Earticle

이 연구는 광역 지자체별 노인의 통합돌봄 요구수준을 파악하고, 비교하여 향후 광역 지자체 수준에서 노인대 상 지역사회 통합돌봄의 필요성에 대한 객관적인 근거를 제시하고자 시도되었다. 한국보건사회연구원의 ‘2017년 노 인 실태조사’에 참여한 17개 광역 지자체 노인 10,299명의 설문자료를 이용한 이차자료 분석연구이며, 분석은 SAS 프로그램을 이용하였다. 의료 요구, 일상생활 수행지원 요구, 사회적 활동 지원요구의 지역간 차이는 최저 지역에 비 해 최고지역에서 각각 2,4배, 6.0배, 2.0배 높게 나타났다. 이에 따라 의료요구군, 복지요구군, 통합돌봄 요구군의 크 기도 지역별로 매우 다양하였다. 이 연구의 결과를 통해 통합돌봄 요구는 광역 지자체별로 차이가 있음이 확인되었다. 따라서 통합돌봄 서비스를 전국적 수준에서 효율적으로 제공하기 위해서는 광역 지자체별 대상자 요구수준을 정확히 파악하고 이에 따라 돌봄 서비스 내에서 우선 순위 선정과 활용 가능한 자원 파악 및 적절한 배분이 뒤따라야 할 것이다.

This study was conducted to identify and compare the needs of the integrated by local government, and to provide basic data for the provision of integrated care services. This is a secondary data analysis study using data from 10,299 elderly people living in 17 local governments who participated in the ‘2017 National Survey on the Aged People in Korea’. The difference in medical needs, daily living support needs, and social activity support needs were 2.4, 6.0, and 2.0 times higher in the highest regions than in the lowest regions. In addition, the size of the medical needs group, welfare needs group, and integrated care needs group varied by region. Through this study, it was confirmed that the level of integrated care needs varied by region. Therefore, in order to efficiently provide the services at the national level, it is necessary to accurately assess the needs of the aged in each local government, and accordingly, prioritize and identify available resources within the care service and appropriate allocation.

본 연구는 보건복지 연계·협력의 실천 현황을 논의하고, 통합돌봄을 시민의 기본적 권리로써 보장 할 수 있는 전략적이고 실천적인 방안을 도출하고자 하였다. 조사 자료는 서울시 A구의 「돌봄SOS센터」의 보건 의료·복지 현장 돌봄 종사자 15명에 대한 표적집단면접조사(FGI) 자료이다. 자료 분석은 토픽모델링(SNS Keyword analysis)과 주제분석방법(Thematic analysis)을 병행하여 실시하였다. 토픽 모델링의 결과, 돌봄 종사자 간 보건복지 연계·협력의 필요성에 대한 이념 합의와 양 영역은 상호 대체가 불가한 전문적인 영역이라는 영역 합의에 대한 공감대가 높이 형성되어 있었다. 또한 보건복지 종 사자 간 상호 존중을 통한 업무 조화와 서로를 같은 팀원으로 받아들이는 유대감과 상호 원활한 소통으로 인한 긍정적 관계를 맺고 있었다. 반면 다양한 직종 간 불명확한 업무 분장, 직급 차이로 인한 갈등, 불합 리한 업무 수행체계 등이 보건복지 연계·협력의 걸림돌로 존재하였다. 향후 보건복지 간 체계적인 서비스 제공 계획 수립, 명확한 업무 범위와 역할 재조정, 사례회의의 활성화, 통합적 전산시스템 구축 등 통합적 보건복지 협력체계 검토 및 정책 변화를 제안한다.

This study aims to examine the current status of collaboration in health and welfare, and to derive a strategic and practical plan to ensure that citizens have sufficient access to integrated care. To this end, four group interviews were conducted with 15 healthcare and social care professionals at the Integrated Care Center in A-gu, Seoul, using the Focus Group Interview Survey (FGI). The topic modeling method and thematic analysis were used to extract the main topics and determine the key meaning associated with them. After topic modeling, a high level of ideological consensus was observed in terms of the need for collaboration in health and welfare. There was also domain consensus indicating that both areas are comprised of distinct professional groups that cannot serve as substitutes for each other. Positive relationships were also found to be fostered among care workers, through harmonization of work, mutual respect among health and welfare workers, accepting each other as team members within the same collectivity, and maintaining smooth communication. On the other hand, the challenges and barriers included an unclear division of work among various occupations, conflicts arising from differences in positions, and the assignment of unreasonable tasks to workers. This research findings are expected to be useful for researchers, practitioners, and policymakers in reviewing and enhancing the integrated health-welfare system.

