A Relationship of Care Time with Functional Status and Patients Characteristics among Patients in Long-term Care Hospitals

장기요양환자에서 환자 특징 및 기능상태와 환자돌봄 시간과의 관련성

  • Yi, Jee-Jeon (Graduate School of Public Health, Yonsei University) ;
  • Kim, Jeong-In (Graduate School of Public Health, Yonsei University) ;
  • Yu, Seung-Hm (Department of Preventive Medicine and Public Health, Yonsei University Medical College) ;
  • Yoo, Hyeong-Sik (Department of Health Administration, Kyungbuk College) ;
  • Yi, Sang-Wook (Department of Preventive Medicine and Public Health, Kwandong University Medical College)
  • 이지전 (연세대학교 보건대학원) ;
  • 김정인 (연세대학교 보건대학원) ;
  • 유승흠 (연세대학교 의과대학 예방의학교실) ;
  • 유형식 (경북대학 보건행정과) ;
  • 이상욱 (관동대학교 의과대학 예방의학교실)
  • Published : 2004.09.01

Abstract

Objectives : The aim of this study was to investigate the functional status variables related to the care time of health professionals for patients in long-term care facilities. Methods : The functional stati of 1001 patients in 8 long-term care hospitals were examined by the Resident Assessment Instrument for Long-term Care Facility Version 2.0. The care time of health professionals for patients was calculated using data from a self-reported task survey by nurses, auxiliary nurses, private aides, doctors, physiotherapists and social workers. Results : The average care time per diem was 240.6 minutes. The care time by doctors, nurses and private aides were 11.0, 71.0 and 139.5 minutes, respectively. The lower the function of activities of daily living (ADL) and the greater the symptoms of extensive services, special care and clinical complexity, the more care time was served. On the contrary, the greater the symptoms of nursing rehabilitation, depression, cognitive disorder, behavior problem and psychiatry/mood disorder, the less care time was served. Age and gender were not significantly related to the care time. Conclusions : Developing a case mix classification system for elderly long term care patients may be helpful for both of patients and health care providers. The ADL, extensive services, special care and clinical complexity of variables should be considered in the development of a case mix system for the long term care of patients in Korea.

