The Working History and Old-age Income Security correlates of Middle- and Old-aged Self-employed Workers in Korea

Han Ki Myung(한기명) 연세대학교 사회복지연구소 2018 한국사회복지조사연구 Vol.56 No.-

This study problematizes the lack of appropriate action by Korean Social security system against the increasing social risks of middle- and old-aged self-employed workers, analyzing the distinctive characteristics of their working history from wage workers, as well as their effect on the risk of zero or low pension benefits. This research follows the definition of self-employed by Economically Active Population Survey in Statistics Korea. Targeting those who have experienced self-employment at least once over their lifetime according to the working history data in Korean Retirement and Income Study. For analysis of their enrollment and Receiving National Pension, working history, this study utilizes descriptive statistics, t-test, chi-square test, and binary logistic regression. The result shows that factors such as gender, age, marital status, home ownership, industries (whether in accommodation and restaurants or agriculture and fishing), and income levels are the common variables that affect the likelihood of enrollment and Receiving National pension. In the case of working history, the focus of this research, those who have experience in permanent worker displayed higher likelihood of enrollment, while those who had been temporary and daily workers were less likely to receive. In other words, the differences in their working history lead to significant gaps in the rate of enrollment and Receiving national pension, which derives from the instability and low-income levels of the self-employed. Based on the findings of this study, a protective measure is urgently necessary to alleviate such social risks. We suggest extending the current social insurance subsidies (offered to low-income wage workers, agriculture, and fishing industries) to the low-income self-employed workers who earn less than 40 million won, and gradually expanding to those lower than the 80 million won mark. 본 연구는 우리나라의 사회보장제도가 점차 늘어나는 중고령 자영업자의 사회적 위험에 충분히 대응하지 못하고 있다는데 문제의식을 갖고, 중고령 자영업자의 생애 근로이력이 기존 임금근로자와는 다른 특성을 보이고, 이것이 자영업자의 무연금 및 저연금의 위험에 어떠한 요인이 영향을 미치고 있는지에 대해 분석하였다. 자영업자의 정의는 통계청의 경제활동인구조사의 정의에 따랐으며, 국민노후보장패널 직업력 조사 자료에서 자영업자를 한 번이라도 경험한 중고령자를 대상으로 이들의 국민연금 가입 및 수급 결정요인을 살펴보았다. 이에 대한 분석을 위해 가입 및 수급 여부에 따른, 생애 근로이력에 따른 기술분석과 t-test, 카이제곱검정, 이항로짓회귀분석을 실시하였다. 분석결과, 성별, 연령, 배우자 유무, 주택 소유 여부, 숙박 음식업에 비해 농림수산업이, 소득이 상대적으로 높은 집단에 대한 변수가 가입 및 수급 여부에 공통적으로 영향이 있는 것으로 나타났다. 특히 본 연구에서 중점을 두고 있는 생애 근로이력의 경우, 상용직 경험이 가입 가능성을 높이고, 임시 일용직 경험이 수급 가능성에 취약하다는 점을 밝혔다. 즉, 자영업 근로이력에 따른 차이가 가입 및 수급에도 큰 차이를 보이며, 이러한 취약성은 자영업자의 불안정하고 낮은 소득에서 기인한다. 따라서 본 연구의 결과를 토대로 이러한 사회적 위험을 완화하기 위해 사회적 보호 대책이 시급하며, 현재 저소득 임금근로자와 농어업인에 적용되는 사회보험료 지원사업을 4천만원 미만 혹은 8천만원 미만의 영세자영업자에게까지 단계적으로 확대 적용하는 방안을 제시하였다.

위계적 질환군 위험조정모델 기반 의료비용 예측

한기명 ( Ki Myoung Han ),유미경 ( Mi Kyung Ryu ),전기홍 ( Ki Hong Chun ) 한국보건행정학회 2017 보건행정학회지 Vol.27 No.2

Background: This study was conducted to evaluate the performance of the Hierarchical Condition Category (HCC) model, identify potentially high-cost patients, and examine the effects of adding prior utilization to the risk model using Korean claims data. Methods: We incorporated 2 years of data from the National Health Insurance Services-National Sample Cohort. Five risk models were used to predict health expenditures: model 1 (age/sex groups), model 2 (the Center for Medicare and Medicaid Services-HCC with age/sex groups), model 3 (selected 54 HCCs with age/sex groups), model 4 (bed-days of care plus model 3), and model 5 (medication-days plus model 3). We evaluated model performance using R2 at individual level, predictive positive value (PPV) of the top 5% of high-cost patients, and predictive ratio (PR) within subgroups. Results: The suitability of the model, including prior use, bed-days, and medication-days, was better than other models. R2 values were 8%, 39%, 37%, 43%, and 57% with model 1, 2, 3, 4, and 5, respectively. After being removed the extreme values, the corresponding R2 values were slightly improved in all models. PPVs were 16.4%, 25.2%, 25.1%, 33.8%, and 53.8%. Total expenditure was underpredicted for the highest expenditure group and overpredicted for the four other groups. PR had a tendency to decrease from younger group to older group in both female and male. Conclusion: The risk adjustment models are important in plan payment, reimbursement, profiling, and research. Combined prior use and diagnostic data are more powerful to predict health costs and to identify high-cost patients.

