It was found that 8 out of every 10 staff members assigned to community-integrated care sites are part-time workers who also handle other duties. At the “4th Community-Based Integrated Care Forum” hosted by the Ministry of Health and Welfare on September 30 at B&D Partners in Seoul, experts proposed that establishing a proper community-centered delivery system requires improvements in the management of dedicated staff, the unification of entry points at town, township, and neighborhood levels, and the establishment of publicly operated care centers in vulnerable areas.
The forum, held under the theme “Directions for the Development of a Community-Led Integrated Care Operating System,” was attended by experts from various sectors, including local governments, public health centers, research institutions, and the media, and was livestreamed on the Ministry of Health and Welfare’s YouTube channel.
Professor Min So-young of Kyonggi University, who delivered the opening presentation, identified accountability, professionalism, adequacy, accessibility, and integration as the five key criteria for a community-centered delivery system. According to data from the Ministry of the Interior and Safety and the Ministry of Health and Welfare cited by Professor Min, the plan calls for 5,394 dedicated integrated care staff (90 at city and provincial headquarters, 1,126 at city, county, and district headquarters, 4,178 at towns, townships, neighborhoods, and public health centers), but only 32.9%—or 1,757—were actually reflected in the staffing quotas. Of the 6,053 staff actually deployed, 4,894 (80.8%) held dual roles, while only 1,159 were dedicated to integrated care. Professor Min pointed out that there are cases where personnel unrelated to integrated care expertise are assigned, or where integrated care staff are reassigned to other duties, and emphasized the need to establish appropriate workload standards per staff member.
He analyzed that if the results—where services were linked to 37,000 people during the first 100 days of implementation—were divided among the 229 cities, counties, and districts, this would amount to approximately 161 people per locality; if divided among the roughly 3,500 towns, townships, and neighborhoods, it would amount to about 10 people per locality. He also highlighted the problem of interrupted professional development due to rotational assignments and proposed that the core duties of social welfare positions and mandatory career paths be clearly defined.
In terms of accessibility, the report recommended unifying the service window so that residents—regardless of whether they are seeking care or assistance with general crises—can receive intake and counseling at a single “Health and Welfare Outreach Team” office in their town, township, or neighborhood. Noting that rural and fishing villages lack or have insufficient nonprofit organizations to provide direct services, the report cited a survey by the Korea Rural Economic Institute showing that 18.4% of elderly people in rural areas need assistance with daily living, and 47.2% of them receive no public or private care at all. Accordingly, they identified the establishment of publicly operated care centers—which directly provide integrated home care, day and night care, and transportation support—and the expanded participation of public health centers as key areas for improvement.
The second presenter, Professor Kim Yeon-ah of Sungkonghoe University, pointed to the fragmented supply structure centered on small-scale institutions as a problem. By 2025, 85.5% of long-term care institutions will be operated by sole proprietors, while corporations will account for 13.2% and local governments for only 1.1%. 75.9% of social service providers have 20 or fewer employees. The number of long-term care facilities increased by 18%, from 24,858 in 2021 to 29,369 in 2025, and and long-term care benefit expenditures rose by 59%, from 11.1 trillion won to 17.7 trillion won.
Professor Kim pointed out that a lack of information sharing and communication among institutions leads to service duplication and gaps, and proposed creating a collaboration-based care ecosystem through initiatives such as consortium-style regional care projects, the establishment of community care centers run by residents, and the creation of care jobs for residents.
The comprehensive discussion, moderated by Kang Hye-kyu, Director of the Korea Central Social Service Agency, included representatives from the Association of Mayors of Cities, Counties, and Districts of Korea; the Hongseong County Public Health Center; the Gangwon Province Integrated Care Task Force; the Korea Self-Sufficiency Welfare Development Institute; and the Seoul Shinmun, who discussed practical implementation strategies.
Park Jae-man, Director of Integrated Care Support at the Ministry of Health and Welfare, stated, “For integrated care to take root on the ground, local governments—which are closest to residents—must take the lead in linking and coordinating local medical and care resources, and this effort must be supported by a foundation that involves the participation of various stakeholders in the local community.” “We will actively support local governments so they can establish delivery systems tailored to local conditions and build a care infrastructure in collaboration with the local community,” he added.
