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Legal improvement plan for institutionalizing nursing care services

  • Legal Theory & Practice Review
  • Abbr : LTPR
  • 2024, 12(1), pp.161-213
  • Publisher : The Korea Society for Legal Theory and Practice Inc.
  • Research Area : Social Science > Law
  • Received : February 3, 2024
  • Accepted : February 24, 2024
  • Published : February 29, 2024

Song Myeong-Hwan 1

1호서대학교 법학연구소

Accredited

ABSTRACT

The extreme economic and psychological burden of long-term care appears to be tragedies such as "care bankruptcy," "care suicide," and "care murder." In particular, the demand for nursing care is rapidly increasing due to the recent deepening aging and changes in family composition. However, if a caregiver is hired privately, the cost of care is around 110,000 won to 140,000 won every day, which is a significant economic burden. However, since the current law does not specify "care" for medical care benefits, patients in need of care have to pay high costs or their families have to take care of the patients themselves. The public's burden of nursing costs ranges from 6.9 trillion won to 8 trillion won, and in the case of severely ill patients, it costs 2 to 3 million won per month, making it the No. 1 cause of the burden of national medical expenses. If the family is in charge of nursing, indirect costs such as job losses and transportation costs are considerable, which causes poverty among low-income people, and unlike most foreign countries, where nursing is provided by hospital nursing personnel, the quality of nursing services is poor and people are dissatisfied. Nursing is not covered by medical institutions and is not included in hospitalization services, resulting in a problem that the hospital is not responsible for worsening the patient's condition due to nursing mistakes, and currently results in legal responsibility under the private contract relationship between the patient and the caregiver. In addition, caregivers are not regular nursing personnel, but non-qualified personnel such as dispatchers are also possible, making it difficult to trust the quality level of nursing care because quality control is not performed. To solve this problem, the government also promoted a pilot project (so-called ‘comprehensive nursing service’) to expand nursing staff (nurses, nursing assistants, etc.) in hospitals to provide nursing services and apply health insurance. After the MERS outbreak in 2015, hospital-acquired infections were pointed out as one of the major problems, and the 'comprehensive nursing service', which was called a 'hospital pilot project without guardians', was changed to 'integrated nursing service' with the revision of the Medical Service Act in December 2015. A legal basis was established, and the number increased from 7,443 beds in 112 institutions at the end of 2015 to 64,108 beds in 621 institutions as of the end of 2021. The introduction of integrated nursing care services was caused by the increase in medical demand, the burden of nursing care costs on patients, and the problems with the Korean nursing culture that emerged through the MERS outbreak. Korea has now begun to accept nursing as a social security issue in earnest. can see. However, the current nursing care reimbursement policy only highlights practical issues such as fees and operating systems, and no full-scale research has been conducted on various legal issues related to reimbursement. This study aims to explore the possibility of socialization of nursing by examining the normative basis of nursing as a basic constitutional right and examining legislative solutions through the enactment and revision of related social security and health care laws.

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This paper was written with support from the National Research Foundation of Korea.
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