본 연구는 2026년 돌봄통합지원법의 본격 시행을 앞두고 제도의 성공적인 안착을 위한 구체적 법제 정비 방향을 모색하는 것을 목적으로 한다. 이를 위해 한국의 통합돌봄 관련 정책과 돌봄통합지원법의 주요 내용을 분석하고, 선험국 인 영국과 일본의 의료돌봄 통합 관련 법･제도 동향을 비교･검토하여 한국의 돌 봄통합지원법이 실효성을 확보하기 위한 향후 개선방안을 모색하였다. 영국은 ｢Health and Care Act 2022｣를 통해 지역 제공조직 재편과 법정 운영 체계 구축을 완성하고, ICS–ICB–ICP 간 정보공유와 데이터 표준화를 법제화하 여 의료돌봄 통합의 실행력을 강화하였다. 일본은 중앙–지방정부 간 역할 분담, 지역의료계획과 기능분화, 의뢰･회송･정보 공유의 의무화를 통해 다층적 거버넌 스 기반의 지역포괄케어를 제도적으로 확립하였다. 이러한 해외 사례는 한국이 돌봄통합지원법의 실효성을 높이기 위해 지역 책임성 강화, 민･관 협력 기반 확 충, 정보 연계 및 재정 조정 구조 마련 등 구체적 실행 전략이 필요함을 보여준 다. 결론적으로 한국의 통합돌봄 정책은 바람직한 지역 단위 통합 모델을 발굴하고, 거버넌스를 확립할 필요가 있다. 또한 통합돌봄체계에서 의료와 돌봄을 잘 연계할 수 있도록 영국의 데이터 기반 통합체계와 일본의 기능분화･연계 사례를 참고하여 꾸준한 제도적 개선을 시행해야 의료돌봄 중심의 지역 기반 통합케어 로 발전할 수 있을 것이다.

This study aims to explore concrete legislative refinement strategies to support the effective implementation of Korea’s Integrated Care Support Act, scheduled to take full effect in 2026. To this end, it analyzes the legislative intent and core provisions of Korea’s integrated care policies and the Support Act, identifying structural features and key issues of the current legal framework. The study further examines and compares legislative and institutional developments related to health and social care integration in the United Kingdom and Japan, focusing on each country’s system design and implementation mechanisms. Through this comparative legal analysis, the study proposes considerations for legislative improvement and the development of subordinate regulations to ensure the practical effectiveness of Korea’s Integrated Care Support Act. The United Kingdom, through the Health and Care Act 2022, has reinforced the operational foundation for integrated care by reorganizing regional provider structures, establishing statutory governance arrangements, and legally mandating information sharing and data standardization across ICS–ICB–ICP bodies. Japan has institutionalized a multilayered governance model for community-based integrated care by clearly delineating central–local government roles and legally requiring regional healthcare planning, functional differentiation, patient referral and discharge coordination, and information sharing. These international cases suggest that Korea must strengthen regional accountability, expand public –private collaborative mechanisms, and establish systems for information integration and financial coordination to enhance the effectiveness of its Integrated Care Support Act. In conclusion, Korea’s integrated care policy can advance toward a community-based, medical–social care integration model by adopting key elements demonstrated in the UK’s data-driven integration framework and Japan’s legal mandates for functional coordination and care transitions.

Purpose: The purpose of this study was to identify interprofessional competencies for the integrated community care of older people. Methods: This study used a methodological approach, and the specific process aimed to identify the components of interprofessional competencies for integrated community care using a scoping review and validating the identified competencies with the Delphi method. The scoping review first identified relevant studies through the following electronic databases: PubMed, CINAHL, Embase, and the Cochrane Library. We then selected studies that met the inclusion criteria and analyzed their results to identify a draft version of the competencies. Expert panels validated the list of competencies through two rounds of the Delphi survey. Results: The two rounds of the Delphi survey revealed a consensus. Finally, we developed an interprofessional competency for integrated community care comprising 19 interprofessional core competencies, 20 integrated core care competencies for community care administrators, 13 integrated core care competencies for care coordinators, 13 integrated core care competencies for local service providers, and 12 integrated core care competencies for community health leaders. Conclusion: This study can help inform job descriptions, evaluate relevant professionals’ performances, and develop a competency-based curriculum for better practice.

Purpose: This study investigated the levels of delirium knowledge, delirium nursing-related stress, emotional intelligence, and delirium nursing competency among nurses in integrated nursing care wards, and aimed to identify factors influencing their competency. Methods: A descriptive survey design was employed, and data were collected from 184 nurses working in integrated nursing care wards at general hospitals located in Seoul and Daejeon, South Korea. The research instruments included measures of delirium knowledge, delirium nursing-related stress, emotional intelligence, and delirium nursing competency. Results: Delirium knowledge, emotional intelligence, and experience with delirium education were significant influencing factors, explaining 12% of the variance on delirium nursing competency. Conclusion: Based on these findings, it is recommended that future research within the field of nursing should explore a broader range of variables that may influence delirium nursing competency, particularly among nurses working in integrated nursing settings. In addition, from the perspective of foundational nursing education, it is necessary to conduct experimental studies and develop targeted educational programs aimed at reaching a deeper understanding of the various mechanisms underlying delirium.