서비스양을 고려한 수가 결정모형에 의한 추정 환산지수와 실제 환산지수의 비교

한기명 ( Ki Myoung Han ),조민호 ( Min Ho Cho ),이수진 ( Soo Jin Lee ),전기홍 ( Ki Hong Chun ) 한국보건행정학회 2013 보건행정학회지 Vol.23 No.4

Background: Price control alone may not successfully restrain growth in health expenditures. This study aimed to propose fee adjustment model suitable for Korea reflecting health service volume and to clarify applicability of the model by comparing actual conversion factor with estimated conversion factor from simulation of this model. Methods: Fee adjustment model was developed based on Alberta`s fee adjustment formula in Canada and 7 alternatives were assessed according to diversely applied parameters of the model. Results: Estimated conversion factors of the tertiary care hospital and the hospital were lower than actual conversion factors, since the utilization of heath service has been increased. However, there was no big difference between estimated conversion factors and actual conversion factors of the general hospital and the clinic. Eventually this fee adjustment model could estimate proper conversion factor reflecting health service volume. Conclusion: This model may be applicable to the mechanism as determining conversion factor between insurer and provider via negotiation and controling growth in health expenditures.

노인 와상환자 돌봄 인력의 돌봄보조기술 활용가능성에 관한 탐색적 연구

한기명 ( Han Ki Myung ),김영선 ( Kim Young Sun ),신혜리 ( Shin Hye Ri ) 한국사회복지연구회 2020 사회복지연구 Vol.51 No.4

This study aimed to examine opinions of care workers in nursing and residential care facilities who provide service for seniors with limited mobility towards care technology in elderly care. In this regard, this research study conducted in-depth interview of 18 employees at nursing facilities who care for seniors with mobility issues. Participants reported that the most challenging part of the work is when they have to lift over a patient or help get a patient in and out of the bath that is physically and mentally demanding. Further, they asserted care technology solutions that help alleviate the many physical demands of nursing must be widely implemented along with financial support from the Nation, local governments, the National Health Insurance Service. A lack of awareness is one of the barriers care worker face when adopting care technology due to limited functions and capabilities. Therefore, the study suggested the benefits of the caregiver-friendly work environment and made clear the importance of development of care technologies focused on the needs of carers to prevent work injuries, improve their job satisfaction, and quality of care for care recipients.

지불의사액에 기초한 사회서비스 가치평가: 노인장기요양보험 방문요양서비스를 중심으로

남재욱 ( Nahm Jaewook ),한기명 ( Han Kimyung ) 한국사회보장학회 2022 사회보장연구 Vol.38 No.2

The purpose of this study is to find an alternative value evaluation method including the social value or positive externality created by social services. To this end, this study applied a value evaluation method based on users’ WTP in the field of Home-Visit Care Service for older adults, and compared it with the existing service unit price. As a result of the analysis, the WTP for the survey participants in this study was about 1.87 to 1.99 times higher than the current unit price of the Home-Visit Care Service. This means that the actual value of the Home-Visit Care Service is higher than the market present. Among the respondents, respondents with service experience expressed a higher WTP, and their WTP was higher when their previous service satisfaction was high. Moreover, Respondents recognized that service providers were the most important in terms of service satisfaction and value. Taken together, Home-Visit Care Service for older adults actually create higher value than the existing value evaluation, and the value can be even higher by expanding service experience and improving service quality. This suggests the need to expand public investment in visiting care services, and the most important investment area is manpower.

사회적 농업에서 종사하는 발달장애인의 일자리 만족도에 영향을 미치는 요인: 푸르메 여주팜을 중심으로

이지선(Lee, Ji Sun),한기명(Han, Ki Myung),최려나(Cui, Li Na) 한국직업재활학회 2022 職業再活硏究 Vol.32 No.1

