韩国及主要国家养老保障政策述评及其启示

K. Kim
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摘要

本研究通过与主要国家临终关怀支持政策和临终关怀/姑息治疗服务系统相关的海外案例研究,考察了主要国家的最新趋势,并通过与韩国的比较分析得出启示,提出必要的改进措施和政策建议。作为海外案例研究的结果,主要国家正在推动以区域综合系统为中心的服务和以区域基础医院为中心的家庭护理,以提高社会成员的死亡质量并支持善终。此外,还建立了一个系统,连接与临终关怀支持相关的设施,提供多样化的服务,并为临终关怀和姑息治疗服务提供互联网络。另一方面,在韩国,法律和制度基础提出的死亡范围仍然非常狭窄,死亡被视为一个事件而不是生命的连续体,并为此建立了最低限度的法律和制度依据。因此,我们还需要逐步扩大法律和制度基础,使与老龄化快速发展密切相关的善终和善终准备得以实现。最重要的是,国内系统目前感兴趣的临终服务领域很窄,而且对心理和社会领域的政策兴趣仍然缺乏,这是一个限制,因此有可能轻松地将死亡作为生命的一个元素来讨论,而不是避免死亡。还要营造积极的社会氛围,加强对留守家庭成员的服务,为政策奠定基础。要实现这一点,就需要在更大的框架内做出政策努力,逐步克服当前利益和领域的狭隘性。此外,还需要改进这一制度,以便通过参考主要国家的案例,根据我们的情况发展这一制度来实现更多样化和全面的临终关怀支持。
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A Review on the Well-dying Support Policies in Korea and Major Countries and Implications
This study examines the recent trends in major countries through overseas case studies related to well-dying support policies and hospice/palliative care service systems in major countries, and draws implications through comparative analysis with Korea to suggest necessary improvement measures and policy recommendations. As a result of overseas case studies, major countries are promoting the provision of services centered on regional comprehensive systems and home care centered on regional base hospitals to improve the quality of death of members of society and support well-dying. In addition, a system was established to connect facilities related to well-dying support and provide diversified services, as well as provide an interconnection network for hospice and palliative care services. On the other hand, in Korea, the scope of death proposed by the legal and institutional foundation is still very narrow, and death is regarded as an event rather than a continuum of life, and the minimum legal and institutional foundation required for this is established. Therefore, we also need to gradually expand the legal and institutional foundation so that well-dying and preparation for a good death, which are closely related to the rapid progress of aging, can be realized. Above all, it is a limitation that the area of well-dying service that the domestic system is currently interested in is narrow, and policy interest in the psychological and social areas is still lacking, so it is possible to comfortably discuss death as an element of life rather than avoiding death. It is also necessary to create a positive social atmosphere, strengthen services for the remaining family members, and prepare a policy foundation. To realize this, it is necessary to make policy efforts to gradually overcome the narrowness of current interests and areas in a larger framework. In addition, there is a need to improve the system so that more diversified and comprehensive well-dying support can be achieved by developing it to suit our situation by referring to the cases of major countries.
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