노인돌봄정책 전환의 효과

Effect of Elderly Care Policy Transition: Focusing on the Impact of Customized Care Services for the Elderly on Life Satisfaction

본 연구는 2020년 시행된 경증노인 돌봄서비스인 노인맞춤돌봄서비스의 성과를 이용당사자 관점에서 파악하기위한 것이다. 이를 위해 서울시 25개구에서 해당 서비스를 18개월 이상 이용한 노인 307명을 대상으로 설문조사를 진행하여, 지원형서비스와 참여형서비스의 효과를 구조모형 검증을 통해 확인하였다. 지원형서비스는 노인의 일상생활수행능력과 사회관계망을 다중매개로 그리고 자기돌봄을 이중매개로 생활만족도에 영향을 미치고, 노인의 일상생활수행능력과 사회관계망은 자기돌봄에, 그리고 자기돌봄은 생활만족도에 정적인 영향을 미치고있었다. 생활만족도에 사회관계망이 가장 큰 영향을 미치고, 다음으로 지원형서비스, 일상생활수행능력, 자기돌봄 순으로 나타났다. 특히, 사회관계망은 노인의 자기돌봄에도 가장 큰 영향을 미치는 요인이었다. 반면 참여형서비스는 관련된 변인들간에 직, 간접적으로 유의한 매개효과가 나타나지 않았다. 이는 현 노인맞춤돌봄서비스실행상 오류와 코로나로 인한 대면활동의 제약에 기인한 것이다. 따라서 성과확인을 위해서는 좀 더 시간이 필요하며, 수행인력의 기획력과 전문성이 제고되고 그들의 고용안정과 처우개선이 필요하다.

The aim of this study was to determine whether customized elderly care services implemented in 2020 to support lives of the elderly with mild dementia had intended effects on service users. A survey of elderly people who had used customized elderly care services for at least 18 months was carried out in 25 districts of Seoul, the capital city of Republic of Korea. Using structural modeling, this study confirmed the impact of support-type and participation-type customized care services for the elderly on life satisfaction, which included activities of daily living, social network, and self-care as dual mediation variables. Results revealed that the support-type service had an impact on life satisfaction via the mediation of activities of daily living and social network as well as via the dual mediation of self-care. The elderly’s activities of daily living and social network had a positive impact on self-care, with self-care having a positive impact on life satisfaction. The most important variable influencing life satisfaction was discovered to be social network, followed by support-type service, activities of daily living, and self-care. The social network variable in particular was found to have the greatest influence on self-care. However, the use of participation-type services had no direct or indirect impact. It had no significant mediation impacts on activities of daily living, social network, self-care, or life satisfaction either. These findings might be attributed to limited contact activities due to the COVID-19 pandemic, sub-level program characteristics, and implementation errors. Based on these findings, practical policy recommendations are made to ensure that customized elderly care services can be established as an effective elderly care community service as originally intended.