농촌노인의 건강관리실태와 정책과제

Abstract

고령화가 급속하게 진행되면서 노인건강관리의 중요성이 부각되고 있다. 우리나라는 노인 빈곤율과 자살률이 OECD 국가 중에서 1위이며, 치매 등으로 인해 돌봄이 필요한 노인은 계속 증가하고 있다. 해마다 늘어나는 노인의료비 지출과 장기요양 비용에 대한 부담을 줄이기 위해서는 실효성 있는 노인건강관리정책이 요구된다.

2008년 노인장기요양보험제도 도입 이후 장기요양 이전 상태인 허약노인 대상 건강관리서비스에 대한 관심이 커지고 있다. 허약노인 대상 건강관리정책은 분절적으로 제공되고 있는 보건과 복지서비스가 연계·통합될 때 효과성이 높아진다. 노인인구 비율이 높은 농촌지역에서 노인건강관리의 필요성은 더욱 부각되며, 의료취약지역에 거주하는 허약노인의 건강관리를 지원할 수 있는 정책이 우선적으로 필요하다.

본 연구는 농촌노인의 건강수준 및 건강관리실태를 파악하고, 농촌 허약노인에 초점을 맞춰 이들의 건강증진을 위한 보건복지서비스 과제를 제시하고자 추진되었다.

Background of Research This study is designed to investigate the health status of the rural elderly and how they are caring for themselves for health promotion and suggest potential solutions for frail elderly people based on the collaboration between health and welfare services. Health promotion for frail elderly people is to slow the pace of them falling into the state of requiring medical needs and long-term care services. To enhance the effectiveness of the health-related services for the frail elderly people, the healthcare sector and social welfare sector should build a cooperative system. In rural areas where aging has been more rapid, the importance of health-caring for the elderly is being magnified, and services for frail elderly people are urgently necessary.

Method of Research This study conducted the literature review, survey, case study, focus group interview, secondary analysis of existing raw data, and researches commissioned. In order to identify the health status of the rural elderly, raw data from the “Community Health Survey” of Korea Centers for Disease Control and Prevention were used for the analysis of 2010. Also, in a survey on the health status of rural frail elderly people, a target population of 628 persons were surveyed for 3 weeks from August of 2013.

Research Results and Implications For better policies related with the rural elderly's health status, the health sector and social welfare sector need to be linked together with the aim of supporting their healthy life. Although the prevalence rate of disease of the former was lower than that of the latter, the quality of life perceived by the rural elderly was lower than that by the urban elderly. The rural elderly had to work for a living, although they felt burdened. Their prevalence rate of arthritis was higher due to farm working and the inconvenient housing environment. The elderly who could conduct the eight actions of IADL(Instrumental Activities of Daily Living) by themselves amounted to 45.9 percent. The male aged had needs for indoor activities, while the female aged had needs for outdoor activities. Furthermore, many elderly people thought that not skipping meals and walking or taking moderate exercise were more helpful for maintaining health than working out or participating in physical activities. Social services for the rural elderly have to be designed based on an understanding of their rural life, considering their sociological characteristics, their state of disease prevalence and health status, etc. To develop health enhancement policy for the rural frail elderly people, the Ministry of Health & Welfare and Ministry of Agriculture, Food and Rural Affairs of Korea need to share the role. And the social service delivery system should be developed based on the community in collaboration with the central government and local government, and connecting the health sector and social welfare sector is also needed. For rural areas, the role of primary health care posts needs to be strengthened and repositioned, and transportation service, public meals service, and bathing facilities need to be expanded. When administering inhome services to eliminate blind spots in elderly care, the local community's efforts to reflect local characteristics need to go side by side.

Researchers: Mihyoung Cho, Dae-Shik Park, Yong-Woog Choi Research Period: 2013. 1 〜 2013. 12 E-mail address: mihyoung@krei.re.kr