초고령사회 전환기의 건강노화와 장기요양 거버넌스: 국제사례와 한국의 정책 방향

초록

This study analyzes Korea’s fragmented governance for healthy ageing and long-term care amid rapid super-ageing, and proposes reforms for a sustainable, integrated care system. We reviewed international paradigms (compression of morbidity, ageing in place) and examined governance reforms in Japan and Thailand, focusing on financing and administrative structures; we then assessed Korea’s policy status and drew reform options. Findings indicate that aligning financial incentives is pivotal for integrated care: Japan combines decentralized insurer accountability with performance-based incentives, and Thailand uses a local coordinated fund that links health promotion with long-term care. Korea’s financial and organizational fragmentation weakens local-level incentives for preventive and integrated care. We conclude that Korea should realign goals and incentives across health insurance, long-term care insurance, and health promotion funds, and adopt mechanisms such as shared-savings to reward local efforts that advance healthy ageing.

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