Purpose: This study aimed to explore the differences between patient and nurse perceptions of nursing needs and performance in integrated nursing care service wards within small to medium-sized hospitals. Methods: The participants of the study were 116 patients and 116 nurses in the integrated nursing care service wards of small and medium-sized hospitals in U and Y cities. Data collection was conducted between July 18 and August 12, 2022. The collected data were analyzed using descriptive statistics, the paired t-test, the independent t-test, and the importance-performance analysis. Results: Only the difference between nurse-perceived nursing needs and nursing performance (gap 2) was statistically significant (t=4.18, p<.001). Patients' physical needs were higher than what nurses perceived, and patients' financial were higher than nursing performance as perceived by both nurses and patients. In addition, nurses' performance was lower than the perceived nursing needs in all domains. According to the importance-performance analysis, the "concentrate here" areas included infection control, respect for patients' rights, and education of patients and families about diseases and treatment plans. Additionally, financial issues in nursing were identified as a "low priority" area requiring long-term intervention. Conclusion: It is crucial to prioritize nursing care that addresses patients' needs for infection control, respect for rights, and education. Nurses should also meet the physical and economic support needs of patients. Furthermore, it is recommended to adjust the nurse staffing ratio and foster systematic collaboration among hospitals, taking into account the circumstances of small to medium-sized hospitals.

Purpose: Local government public health nurses (LG PHNs) in South Korea deliver integrated community health and welfare services. However, their professional identity is often challenged within welfare-centered administrative structures, and the structural barriers to their role performance have not been fully explored.Methods: An exploratory qualitative study using focus group interviews was conducted. Seven LG PHNs from various local government divisions participated. Data were analyzed thematically to identify key challenges in role performance.Results: Three main themes emerged: (1) Systemic unreadiness and structural support gaps in deployment, characterized by inadequate orientation and ambiguous role boundaries resulting from rapid policy implementation; (2) Challenges in professional identity negotiation within integrated welfare-health frameworks, where the underutilization of nursing expertise and overlapping responsibilities within administrative settings led to role confusion and professional marginalization; and (3) Institutional isolation and absence of clinical governance, resulting from a lack of systematic clinical supervision and institutional backing. Participants reported significant difficulty prioritizing specialized nursing tasks due to limited resources and structural hierarchies.Conclusion: LG PHNs’ effectiveness is hindered by fundamental structural limitations and governance gaps. To prepare for the 2026 nationwide implementation of integrated care, a transition toward nursing-led care management is essential. Policy measures should include establishing a legal role framework, implementing dual-reporting systems for clinical supervision, and promoting inter-professional education (IPE) to empower LG PHNs as proactive community health leaders.

Purpose: This study aimed to develop a flipped learning?based integrated education program that combines video-based prelearning, theoretical lectures, and hands-on training on excretion care robots. The program was applied to nurses to verify its effects on their knowledge, attitudes, and skills related to excretion care and the use of such robots. Methods: A randomized controlled trial was conducted with 50 nurses working at a hospital in Seoul, Republic of Korea. The experimental group received a flipped learning?based integrated education program, which included asynchronous pre-learning, in-person didactic session, and in-person hands-on session. The control group received basic education on the use of excretion care robots. Outcome variables included knowledge, attitudes (self-efficacy, perceived usefulness and ease of use, anxiety, intention to use), and skills (proficiency, accuracy of execution and outcomes). The data were analyzed using independent t-tests. Results: Compared to the control group, the experimental group showed significantly higher scores in knowledge, self-efficacy, perceived usefulness and ease of use, intention to use, proficiency, and accuracy of the performance. Additionally, their level of anxiety regarding excretion care robots was significantly lower (p<.05). Conclusion: The integrated education program combining video, theoretical, and practical components was effective in enhancing nurses' knowledge, attitudes, and skills. These results suggest that such a program can serve as a valuable educational strategy to facilitate the clinical adoption of technology-based care devices like excretion care robots.

The purpose of this study is to analyze the leading projects for Community-based Integrated Care for the Elderly (CICE) in terms of network governance. This study applied the effectiveness criteria of network governance suggested by Provan & Milward (2001). This study presented the necessary conditions for more autonomous project management through case analysis. The findings showed that at the community level, to secure the legitimacy and recognition of the public for the CICE project is required. Evaluation and monitoring to confirm the performance of the project is demanding. At the network level, it suggests to strengthen the linkage between actors while minimizing project overlapping among network. Moreover, it requires more clear role definition for private participants and more active participation. Lastly, at the level of organization/participation, it should secure the necessary financial and human resources in the final execution stage, and design a project that considers the needs of the beneficiary.

