Journal of the Korea Academia-Industrial cooperation Society (한국산학기술학회논문지)

The Korea Academia-Industrial cooperation Society (한국산학기술학회)
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The reform of inspection of adult social care market in the UK and policy suggestions for long-term care in South Korea

영국 성인돌봄서비스 시장에 대한 감독 개혁과 한국 장기요양의 시사점

  • Chon, Yongho (Dept. of Social Welfare, Incheon National University)
  • 전용호 (인천대학교 사회복지학과)
  • Received : 2017.11.06
  • Accepted : 2018.04.06
  • Published : 2018.04.30
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Abstract

The UK is famous for being the first country in Europe to adopt the policies of marketisation regarding social welfare. Numerous other countries, including social democratic countries, have followed suit, and South Korea has also adopted the marketisation of care through the introduction of long-term care insurance. The aim of this study is to examine recent reforms concerning adult social care market in the UK, and to determine policy recommendations to further develop the Korean long-term care insurance market. Findings show that the UK has actively regulated and managed the care market. In particular, after the sudden bankruptcy of nursing homes, the CQC systematically analyzes the risks of bankruptcy of big service providers in terms of financial conditions and quality of services according to the six steps detailed in the Care Act 2014. If some service providers experience high levels of risk, the CQC reports results to local authorities in order to manage the risk of bankruptcy of these service providers. Such reforms in the UK suggest a number of policy measures for South Korea in which the problems of long-term care market are prevalent, including increased system management, introduction of a new inspection system, the expansion of public-based inspection organizations, and disclosure of information by the National Health Insurance Corporation.

영국은 사회복지 돌봄에서 시장화를 유럽에서 가장 먼저 추진한 나라로 유명하다. 영국의 시장화 정책은 사회민주주의 국가에게도 영향을 끼칠 정도로 여러 나라가 시장화 정책을 도입해서 추진하고 있고 우리나라도 장기요양보험제도를 통해서 시장화 정책을 적극 도입했다. 본 연구의 목적은 영국 정부가 최근에 단행한 성인 돌봄 시장의 감독 강화 개혁을 분석하고 이를 토대로 한국 장기요양보험의 정책적인 시사점을 모색하는데 있다. 연구결과에 따르면, 영국은 시장을 적극적으로 관리 감독하고 있는 것으로 나타났다. 특히, 대규모 요양시설의 갑작스러운 파산 이후에 '2014년 돌봄 법'을 제정해서 돌봄품질위원회(Care Quality Commission)가 6단계별로 대규모 서비스 제공기관의 재정 상태와 서비스 질 등 측면에서 파산의 위험성을 사전적으로 분석하고 있다. 이를 통해서 제공기관이 일정한 수준으로 위험성이 높아지면 그 결과를 지방정부에 통보해서 파산과 같은 상황에 체계적으로 대응하도록 했다. 영국의 개혁은 장기요양 시장에 문제가 있는 한국에 시장에 대한 감독 강화, 새로운 감독 시스템 구축, 공공 감독 조직의 확대, 국민건강보험공단의 정보 공개 등의 정책적인 시사점을 제시한다.

Keywords

References

  1. Y. H. Chon, "A study on the marketisation of long-term car for the elderly in UK and Germany," Health and Social Welfare Review, vol. 32, no. 2, pp. 143-169.
  2. Meagher, G. & Szebehely, M. (2013) Marketisation in Nordic eldercare: a research report on legislation, oversight, extent and consequences, Stockholm University, 2013.
  3. Brennan, D., Cass, B., Himmelweit, S., & Szebehely, M., The marketisation of care: Rationales and consequences in Nordic and liberal care regimes. Journal of European Social Policy, 22(4): 355-362, 2012. DOI: https://doi.org/10.1177/0958928712449772
  4. Forder, J. & Allan, S., The impact of competition on quality and prices in the English care homes market, Journal of Health Economics, 34, 73-83, 2013.
  5. Department of Health Market Oversight in Adult Social Care: Consultation, London, 2012. DOI: https://doi.org/10.1016/j.jhealeco.2013.11.010
  6. National Audit Commission, Oversight of user choice and provider competition in care markets, London, 2011.
  7. Rodrigues, R. & Glendinning, C. Choice, Competition and Care: Determinants in English Social Care and the Impacts on Providers and Older Users of Home Care Services, Social Policy & Administration, 49(5): 649-664, 2015. DOI: https://doi.org/10.1111/spol.12099
  8. Allan, S. & Forder, J., Care markets in England: Lessons from research, PSSRU, 2012.
  9. Means, R., Richards, S., & Smith, R., Community care: policy and practice. Basingstoke: Palgrave, 2003.
  10. Y. H. Chon & Y. S. Jeong, A study on the introduction and development of Quasi-markets in the UK: Towards finding policy implications for the development of long-term care insurance in Korea, Korean Social Policy Review, 17(3): 257-287, 2010. https://doi.org/10.17000/kspr.17.3.201012.257
  11. Le Grand, J., & Bartlett. J. ed., QUASI-MARKETS AND SOCIAL POLICY. Basingstoke: The Macmillan Press, 1993. DOI: https://doi.org/10.1007/978-1-349-22873-7
  12. Laing&Buisson, Care of Older People: UK Market Report, London, 2015
  13. HSCIC, Community care statistics: social services activity, England, 2013-2014. final release, London, Health and Social Care Information Cetre, 2014.
  14. Laing&Buisson, Care of Older People: UK Market Report, London, 2015.
  15. Department of Health Care and Support Statutory Guidance: Issued under the Care Act 2014, London, 2014.
  16. Association of Directors of Adult Social Services, Budget Survey, London, 2015.
  17. Center for Health and the Public Interest The future of the NHS? Lessons from the market in social care in England, London, 2013.
  18. Allan, S. & Forder, J., The determinants of care home closure, Health Economics, 24(1): 132-145, 2015. DOI: https://doi.org/10.1002/hec.3149
  19. H. Kwon., "The impact of the marketization on the long-term care provision in terms of service quality," Korean Association of Social Welfare Policy, vol. 41, no. 1, pp. 289-313, 2014. DOI: https://doi.org/10.15855/swp.2014.41.1.289
  20. J. Seok., "A study on rationalization of regulation for strengthening the publicness of long-term care services," Health and Social Welfare Review, vol. 32, no. 2, pp. 423-451, 2017. DOI: https://doi.org/10.15709/hswr.2017.37.2.423
  21. Care Quality Commission Market Oversight of 'difficult to replace' providers of adult social care: Guidance for providers, London, 2015.
  22. Laing&Buisson Care of elderly people: UK market survey 2010/2011, London, 2011.
  23. J. Seok et al., "Policy measures to improve the publicness of long-term care insurance," Ministry of Health and Welfare, 2015.