도의 하위요인 중 유아 교사에 대한 인식이 가장 높은 영향력을 미치는 것으로 나타났다. 또한 의사소통 태도 하위요인 중 의사 소통 가치에 대한 인식, 의사소통 만족도 및 의사소통 어려움 하위요인 중 유아교육기관과 관련된 어려 움도 상대적 영향력을 미치는 것으로 나타났다. 본 연구 결과를 토대로 어머니의 유아교육공동체 인식을 증진하기 위한 방안을 논의하였다. The purpose of this study was to examine how the difficulties and attitudes in mother-teacher communication affect mother s awareness of early childhood educational community. The subjects in this study were 200 selected mothers who have kindergarten child three to five years old in western age in Busan or Daegu. The results are as follows. First, there was a meaningful negative correlation between mother s difficulties in mother-teacher communication and mother s awareness of early childhood educational community. And there was a meaningful positive correlation between mother s attitudes in mother-teacher communication and mother s awareness of early childhood educational community. Second, it was performed Stepwise regression analysis related Mother s awareness of early childhood educational community according to sub factors of mother s difficulties and attitudes in mother-teacher communication. Especially, as the following four sub factors were used as independent variable, they explains total 43% of the relative influence.