이 연구는 한국사회의 인구고령화로 돌봄에 대해 새롭게 발생하는 사회적 위험인 노인돌봄정책을 한국과 일본을 비교분석하였다. 노인이 시설이나 병원에서 생이 마감되는 것이 아니라 살던 곳에서 건강한 노후를 보낼 수 있도록 주거, 의료, 요양, 예방 및 돌봄서비스에 대한 노인돌봄정책이 요구되고 있다. 한국은 2018년 보건과 복지서비스가 연계되는 노인복지시스템을 구축하게 위해 지역사회 통합돌봄(커뮤니티케어)을 추진하였다. 일본 또한 초고령사회의 돌봄이 사회문제로 심각해지면서 새로운 돌봄서비스 정책으로 2009년에 ‘지역포괄케어시스템’을 도입하여 지방자치단체 차원에서 일상생활지원과 개호예방 서비스를 함께 제공하고 있다. 연구분석방법은 Gilbert&Terrell이 제시한 사회복지정책분석의 기본틀에 의한 급여의 대상, 급여의 내용, 재정, 전달체계등 네가지를 기준으로 분석하였다. 첫째 대상은 일본의 경우 노인에서 출발하여 장애인, 취약계층, 어린이등 사회적약자를 모두 포괄하는 접근을 하고 있으나 우리나라는 노인, 장애인, 노숙자, 정신질환자를 대상으로 하고 있다. 둘째 급여내용 은 지역사회 통합돌봄은 주거지원 인프라 확충, 집으로 찾아가는 방문, 건강·의료, 돌봄·요양등 재가서비 스 지원이다. 일본의 지역포괄케어센터는 자립생활지원으로 생활지원, 의료·간호, 개호·재활, 보건·예방과 주거를 아우르는 포괄적 서비스제공으로 우리나라와는 일부 공통점과 차이점이 있다. 셋째 전달체계는 우리나라 지역사회 통합돌봄은 서비스연계를 위한 지역 자율형 전달체계 구축으로 읍면동에 케어안내창구 신설, 지역케어회의 등 시군구 단위의 지역사회 민·관 서비스 연계·협력을 제시하고 있다. 반면 일본은 서비스 상담, 신청 및 지급결정은 시정촌, 지역포괄케어센터는 케어플랜 수립을 담당 한다. 넷째 재정은 지역포괄케어시스템을 운영하기 위한 재원으로 지역의료개호종합확보기금, 개호보험, 국가보조금과 자자체 사업 등으로 운영된다. 한국의 지역사회 통합돌봄 정책의 재원은 건강보험과 장기요양보험에서 일부제시하고 있지만 구체적인 재원을 제시하지 않고 있다. 향후 개인의 존엄을 지키며, 이용자 욕구를 충족시킬 수 있는 제도적 기반 구축을 위한 정부의 역할과 지역단위에서의 추진 노력이 필요하다. 또한 지역사회통합돌봄의 성공적 정착을 위해서는 집에서 독립 생활을 할 수 있는 효율적 전달체계가 필요하며 장기요양 재가서비스와의 연계운영을 고려해야 한다. 재정은 건강보험과 장기요양보험재정과 국고재정등 재정규모 및 분담원칙등 전략이 필요하다.

This study compared and analyzed the elderly care policy, which is a new social risk to care due to the population aging of Korean society, between Korea and Japan. In the elderly care, housing policies, medical care, nursing care, prevention and care services are required so that the elderly can spend a healthy old age where they lived rather than ending their lives in facilities or hospitals. In 2018, Korea promoted community integrated care (community care) to establish a welfare system for the elderly that links health and welfare services. Japan also introduced the "Regional Comprehensive Care System" in 2009 as a new care service policy as care in a super-aged society becomes serious due to social problems, providing daily life support and nursing prevention services at the local government level. The research method was based on four criteria: the target of salary, the content of salary, finance, and delivery system based on the basic framework of the social welfare policy analysis proposed by Gilbert & Terrell. In the case of Japan, the first target is the elderly, starting with the elderly, the disabled, the vulnerable, and children, but in Korea, the elderly, the disabled, the homeless, and the mentally ill are targeted. The second part of the benefit is the expansion of residential support infrastructure for integrated community care, home-visit healthㆍcare, and home care services such as caringㆍcare. Japan's regional comprehensive care centers include housing and housing methods, living support, medical and nursing, nursing care and rehabilitation, and health and prevention as support for self-reliant living. Third, the delivery system suggests the establishment of a local autonomous delivery system for integrated care in the local community in Korea, establishing a care information center in Eup, Myeon, Dong, and linking and cooperating with public and related services at the city, county, and district levels, such as local care meetings. Japan Regional Comprehensive Care Center provides service counseling, applications, and payment decisions to municipalities and establish care plans. Fourth, the financial resources for operating the regional comprehensive care system are operated by the Regional Medical Care Comprehensive Security Fund, nursing care insurance, national subsidies, and their own projects. Meanwhile, health insurance and long-term care insurance are sources of Korea's integrated community care policy. In the future, the government's role in establishing the institutional foundation that can protect individual dignity and satisfy user needs and efforts to promote it at the regional level is needed. In addition, for successful settlement of community integrated care, it is necessary to expand home care services that can live independently at home and consider linking operations with long-term care home care services. Finance needs strategies such as health insurance long-term care insurance finance and national treasury finance

