KIHASA has released its February issue of the Health and Welfare Policy Forum, No. 328. (The articles are available for download here.)

SUMMARY OF THE FOREWORD: "The Role and Policy Direction of Long-Term Care Insurance for the Elderly in a Super-aged Society," Nam, Hyun-Joo, Professor of Social Welfare, Gachon University

Korea will become a super-aged society in 2025, with the population aged 65 and over expected to exceed 20.3 percent of the total population. By 2040, the proportion of its elderly population will have further increased to 34.3 percent. Such demographic changes leave a super-aged Korea deeply concerned over what direction its long-term care insurance should take. This concern is heightened now, as, in the wake of COVID-19, the necessity of elderly care is increasingly pronounced and society needs to transition to meet those care needs. Germany and Japan are the only countries that started addressing eldercare needs with an indpependent social insurance scheme earlier than Korea. With its long-term care insurance implemented in 2008, Korea is regarded as having started preparing for its growing long-term care needs early on, when the percentage of the 65-plus population was still low.

During its early stages of implementation, the long-term care system faced difficulties due to a lack of infrastructure and a specialized workforce. The system was assessed as limited in meeting care needs and providing user choices. Criticisms were leveled at it for bringing between regions disparities in and excessive competition around service provision, as well as at long-term care workers having to work under poor working conditions. To improve the situation, the Five-Year Basic Plan for Long-Term Care was introduced, leading to an expansion in coverage and improvements in service quality.

Ater all these years with the long-term care system in place, however, concerns persist about ensuring the dignity, self-determination, and choices of older people in eldercare, as well as recognizing the value of care work. Funding is also a priority concern. Ways need to be sought to keep the long-term care system financially sustainable in a super-aged Korea. Increasing the share of national subsidies in the long-term care insurance fund is an option worthy of serious consideration, especially for a country where population aging is more rapid than anywhere else in the world.

MONTHLY FOCUS: Current State and Implications of Long-Term Care as Seen Through the 2022 Long-Term Care Survey

"Daily Lives of Long-Term Care Recipients and Policy Implications for Improving Long-Term Care Services," Kang, Eunna, KIHASA

This article aims to examine the daily lives of long-term care recipients by using long-term care survey data for 2022, focusing mainly on their healthcare use, mobility and ability to eat, and long-term care service use status. While this analysis revealed certain commonalities among long-term care recipients, it also identified characteristics that vary among them depending on the long-term care classifications to which they belong and the types of services they use. Based on our findings, I proposed improvements to long-term care services with the goal of promoting healthier and more dignified lives for the recipients.

"Long-Term Care and Needs for Improvement as Experienced by Families of Care Recipients," Lee, Sun Hee, KIHASA

The purpose of this article is to investigate the impact of long-term care services on reducing the burden of care on families and to present policy recommendations for improving these services by examining perceived needs for improvements. Families using long-term care have generally had positive experiences with the system, reporting that the services have reduced their burden of care and that their satisfaction with the overall system is high. This study also identified unmet benefit needs among families for some services. I proposed several policy tasks, including: strengthening information and education linkages to ensure families are aware of the available services and how to access them; diversifying visiting service benefits to better meet the needs of families; and strengthening medical services for both home-visit and facility service users to improve the overall operation of the system.

"Current State of Service Quality Management at Long-Term Care Providers and Policy Options for Improvement," Kim, Sejin, KIHASA

In this article, I explore how long-term care providers manage service quality, drawing on the 2022 Long-Term Care Survey, and propose policy options to enhance the long-term care offered by these organizations. This study found that long-term care provider organizations often employ an additional workforce of informal employees, beyond the minimum required by national regulations, in an effort to deliver quality services. However, quality management efforts, such as employing an additional workforce, were found to be relatively insufficient in providing visiting care--such as occasional day or nighttime services--or highly demanding care. Facilities offering day and nighttime care, short-term care, and long-term care demonstrate considerable effort in safeguarding users' autonomy and rights and delivering professional care. However, they were found to be less committed to safeguarding users' right to choices regarding meal service, enhancing services in small-group care settings (including dementia care), and adopting new technologies such as digital rehabilitation devices and location trackers for seniors. Based on these findings, I suggest policy options for enhancing the quality of services provided at long-term care organizations.

"Long-Term Care Workforce: The Current Working Conditions and Policy Implications," Namkung, Eun Ha, Ewha Womans University

Based on the results of the 2022 Long-Term Care Survey, this article examines the working conditions and working environment of long-term care (LTC) workers. The findings suggest that LTC workers, especially home-visiting personal carers, are in unstable employment and have irregular work patterns. In addition, LTC workers experience various types of unfair treatment, such as verbal, physical, and sexual misbehaviors and non-standard work demands, from care recipients or their families. A significant number of LTC workers, especially those working at institutions or daycare/short-term care centers, and LTC social workers, have long working hours, lack resting areas, and are obligated to respond to frequent off-hours calls and text messages. This article concludes by presenting policy implications aimed at improving LTC workers' employment stability, working conditions, and working environment.

POLICY ANALYSIS AND TRENDS

"Analysis of the Health and Welfare Policy Agenda from Selected 2023 International Meetings," Shin, Yoon-Jeong, KIHASA

This report analyzes discussions held in 2023 at G20, OECD, APEC, and ASEAN meetings on health and social protection issues. The main agenda items that emerged include: building a global response system for pandemic preparedness; strengthening the resilience of the healthcare system; utilizing digital technologies in health and welfare policies; responding to climate change; and reshaping social policies in the endemic era. In order to strengthen Korea's global leadership in major international meetings in the field of health and welfare policies, it is necessary to: actively cooperate in building a global pandemic response system; help to expand universal health coverage from a global perspective; put climate change and digitalization at the top of the national health and welfare policy agenda; and establish international cooperation with developed and developing countries in response to emerging social risks.

HEALTH AND WELFARE NEWS IN BRIEF