본 연구는 사회적 농업에 종사하는 발달장애인의 일자리 만족도에 영향을 미치는 요인을 파악하여 사회적 농업이 갖는 일자리로서의 가능성을 탐색하고자 하였다. 이를 위해 사회적 농업 형태의 장애인표준사업장에 취업한 발달장애인 근로자 31명을 대상으로 설문조사를 진행하였고, 설문지는 장애인고 용패널조사 문항에서 취업 선택 이유, 근무 시 어려움, 가족의 지지, 일자리 만족 등의 문항으로 구성하였다. 수집된 자료는 기술통계와 다중선형회귀분석을 수행하였다. 연구 결과, 연구참여자들은 현 직장 의 취업 선택 이유로 정규직으로서 직업 유지의 안정성, 최저임금 이상의 보수, 추천한 주변인의 역할이 크게 작용했다고 응답하였고, 연구참여자의 일자리 만족도 수준은 전체 장애인의 일자리 만족 수준 보다 월등히 높았다. 발달장애인 근로자의 일자리 만족도에 영향을 미치는 요인을 살펴본 결과, 가족 의 취업 지지와 근로자의 대인관계능력, 국민기초생활보장 수급 여부가 유의미한 영향을 미쳤다. 이러한 결과를 토대로, 다음과 같은 제언을 하였다. 첫째, 발달장애인의 일자리 만족을 높이기 위해서 가족이 장애인 당사자의 취업 및 직장생활에 대해 지지해주는 것이 중요하다. 둘째, 직장 내에서 동료와 상호작용하는 기술을 배우고, 대인관계능력을 유지할 수 있도록 하는 교육훈련 프로그램이 필요하다. 셋째, 발달장애인 근로자에게 정규직으로서 최저임금 이상의 보수를 제공할 수 있는 사회적 농업 일자리 모델을 성공적으로 정착시키기 위한 지원 및 연구를 다각도로 수행하는 것이 필요하다. The purpose of this study was to investigate factors related to employment and factors affecting job satisfaction of workers with developmental disabilities. Survey data was collected from 31 workers with developmental disabilities who were employed as permanent employees at a social farm. Survey questions consisted of questions such as reasons for employment choices, difficulties in working, and job satisfaction and were extracted from Survey of Panel Survey of Employment for the Disabled. Descriptive statistics and multi-linear regression analysis were performed. As a result of the study, it was found that the stability of job maintenance as permanent employees, remuneration above the minimum wage, and close persons’ recommendations played a major role as reasons for choosing the current employment. The level of job satisfaction of study participants was significantly higher than that of all people with disabilities. As a result of examining the factors affecting the job satisfaction, the family s support for employment, the workers’ interpersonal skills, and the receipt of national basic living security significantly associated to the job satisfaction. Based on these results, the following suggestions were made. First, in order to increase job satisfaction of people with developmental disabilities, it is important that the family’s support for employment and work life. Second, there is a need for an education and training program that allows workers to learn interpersonal skills to interact with colleagues in the workplace. Third, active support and further research should be people with developmental disabilities in social farming that can guarantee permanent employment.

농업인안전재해보험의 개선에 관한 연구: 민영보험적 한계를 중심으로

김진수 ( Kim Jinsoo ),한기명 ( Han Kimyung ),남재욱 ( Nahm Jaewook ),최승훈 ( Choi Seunghoon ) 한국사회보장학회 2021 사회보장연구 Vol.37 No.2

This study analyzed accidents insurance for farmers, which is operated in the form of private insurance and sought evaluation and improvement measures from the perspective of social security. The results are as follows. First, the low-income class was excluded due to voluntary participation, and spouses were excluded despite being family-oriented farmers. The low-risk younger generation avoided the problem of adverse selection. Second, the moral hazard phenomenon has intensified due to private management in the form of the government treasury. Third, it was found that the farmers’ accident insurance did not sufficiently reflect the characteristics of the farmers’ accidents in the business. This private insurance factor for compensation for agricultural accidents was limited in fulfilling the social security function of agricultural accidents. Therefore, it is necessary to urgently improve the social security role of compensation for agricultural disasters. Furthermore, we should shift to social security for all economically active population including farmers in a long-term perspective.

발달장애인의 사회적 농업 분야 표준사업장에서의 취업 초기 경험에 대한 질적연구

이지선(Ji-sun Lee),한기명(Ki-Myung Han) 한국장애인복지학회 2024 한국장애인복지학 Vol.64 No.64

본 연구는 국내 유일의 컨소시엄형 표준사업장에서 최저임금 이상의 급여를 받는 발달장애인 근로자의 취업 초기 경험과 변화 등을 탐색함으로써 장애인 당사자 관점에서의 직무만족, 농업 분야에서의 표준사업장이 갖는 일자리로서의 의미와 가치는 어떠한지를 확인하고자 하였다. 이를 위해 표준사업장에서 일하는 발달장애인 근로자와 가족, 직무지도원과 관리자를 포함한 19명을 대상으로 개별 면담을 진행하였다. 주제분석 결과, 16개의 소주제가 발견되었고, 이를 범주화하여 나타난 핵심 주제는 (1) 각자의 자리에서 최선을 다함, (2) 농업, 나에게 맞는 일, (3) 긍정적 변화가 나타남, (4) 보통의 삶을 살아감으로 도출되었다. 이러한 결과를 바탕으로 업종이 제한적인 표준사업장의 농업 분야 확대 필요성과 발달장애인의 일자리로서의 사회적 가치 등 정책적·실천적 개선방안을 제시하였다. This study explored the early work experiences of people with developmental disabilities who are paid above the minimum wage through in-depth individual interviews with 19 participants, including workers with developmental disabilities, their families, and non-disabled workers, who had been working at a subsidiary-type standard workplace for the disabled in the agricultural sector for six months. Four key themes and 16 sub-themes emerged from the thematic analysis of the workers' experiences: (1) ‘doing the best they can in their positions’, (2) ‘farming, a job that suits me’, (3) ‘seeing positive changes’, and (4) ‘living a normal life’. Based on these findings, policy and practical improvements were suggested.