본 연구는 지역사회 통합돌봄 현장에서 수행되는 사례관리 실천 중 ‘우수실천(Best Practice)’의 의미와 구성요소를 탐색하는 것을 목적으로 한다. 이를 위해 본 연구는 2022년 보건복지부 통합돌봄 추진단에 우 수사례를 제출한 선도사업 지자체의 통합돌봄 담당자 10명을 대상으로 초점집단면접(focus group interview)을 실시하고, 수집된 자료를 질적 내용분석 방법으로 분석하였다. 연구참여자들은 모두 통합돌 봄 사례관리 업무를 수행한 경험을 가진 실무자로서, 우수실천으로 인식한 사례의 특징과 수행 과정, 요구 되는 역량과 환경에 대해 진술하였다. 분석 결과, 통합돌봄 우수실천은 첫째, 통합돌봄 정책 목표가 실천 과정에서 실현되는가, 둘째, 대상자 중심의 공생적 가치가 구현되는가, 셋째, 노인의 복합적 욕구에 부합하 는 유연한 지역자원 연계가 이루어지는가로 구성되었다. 또한 우수실천을 가능하게 한 요인으로는 사례관 리자의 전문적 판단과 관계형성 역량, 초기상담 및 자원조정 역량, 다직종 간 협업과 정보공유가 가능한 조 직적 환경이 도출되었다. 연구결과는 향후 통합돌봄 본 사업 추진 과정에서 우수실천의 기준 설정, 담당자 역량 강화, 협업 구조 설계에 대한 정책적·실천적 시사점을 제공한다.

As Korea transitions to nationwide implementation of community-based integrated care, there is an increasing need to define best practices in integrated care management. While previous studies have mainly focused on institutional design and service delivery systems, less attention has been given to how best practices are perceived and enacted by the integrated care workforce. This study aims to investigate the meaning and essential components of best practices in community-based integrated care from the perspectives of those working in the field. A qualitative descriptive design was employed, featuring focused group interviews with ten integrated care workers from local governments that submitted best practice cases to the Ministry of Health and Welfare’s Integrated Care Task Force in 2022. All participants had direct experience in integrated care management. The interview data were analyzed using qualitative content analysis to identify recurring themes related to best practices. The findings reveal that best practices in community-based integrated care are characterized by: (1) the achievement of integrated care policy goals throughout the practice process, (2) the implementation of person-centered and community-oriented values, and (3) the flexible coordination of local resources to meet the complex needs of older adults. Additionally, key enabling factors include practitioners’ professional judgment and relationship-building skills, competencies in initial assessment and resource coordination, and organizational environments that foster interprofessional collaboration and information sharing. These findings provide empirical evidence to guide the development of standards for best practices, workforce capacity-building strategies, and collaborative governance structures in the upcoming nationwide implementation of community-based integrated care.

본 연구는 서울형 커뮤니티케어인 서울 돌봄SOS센터 시행에 따라 영국 국민건강서비스(NHS)의 새로운 통합 돌봄모델인‘뉴케어모델(New Care Models)’의 시범지역 사례를 비교․분석함으로써 향후 서울형 지역사회 통합돌 봄모델의 운영매뉴얼 개선 및 사업의 발전적 운영을 위한 개선방안을 제안하는 데 목적이 있다. 연구방법으로는 영국의 사회적 돌봄과 보건의료를 중심으로 한 통합돌봄 접근에 대한 이론적 논의를 실시하고 뉴케어모델의 대 표적인 시범도시인 토베이를 중심으로 서울시와 도시간 비교연구를 최대유사체계분석기법(MSSD, Most Similar Systems Design)을 활용하여 실시하였다. 연구 결과에 따른 제언으로는 보편적인 지역사회 통합돌봄의 방향을 지향해야 한다는 점, 다학제간 팀 구성 과 민관연계 협력위한 제도적 장치 마련, 통합돌봄서비스 내용의 다양화, 공식적‧비공식적 돌봄종사자 지원 및 관리, 지역주민 및 시민의 역할 강조, 끝으로 서비스 품질 관리 위한 다양한 방식 적용 등을 제안하였다.

