노인돌보미서비스 성과에 관한 연구 = (A) study on the outcomes of the elderly care service in community

다국어 초록 (Multilingual Abstract)

The purpose of this dissertation is to measure the outcomes of "Elderly Care Service in Community (hereafter ECSC)," which has been provided by the Government since 2007. In order to analyse the differentials in the outcomes of manpower and services according to the characteristics of helpers and users, it measures not only the helpers' expertise and responsiveness, but the adequacy, accessibility, continuity and effectiveness of the services.
Total 413 sample surveys were conducted, the sample of which consists of 160 samples for the helpers and 253 samples for the elderly from 38 local county-level and 19 metropolitan city-level service providers in Korea.
Two methods of analysis were employed: one is reliability analysis for categorizing underlying factors of survey items, the other is analysis of variance(t-test and ANOVA) for examining the mean difference among variables concerned. After being collected, the data was analysed by the statistics program "SPSS 14.0 for windows".
The analysis found out that the ECSC helper's responsiveness to the service delivery was influenced by variables such as helper's age and the experience of the ECSC education. That is, the responsiveness of the helpers aged over 50s was higher than that of those aged 30s. And, interestingly, the helpers who did not take the required helper service education tends to be higher in responsiveness. Besides, the responsiveness was also impacted by the elderly's source of main income, health status, and life satisfaction. More specifically, the elderly whose income comes from family and relatives rather than from the outside such as government's financial assistance and are higher in responsiveness. And the more the elderly feel heathy and satisfied, the higher the responsiveness becomes.
The analysis of the outcome of the ECSC showed that the adequacy of the ECSC was differentiated according to the helper's and the elder's place of residence, helper's travel time (method), the elderly's health status, life satisfaction, and past experience of residential care service. In the case of both helpers and the elderly, it appears to be higher in rural areas than in urban and metropolitan ones. Moreover, the shorter the helper's travel time is, the higher the adequacy becomes. In addition, the healthier the elderly is and the higher their life satisfaction is, the higher the adequacy becomes. Finally, whether the elderly has an experience of residential care service or not influences the adequacy.
The analysis also found out that, in terms of accessibility, the helpers in local provincial areas seems to be higher than those in urban and metropolitan areas. In addition, the shorter the helper's travel time, the higher accessibility becomes. Moreover, whether the helper received an ECSC education or not influences accessibility. On the other hand, the elderly in local provincial areas appears to be more accessible than those in metropolitan areas. The healthier the elderly is and the higher their life satisfaction is, the higher accessibility becomes. Interestingly, both who applies for ECSC and who bears the expense influences the accessibility. For example, accessibility is higher when ECSC was applied by neighbor than by public servant. And it seems to be higher when the expense is burdened by the elderly themselves or their family than that from the outside.
The study revealed that the continuity of ECSC was affected by the level of monthly payment (care-giver allowance) which is given to the ECSC helpers, More specifically, the continuity of ECSC is higher when the helper got more than nine million won. It also influenced by the elderly's health condition and life satisfaction. That is, the healthier the elderly is and the higher their life satisfaction is, the higher the continuity of the ECSC becomes. In addition, continuity of the ECSC is higher when the expense is burdened by the elderly themselves or their family than that from without. Furthermore, whether the elderly has an experience of residential care service or not differentiates the continuity of ECSC.
The study showed that the effectiveness of the ECSC was influenced by two categories of variables: one is the helper's location and care-giver allowance, the other the elderly's main source of income, their health condition, their life satisfaction, their past experience of residential care service, and the way they are informed about the ECSC. More specifically, the effectiveness of ECSC is higher when the helper got more than nine million won. It also influenced by the elderly's health condition and life satisfaction. That is, the healthier the elderly is and the higher their life satisfaction is, the higher the effectiveness of the ECSC becomes. In addition, the effectiveness of the ECSC is higher when the expense is burdened by the elderly themselves or their family than that from without. Furthermore, whether the elderly has an experience of residential care service or not differentiates the effectivenss of ECSC.
Based upon the foregoing analysis, several policy suggestions can be proposed.
Firstly, it is suggested that ECSC be differentiated according to its content, method, and expense.
Secondly, the contents of the ECSC needs to be changed qualitatively.
Thirdly, both improvement in the helper's working condition and enhancement in their expertise are urgently needed,
Fourthly, the ECSC demands a psychological and emotional approach to the elderly using the ECSC.
Fifthly, the ECSC needs to find a way of providing easily available and accessible service for the elderly who are using it.

목차 (Table of Contents)

• Ⅰ. 서론 = 1
• 1. 연구의 필요성 및 목적 = 1
• 2. 연구문제 = 4
• 3. 연구범위 = 6
• 4. 용어의 정의 = 8
• Ⅱ. 이론적 배경 = 10
• 1. 사회서비스 변화와 바우처 제도 = 10
• 1) 사회서비스의 특성 및 유형 = 10
• 2) 바우처제도의 개념 및 특성 = 24
• 3) 국내외 전자바우처 사례 = 31
• 2. 재가노인복지서비스와 노인돌보미서비스 = 37
• 1) 재가노인복지서비스 = 37
• 2) 노인돌보미서비스 = 40
• 3. 성과측정의 이해 = 51
• 1) 성과측정의 개념 = 51
• 2) 성과측정의 필요성 = 54
• 3) 성과측정 차원 = 57
• 4. 재가노인복지서비스에 대한 선행연구 = 67
• Ⅲ. 연구방법 = 75
• 1. 연구설계 = 75
• 2. 연구대상 및 자료수집 = 77
• 3. 측정도구 = 78
• 4. 자료분석 = 81
• Ⅳ. 연구결과 = 83
• 1. 조사대상의 일반적 특성 = 83
• 1) 돌보미 = 83
• 2) 이용노인 = 86
• 2. 노인돌보미서비스 인력 성과 = 90
• 1) 인력 성과지표 기술통계 = 90
• 2) 전문성 = 91
• 3) 대응성 = 93
• 4) 소결 = 97
• 3. 노인돌보미서비스 서비스 성과 = 98
• 1) 서비스 성과지표 기술통계 = 98
• 2) 적절성 = 99
• 3) 접근성 = 103
• 4) 지속성 = 107
• 5) 효과성 = 110
• 6) 소결 = 114
• Ⅴ. 논의 및 결론 = 117
• 1. 연구요약 및 논의 = 117
• 1) 연구요약 = 117
• 2) 논의 = 120
• 2. 정책적 제언 = 123
• 3. 연구의 한계 = 125
• 참고문헌 = 126
• ABSTRACT = 140
• 부록 = 144