Keywords

References

  1. Prat JR. Long term care: Managing across the continuum Aspen pilislers. Maryland. 1999
  2. Prie BE, Cooney LM Jr. Resource utilization grcops. A patient classification system for longterm care. Med Care 1985; 23: 110-122 https://doi.org/10.1097/00005650-198502000-00002
  3. Fetter RB, Shin Y, Freeman JL, Averill RF, Thorrpson JD. Case mix definition by diagnosis-related groups. Med Care 1980; 18(2Suppl): 1-53
  4. Shin YS, Lee YS, Park HY, Yeom YK. Development and Evaluation of Korean Diagnosis Related Groups: Medical service utilization of inpatients, Korean J Prev Med 1993; 26: 293-309 (Korean)
  5. Cooney LM Jr.Fries BE. Validation and use of resource utilization groups as a case-mix measure for long-term care. Med Care 1985;23: 123-132 https://doi.org/10.1097/00005650-198502000-00003
  6. Cameron JM. Case-mix and resource use in long-term care. Med Care 1985; 23: 296-309 https://doi.org/10.1097/00005650-198504000-00002
  7. Katz S, Hedrick SC,Henderson NS. The measurement of long-term care needs and impact Health Med Care Serv Rev1979; 2:3-21
  8. Branch LG, Wetle TT, Scherr PA, Cook NR, Evans DA, Hebert LE, Masland EN, Keough ME, Taylor JO, A prospective study of incident cormrehensive medical home care use armng the elderly. Am J Public Health 1988; 78: 255-259
  9. Williams BC, Fries BE, Foley WJ, Schneider D, Gavazzi M. Activities of daily living and costs in nursing homes. Health Care Finane Rev 1994; 15: 117-135
  10. Abrarrs RC, Teresi JA, Butin DN. Depression in nursing home residents. Clin Geriatr Med 1992; 8: 309-322
  11. Mirman DL, Chen Q, Powell MC, Kuo SB, Bradley CJ, Colenda CC. The incremental direct costs associated with behavioral syrrptoms in AD. Neurology 2002; 59: 1721-1729 https://doi.org/10.1001/archneur.59.11.1721
  12. Arai Y,Zant SH, Kurrnmoto K, Takeda A. Are there inequities in the assessment of dementia under Japan's LTC insurance system? Int J Geriatr Psychiatry 2003; 18: 346-352
  13. Yi JJ, Kim SL ,Yu SH, Yi Sw. Study on casemix in long-term care facilities for elderly. Korean J Hosp Manage 2001; 6: 130-147 (Korean)
  14. Kim CW, Moon OR, Lee SY, Yoo JW, Lee SK. AStudy on EstiITlltion of Caring Derrard for Extended Care Facilities by Activities of Daily Living. Korean J Prev Med 1998; 31: 564-578 (Korean)
  15. Yi JJ, Yi SW, Kim JI, Jung HY, Lee JR, Joo SE, Gang MJ, Kim SK, Mun SH, Mun HJ.Development of Reirrmrsement System for Long-Term Care Beds. Minisry of Health and Welare.Kwachon. 2003 (Korean)
  16. Pries BE,Schneider DP, Foley WJ, Gavazzi M, Burke R, Comelius E. Refining a case-mix measure for nursing homes: Resource Utilization Groups (RUG-Ill). Med Care 1994;32(7): 668-685 https://doi.org/10.1097/00005650-199407000-00002
  17. Fries BE, Schneider DP, Foley WJ, Dowling M. Case-mix classification of Medicare residents in skilled nunrsing facilities: resource utilization groups (RUG-T18). Med Care 1989; 27(9): 843-858 https://doi.org/10.1097/00005650-198909000-00001
  18. Kwon SM. Long-term Care Financing and Delivery in Germany. Korean J Res Geronotl 2003; 12: 27-47 (Korean)
  19. Lee YS. A study on the long term care insurance. J Korea Insur Acad Soc 2003; 66: 113-146 (Korean)
  20. Choi SJ, Cha HB, Kim IK, Suh HK. A Comparative Study on Long- Term Care Policy for the Elderly in Korea and Japan. J Korea Gerontol Soc 2000; 20: 143-167 (Korean)
  21. Kang IO. Estimation of nursing home needs in elderly people [dissertation]. Seoul (Korea): Yonsei Ueiv.; 1998 (Korean)
  22. Walers k, Ililfe S,Tai SS, Orrell M. Assessing needs from patient, carer and professional perspectives: the Camberwell Assessment of need for Elderly people inprirrary care. Age Ageing 2000;29: 505-510 https://doi.org/10.1093/ageing/29.6.505
  23. Stinerran MG. Measuring casemx, severity, and corrplexity in geriatric pafents undergoing rehabilitation. Med Care 1997; 35(6 Suppl): JS90-105; discussion JS106-12
  24. Chun SI. Rehabilitation l : Special Issue;Problems of Medical Rehabilitation in Korea. Korean J Nurs Query 1998; 7: 8-26
  25. Centers for Medicare and Medicaid Services. Revised Long-Term Care Resident Assessment Insnurrent User?s Manual Version 2.0 Centers for Medicare and Medicaid Services. Baltimore, Maryland. 2004
  26. Kim HS, Kwon SM, Kim SM. The Effects of Patient and Facility Characteristics On the Resource Use by the Elderly in Long-term Care Services. Korean J Health Policy Admin 2002; 12: 21-53 (Korean) https://doi.org/10.4332/KJHPA.2002.12.1.021
  27. Sugisawa H. Difference in impact of social support on morale and medical utilization between elderly with low activity of daily living and elderly with high activity of daily Zasshi 1993; 40: 171-180 (Japanese)
  28. Paccincani C, Mignolli G, Platt S. Service utilisation, social aipport and psychiatric status in a cohort of patients with schizophrenic psychoses. A 7 year follow-up study. Schizophr Res 1990; 3: 139-146 https://doi.org/10.1016/0920-9964(90)90047-B
  29. Allen JE. Long term care facility resident assessment insuurrent: User's mamal for use with Version 2.0 of HCFA. Springer Publishing Ccrrpany. New York. 1997
  30. Long term care facility. Available from: URL:http://www.interrai.org/instruments/nursing_facility.php Lastly accessed on 28 May 2004
  31. Yi GM, Kim HJ. Depression and anxiety in comnunity dwelling older persons of Korea. J Korea Gerontol Soc 2000; 20: 109-121 (Korean)
  32. KimSM, Bae SS,KimDH, June KJ, KimCY, Yoon JL. Validity of Resident Assessment Instrument-Mininum Data Set Home Care Version in Korea. J Korean Geliatr Soc 2000;4:68-75 (Korean)
  33. Andeoon A. The Guide to the NUrsing Home Industry. Health Care Infbrrration Associates. Maryland. 2001
  34. Kaplan R Ed. Measures for manufacturing excellence. Harvard business school press Massachusetts.1990
  35. Carpenter GI, Ikegami N, Ljunggren G, Carrillo E, Fries BE, RUG-III and resource allccation: comparing the relationship of direct care time with patient characteristics in five countries. Age Ageing 1997; 26 Suppl 2: 61-65