The purpose of this study was to compare and analyze a pilot program area of the New Care Models, a new integrated care model of the UK National Health Service (NHS), and Seoul community care model to improve the operation manual and to advance the operation of the Seoul-type community care model, following the implementation of the Seoul Care SOS Center. As a research method, theoretical discussions on integrated care approaches centered on social care and health care in the UK were examined and a comparison between Seoul and Torbay area, one of the pilot areas in the UK, were conducted using Most Similar Systems Design (MSSD). The findings suggest the direction of universal integrated community care, establishing institutional arrangements for multidisciplinary teams and public-private cooperation, diversification of integrated care services, support and management of formal and informal care workers, and finally application of various methods to manage service quality.

이 연구는 초고령사회 대응을 위한 한국의 지역사회 통합돌봄 정책과 일본의 지역포괄케어 정책을 분석 하여 지역 기반 커뮤니티 케어 정책의 발전 방안 모색을 목적으로 한다. 커뮤니티 케어 정책에 대한 산물 분석 방법으로 주요 대상, 급여 유형, 재원과 전달체계 구축 양태를 비교 분석하였으며, 연구 결과, 한국은 2018년 지역사회 통합돌봄 정책 도입과 선도사업 실시 이후 2024년 의료·요양 등 지역 돌봄의 통합지원에 관한 법률 제정에 따라 지방자치단체의 책무가 강화되고 고령자와 청장년층을 포괄하는 세대통합적 돌봄 사업을 확대하고 있다. 일본은 동아시아의 대표적 초고령 국가로 2000년 개호보험법 시행에 따라 2005년 에 설립한 지역포괄지원센터의 고령자 중심 예방적 개호 전략에서 2015년 이후 지역공생사회 모델로 전환 하여 주민 참여와 사회적 자본 확충으로 가족돌봄을 강조하는 지역 거버넌스 기능을 확대하고 있다. 이에 한국과 일본의 커뮤니티 케어 정책에 나타난 시사점에 의거 지역 거버넌스 기반 상생적 커뮤니티 케어 정 책의 방향성을 제시하였다.

This study aims to explore the direction of community-based community care policies by analyzing South Korea's community-based integrated care policy and Japan's comprehensive community care policy in response to challenges of an aging society. The analysis of these community care policies compared key targets, types of benefits, funding sources, and the structure of delivery systems. Results showed that, since the introduction of the community-based integrated care policy and pilot projects in South Korea in 2018, the enactment of the Act on Integrated Support for Local Care in 2024 had strengthened the responsibilities of local governments. South Korea is expanding intergenerational care services that encompass both older adults and younger generations. In Japan, as one of the leading aging societies in East Asia, the 2000 introduction of the Long-Term Care Insurance Law led to the establishment of community comprehensive support centers in 2005. Since 2015, Japan has transitioned to a community-symbiotic society model, emphasizing family care through the expansion of local governance functions that can enhance resident participation and social capital. Based on findings from the development of community care in both countries, this study suggests the direction for public-private cooperation and mutually beneficial community care policies rooted in local governance.

이 연구의 목적은 정부가 도입한 읍⋅면⋅동 중심 커뮤니티 케어의 효율화를 위한 통합사례관리 연계 네트워 크 실천 방안 제시를 목적으로 한다. 이의 근거는 국민의 평생사회안전망 보장을 위한 사회보장기본법, 사회보 장급여법 시행과 찾아가는 보건복지서비스 전달체계에서 통합서비스를 관장하는 읍⋅면⋅동 중심 통합사례관리 제도의 확대이다. 따라서 본 연구의 목적을 달성하고자 OECD 복지국가들의 커뮤니티 케어 제도를 분석하였고, 한국에서 도입한 커뮤니티 케어의 개념과 통합사례관리의 통합적 개념인 공공재적 사회서비스 성격을 고찰하였 다. 또한 커뮤니티 케어와 통합사례관리의 연계 및 네트워크 실천을 위한 읍⋅면⋅동 복지환경의 대내외적 여건 분석을 위하여 최초로 SWOT 분석을 시도하였다. 커뮤니티 케어 체계에서 지역사회 통합돌봄 서비스 이용자 (Service User)의 초기 접수로부터 노후에 이르기까지 서비스를 관장하는 읍⋅면⋅동 중심 통합사례관리의 핵심 은 공공과 민간의 협력을 전제로 다양한 기관, 전문가 연계, 네트워크, 조정을 거쳐 서비스 이용자의 욕구를 충 족시키는 과정이다. 이에 읍⋅면⋅동, 지역사회보장협의체, 돌봄서비스 기관, 종교⋅봉사단체 등의 네트워크화와 공⋅사 혼합복지체제로 효율화를 기해야 하는 지방자치단체의 복지거버넌스 전략과 새로운 거버넌스(New Governance) 기능으로 돌봄공동체 구축을 위한 커뮤니티 케어와 통합사례관리 연계 및 네트워크, 조정 기능을 제언하였다.

