농촌노인의 의료·복지서비스 이용 실태 및 정책과제: 기능장애 노인을 중심으로

Abstract

초고령 사회로 진입한 농촌에서 노인의 건강과 돌봄은 중요 과제이다. 나이가 들수록 건강이 악화되어 돌봄이 필요하지만, 그들은 자신의 오랜 삶의 터전인 지역사회 내에서 스스로의 힘으로 살아가기를 원한다. 이러한 노인의 욕구에 맞추어 다양한 서비스를 제공하기 위한 노력들이 이루어지고 있다. 특히 일상생활활동에 어려움이 있는 기능장애 농촌노인이 지역사회에서 원활하게 생활하기 위해서는 가정과 지역사회에서 제공하는 의료·복지서비스가 중요하다. 그러나 서비스 자원이 부족하고 이동거리가 긴 농촌의 특성상 기능장애 농촌노인은 의료·복지서비스 접근성이 낮을 수밖에 없다. 기능장애 농촌노인이 지역사회 내에서 스스로 생활하는 데 필요한 의료·복지서비스는 구체적으로 무엇인지, 이용에 어떤 어려움이 있는지 그 실태를 살펴볼 필요가 있다. 이는 현재의 기능장애 농촌노인뿐만 아니라, 나이가 듦에 따라 신체적 건강 악화 및 기능 제한을 경험할 수 있는 농촌주민 모두의 관심사일 것이다.이 연구는 농촌노인, 특히 일상생활활동에 어려움을 겪는 기능장애 농촌노인의 의료·복지서비스 이용 실태를 살펴보았다. 조사에서 나타난 기능장애 농촌노인의 서비스 이용 문제점을 바탕으로, 서비스 접근성을 개선하고 효과적으로 서비스를 전달할 수 있는 방안을 제시하였다.

Population aging has become an important social subject for our society to cope with because the number of older adults who need various medical and social supports have increased sharply. Older adults would like to stay in their community as they age; health and social services, home- and community- based services, help them remain in the community independently. However, rural older adults consistently have been excluded from the public social and health services. In particular, rural older adults with functional disabilities are experiencing difficulties accessing those services because of their limited mobility and rural environment where social resources are insufficient. Previous studies mostly focused on service delivery systems for older adults and linkage of health and social services. Therefore, the present study investigated the current service use of rural older adults with functional disabilities and identified the barriers that hinder them from accessing and using health and social services. To identify the barriers of service use, this study conducted surveys among rural older adults and health and social service providers in rural areas. Additionally, qualitative interviews among rural older adults with functional disabilities were conducted to explore their use of services and difficulties accessing services. Focus group interviews were also carried out to identify the problems delivering services to rural older adults with functional disabilities. This study revealed that the rural older adults with functional disabilities suffer from physical and mental health deterioration. They visited doctor’s office more often than healthy rural older adults. Similarly, they more often used social services than rural older adults without functional disabilities. However, they were more likely to experience unmet service needs compared to their counterparts, which means that rural older adults with functional disabilities receive insufficient health and social services for their health status. The main barriers to access health and social services for rural older adults with functional disabilities were their limited mobility, lack of transportation, insufficiency of services, and financial burden. Therefore, this study suggested building up a regional system to manage various social and health services and deliver the collaborated services to rural older adults. To improve the delivery system, this study suggested future policy directions and proposed several plans for rural older adults with functional disabilities. Researchers: An Sok, Park DaeShik, and Kim KyungInResearch period: 2016. 11. ∼ 2017. 5.E-mail address: ansok@krei.re.kr