국내 요양병원과 노인요양시설에 대한 코호트 격리의 문제점과 개선방안

Abstract

Domestic confirmed cases are occurring in various age groups, but the death rate is about 95% in those in their 60s or older, and the fatality rate in those over 80 years old reaches 18.7%. In particular, among medical institutions, patients admitted to nursing hospitals with geriatric diseases or chronic diseases or those aged 65 or older who are judged to be in need of care, or those who are under the age of 65 with geriatric diseases are considered to be elderly. In addition to the health vulnerability of having an underlying disease, they are exposed to double risk of COVID-19 infection in that they live in a close space. In fact, 35% of deaths from COVID-19 infection in Korea were related to inpatients at nursing hospitals, residents of elderly care facilities, medical staff, and caregivers. Accordingly, the domestic government may take cohort isolation measures if there is concern about the spread of infection due to the occurrence of a group of confirmed patients in medical institutions. However, unlike tertiary general hospitals, most nursing hospitals and elderly care facilities have only the facilities and manpower that can provide medical services to those who need long-term care due to chronic or geriatric diseases. There are insufficient facilities or manpower to respond to emerging infectious diseases that require a level of isolation or treatment. In this situation, indiscriminate cohort isolation of nursing hospitals and elderly care facilities will inevitably endanger the health and life of high-risk inpatients and residents. Therefore, in this paper, the specific problems of cohort isolation measures for nursing hospitals and elderly care facilities in Korea are the lack of cohort isolation operation facilities, the shortage of specialized health and medical personnel for cohort isolation operation, and violation of the basic rights of inpatients in nursing hospitals and elderly care facilities. In order to find a solution to this problem, after comparing and analyzing the overseas cohort isolation guidelines and domestic cohort isolation guidelines, as a legal and policy improvement measure for cohort isolation measures in domestic nursing hospitals and elderly care facilities, 1) expansion of cohort isolation facilities and I would like to argue that it is necessary to strengthen the cooperative system, 2) expand support for professional health and medical personnel and prepare a human resources exchange system, 3) guarantee the self-determination rights of cohort quarantined patients, and 4) prepare criteria for screening cohort quarantine targets.