The purpose of this study is to propose a linking integrated care management liaison network to promote the efficiency of the municipal-centered community care introduced by the government. The legal and administrative bases for this include the Framework Act on Social Security to ensure the life-long social security network and the expansion the municipal-centered integrated care management system that governs the integrated services developed from the visiting health and welfare service delivery system. Therefore, to achieve the purpose of the study, community care cases among welfare states have been examined, followed by the understanding of concept and theory of Korean community care services and the analysis of the characteristics of social service system. In addition, the study has conducted the first-of-its-kind SWOT analysis on the welfare environment for community care and integrated care management liaison network. The key to the success of the municipal-based integrated care management system that takes care of a comprehensive range of services from the initial-stage receipt of care service users to the senior care is to meet the needs of care service users through various institutions, linkage with experts, networks, and coordination based on cooperation in both public and private sectors. The study has, thus, found that the system of care services requires a welfare governance strategy to build a network of various relevant players, including local self-governing bodies, municipal assurance consultative groups, care service providers and religious and voluntary service groups and to promote the efficiency with the mixed welfare system of both public and private sectors. All in all, the study has suggested the strategy to build up the roles and responsibilities of local welfare governance that promotes linkage and networking to be able to strengthen the new governance function, consolidate the community and integrated care management, and to facilitate the access to the integrated services.

본 연구는 치위생학 전공 학생을 대상으로 방문구강관리 서비스에 대한 인식과 참여 의향을 파악하고, 노인 구강관리 지식과 노인에 대한 태도와의 관련성을 분석하고자 수행되었다. 연구 대상은 A와 B지역 2개 대학 치위생학과 학생 150명이었으며 설문조사를 통해 자료를 수집하였다. 자료 분석은 SPSS 27.0 프로그램을 이용하여 빈도분석, t-test, 일원분산분석을 실시하였다. 연구 결과 방문구강관리 서비스 인지도는 36.0%로 낮았으나 서비스 필요성은 86.0%로 높게 나타났으며 참여 의향은 66.7%가 긍정적으로 응답하였다. 방문구강관리 서비스 수행 인력으로는 치과위생사가 81.3%로 가장 높게 나타났다. 노인구강관리 지식은 인식 및 참여 의향과 유의한 관련성을 보이지 않았으나, 노인에 대한 태도는 서비스 필요성과 참여 의향에서 유의한 차이를 보였다(p<0.05). 이러한 결과는 향후 방문구강관리 서비스 활성화를 위해 치위생학 교육과정에서 노인 구강건강관리와 통합돌봄 관련 교육을 강화하고 긍정적인 노인 태도 형성을 위한 교육이 필요함을 시사한다.

This study aimed to examine dental hygiene students’ perceptions of visiting oral health care services and their willingness to participate, and to analyze the relationship between elderly oral health knowledge, attitudes toward the elderly, and these perceptions and intentions. The participants were 150 dental hygiene students from two universities in regions A and B, and data were collected using a structured questionnaire. Statistical analyses were conducted using SPSS 27.0, including frequency analysis, independent t-tests, and one-way ANOVA. The results showed that awareness of visiting oral health care services was relatively low (36.0%), whereas perceived necessity was high (86.0%). Approximately 66.7% of the students expressed willingness to participate in the service, and dental hygienists were most frequently identified as appropriate providers (81.3%). Knowledge of elderly oral health was not significantly associated with awareness or participation intention. However, attitudes toward the elderly were significantly associated with perceived necessity and willingness to participate(p<0.05). These findings suggest that educational programs promoting positive attitudes toward older adults and strengthening community integrated care education should be incorporated into dental hygiene curricula.

본 연구는 서울시 공동체주택을 대상으로 사회적경제가 공급하는 공동체주택에서 나타나는 통합돌봄의 양상을 분석하였다. 분석방법은 엘리너 오스트롬(1990)의 제도분석틀(IAD: Institutional Analysis and Development Framework)을 적용하였으며, 공동체주택의 정주성과 돌봄이 형성되고 작동하는 방식을 질 적으로 탐구하였다. 연구 결과, 공동체주택은 입주자 간 상호작용을 통해 비공식적 돌봄 체계를 형성하며, 정서적 안정과 사회적 연대를 제공하는 모델로 기능하고 있었다. 특히, 입주자 간 협력과 공유 문화는 아이 돌봄, 긴급 상황 지원, 노인 돌봄 등 다양한 형태로 나타났으며, 이는 공동체 내 안전망 형성에 기여하였 다. 공급자인 사회적경제 기업은 돌봄 문화를 확산시키고 있었으며, 서울시의 지원 프로그램은 입주자의 프라이버시와 공동체 생활의 조화를 돕고 있었다. 주택별 협동조합 설립 의무화는 생활 돌봄 체계를 활성 화하고, 공식적·비공식적 규율과 생활 문화의 공유를 촉진하였다. 이러한 연구 결과를 통해 돌봄 체계로서 공동체주택의 가능성과 정책적·실천적 시사점을 도출하였다.