농업인의 농작업 재해보장 현황과 과제 연구: 재해보장 체제 관점의 적용

김진수 ( Kim Jinsoo ),남재욱 ( Nahm Jaewook ),한기명 ( Han Kimyung ) 한국사회보장학회 2017 사회보장연구 Vol.33 No.3

This study aims to figure out the current situation and issues about public and private systems related to farmers` occupational accidents and analyzed the limitation of the private accident insurance system. The results are following. The farmers` safety insurance, a private insurance covers self-employed farmers` occupational accidents, has several important problems. Firstly, the farmers` safety insurance has wide dead zone due to its voluntary application, hence regressive redistribution is brought out. Secondly, every benefit is paid in lump sum and levels of benefits are lower than those of the industrial accident compensation insurance. Benefits, furthermore, do not consider farmers` characteristics. Thirdly, systems to decide work relatedness are not established yet. Fourthly, the insuring unit does not consider the characteristics of farm working. In the perspective of accident protection regime, the problems of excessive and scant protection are caused simultaneously by the absence of coordination scheme. It is necessary to shift to public accident compensation system to improve these problems in the long run because these are based on the private administration of accident compensation to a not inconsiderable extent. Apart from this, some issues need to be improved by stages before the shift.

수용자 자녀의 부모수감 이후 삶의 변화와 서비스 욕구에 관한 질적 연구

이지선(Lee, Ji Sun),최려나(Cui, Li Na),한기명(Han, Ki Myung) 한국아동복지학회 2022 한국아동복지학 Vol.71 No.1

본 연구의 목적은 부모의 교도소 수감 이후 수용자 자녀가 겪게 된 변화와 어려움을 이해하고, 수용자 자녀를 위한 서비스에 대한 만족과 욕구를 당사자의 관점에서 파악하는 것이다. 이를 위해 교도소에 수감된 부모를 둔 15∼19세의 청소년 14명을 대상으로 일대일 심층 면접을 실시하여 자료를 수집하였으며, 수집된 자료는 질적연구 방법 중 주제분석을 실시하였다. 그 결과, 부모의 수감 후 변화, 도움이 되었던 지원, 서비스 지원 욕구라는 3개의 대주제가 도출되었다. 수용자 자녀들은 부모의 수감 후 주거환경 및 양육자 변경, 경제적 및 심리적 어려움, 가족 내에서의 역할 및 관계 변화와 주변인의 태도 변화를 경험하는 것으로 나타났다. 도움이 되었던 지원으로 경제적 지원, 접견 지원, 동아리 활동, 멘토링 프로그램 참여라고 응답하였으며, 더 바라는 지원으로 경제적 지원의 확대, 다양한 활동 기회, 심리상담 서비스, 수감자 자녀에 대한 사회적 인식개선, 부모의 범죄 사실에 대한 합리적 형량, 법정대리인 부재로 발생하는 행정 절차상의 문제 해결 등이 나타났다. 본 연구의 결과에서 나타난 수용자 자녀 당사자들이 경험하는 심리·사회적 어려움과 욕구를 바탕으로 제도 및 서비스의 개선방안을 제언하였다. This study explored the life changes and difficulties experienced by children of incarcerated parents and identified their specific service needs. Data were collected through one-on-one in-depth interviews with 14 children of incarcerated parents aged 15 to 19. A thematic analysis of the interviews generated three major themes: “changes in life after parental incarceration”, “helpful supports and services”, and “service needs”. Participants reported experiencing changes in their residential environment and caregiver, financial and psychological difficulties, and changes in roles and relationships within the family and in the attitudes of people around them. Supports and services that the participants found helpful included financial and visitation assistance, support groups, and mentoring programs. Participants expressed needs for increased financial assistance, expanded activity opportunities, counseling services, reduced stigmatization of the children of incarcerated parents, reasonable sentences for incarcerated parents, and the resolution of administrative procedure problems that often arise in the absence of a legal representative. Implications and suggestions related to the difficulties experienced by children of incarcerated parents were discussed.