This study examines the patterns of integrated care in community housing provided by the social economy in Seoul. Utilizing Elinor Ostrom's Institutional Analysis and Development Framework (IAD), it qualitatively investigates how care systems are created and operate within an institutional context. The findings indicate that community housing promotes informal care systems through resident interactions, serving as a model that fosters emotional stability and social cohesion. Notably, residents’ cooperation and a culture of sharing manifest in various forms, including childcare, emergency support, and elderly care, which contribute to a safety net within the community. Social economy organizations actively encourage this culture of care, while Seoul's support programs help balance privacy with communal living. The requirement for each residence to establish a housing cooperative has strengthened the living care system, facilitating the development and management of both formal and informal rules, as well as the sharing of cultural practices among tenants. This study highlights the potential for community housing care systems to extend beyond resident interactions into broader community contexts, providing important policy and practical insights.

본 연구는 65세 이상 노인의 돌봄요구군을 분류하고, 군간 특성을 확인하기 위하여 수행되었다. 한국보건사 회연구원이 진행한 ‘2017년도 노인실태조사’의 자료를 이용한 이차자료 분석연구로, 분석대상은 2017년 노인실태 조사 참여자 중 서울시 노인 999명, 가중치 부여 1,295,491명이다. 돌봄요구군의 분류를 위하여, 의료요구, 일상생 활수행 지원요구, 사회적 활동 지원요구의 특성을 파악하였다. 지원요구가 하나도 없는 일반군이 50.4%, 의료요구군 이 17.9%, 일상생활수행 지원요구 또는 사회적 활동 지원요구가 있는 복지요구군이 14.2%, 의료요구와 복지요구가 모두 있는 복합요구군이 17.5%이었다. 성별, 흡연, 치매검진, 지난 1년간 외래이용, 일상생활수행 도움 여부, 비동거 자녀 또는 손녀 여부를 제외한 일반적 특성, 장기요양등급 및 장애등급 현황, 경제적 부담 및 일상생활 도움 정도, 건강행태와 건강상태, 삶의 만족도에서 돌봄요구군간 유의미한 차이를 보였다(p<.001). 복합요구군에게 의료와 복지 의 통합돌봄 서비스를 우선 제공해야 한다. 특히 복합요구군은 의료, 복지, 운동, 영양, 정신건강, 간호의 요구를 모두 가지고 있는 대상자로 다학제적 팀 접근이 필요하다.

The purpose of this study was to classify the care needs of the older adults aged 65 and over and to identify characteristics of care need groups. This was a secondary analysis study using data from 2017 National Survey of Older Persons in Seoul. There were 50.4% in the general group without any support needs, 17.9% in the medical needs group, 14.2% in the welfare needs group with support needs of daily living or social activity, and 17.5% in the complex needs group with both medical and welfare needs. Significant differences were shown in most variables of the general characteristics, grading of long-term care or disability, financial burden and caregiving, health behaviors, health status, and life satisfactions among groups (p<.001). The complex care need group should be provided with integrated care service for medical and welfare through multidisciplinary team approach.

Purpose: This study aimed to examine the impact of an integrated care program implemented by a public health sub-center on the health and quality of life of older adults living alone in a rural area. The integrated care program included art therapy, craft therapy, horticultural therapy, recreational activities, yoga, walking exercises, health screening & health education. Methods: This study was conducted as one-group pretest-posttest pre-experimental design with 32 participants. Data were analyzed using SPSS Statistics 27.0 and G*Power 3.1.9.7. Data were analyzed using frequency, percentages, minimum, maximum, mean, standard deviation, paired t-test, and one-tailed Wilcoxon sign ranked test. Results: Participants in the integrated care program showed significant improvements cognitive function (z=-2.25, p=.012), depression (z=-2.87, p=.001), health-related quality of life (t=3.21, p<.001), but systolic blood pressure was elevated (t=4.62, p<.001). Conclusion: It is necessary to expand the role of public health sub-center as providers of integrated care programs to improve cognitive function in elderly individuals living alone in rural area, reduce depression, and enhance health-related quality of life.