DOI QR코드

DOI QR Code

Effects of Visiting Nursing Services in Long-term Care Insurance on Utilization of Health Care

노인장기요양보험의 방문간호 서비스가 의료이용에 미치는 효과

  • Received : 2016.06.22
  • Accepted : 2016.09.12
  • Published : 2016.09.30

Abstract

Purpose: This is a comparative study using secondary data from the Korean national long term care (LTC) insurance. Methods: Visiting nursing (VN) service users (n=666) and non-users (n=4,375) were extracted and compared in terms of medical expenditures, length of hospitalization, and annual number of ambulatory care visits to investigate effects of VN services in LTC. Results: Total health care expenditures were compared between the two groups and it was found that VN service users spent about $ 1700 than non-users for their medical costs between 2009 and 2011. The average length of in-hospital stay for VN service users was 19.4 days shorter than that of non-users. However, using VN services did not significantly influence the annual number of ambulatory care visits. Conclusion: The study has found that VN services are effective ways of providing community-based LTC services. We recommend LTC policy makers to further utilize VN services to deliver cost effective health care services.

Keywords

References

  1. Kim JS, Shin HR. The Coordination between the long-term care service and health service. Journal of Welfare for the Aged. 2015;67:83-105.
  2. Kim MH, Kwon SM, Kim HS. The effect of long-term care utilization on health Care utilization of the elderly. The Korean Journal of Health Economics and Policy. 2013;19(3):1-22.
  3. Long-term Care Insurance Corporation. Introduction of policy [Internet]. Seoul: National Health Insurance Corporation. 2013 [cited 2016 May 2]. Available from: http://longtermcare.or.kr/portal/site/nydev/MENUITEM_LTCARE/
  4. Lee HY, Moon YP. The effect of long-term care utilization on health care utilization of the elderly. The Korean Journal of Health Economics and Policy. 2015;21(3):81-102.
  5. Kim JS, Sun WD, Lee GJ, Choi ID, Lee HY, Kim KA. Study establish the role of hospitals and nursing care facilities-Focusing on the linkage scheme-. Research Report. Seoul: Korea Institute for Health and Social Affairs; 2013 December. Report No.: 2013-31-18.
  6. Sun WD. Installation analysis and policy implications of the elderly long-term care facilities [Internet]. Sejong: Korea Institute for Health and Social Affairs. 2015 [cited 2016 May 10]. Available from:http://www.kihasa.re.kr/web/publication/periodical/issue /list.do
  7. Elkan R, Kendrick D, Dewey M, Hewitt M, Robinson J, Blair M, et al. Effectiveness of home based support for older people:Systematic review and meta-analysis. BMJ. 2001;323(7315):719-725. https://doi.org/10.1136/bmj.323.7315.719
  8. Oyama Y, Tamiya N, Kashiwagi M, Sato M, Ohwaki K, Yano E. Factors that allow elderly individuals to stay at home with their families using the Japanese long-term care insurance system. Geriatrics & Gerontology International. 2013;13(3):764-773. http://dx.doi.org/10.1111/ggi.12002
  9. Fortinsky RH, Madigan EA, Sheehan TJ, Tullai-McGuinness S, Fenster JR. Risk factors for hospitalization among Medicare home care patients. Western Journal of Nursing Research. 2006;28(8):902-917. http://dx.doi.org/10.1177/ 0193945906286810
  10. Hastings SN, Heflin MT. A systematic review of interventions to improve outcomes for elders discharged from the emergency department. Academic Emergency Medicine. 2005;12(10):978-986. https://doi.org/10.1111/j.1553-2712.2005.tb00810.x
  11. Chung YS. A study on home visiting nursing care and medical care utilization in the elderly patients with long-term care [dissertation]. [Gimhae]: Inje University; 2012. 103 p.
  12. Kang SB, Kim HS. The relationship between home-visit nursing services and health care utilization among nursing service recommended beneficiaries of the public long-term care insurance. Health Policy and Management. 2014;24(3):283-290. http://dx.doi.org/10.4332/KJHPA.2014.24.3.283
  13. Kown JH, Han EJ, Lee JS. Long-term care services payroll management improvement. Research Report. Seoul: National Health Insurance Corporation; 2009 December. Report No.:2009-33.
  14. Jung WS, Yim ES. The effect on health care utilization of the non-use of beneficiaries of long-term care insurance servicearound of geriatric hospital's medical cost-. Journal of the Korea Academia-Industrial Cooperation Society. 2015;16(11):7463-7473. http://dx.doi.org/10.5762/KAIS.2015.16.11.7463
  15. Jung WS. Effect of long-term care utilization on health care utilization of the medicaid elderly. Journal of the Korea Academia-Industrial Cooperation Society. 2014;15(11):6746-6755. http://dx.doi.org/10.5762/KAIS.2014.15.11.6746
  16. Kuk KN, Kim RE, Lim SJ, Park CY, Kim JY, Chung WJ. Factors associated with the non-use of beneficiaries of long-term care insurance service: The case of Jeollanam-do province. Health Policy and Management. 2014;24(4):349-356. http://dx.doi.org/10.4332/KJHPA.2014.24.4.349
  17. Jeon JG. Changes in medical fee and utilization of services before and after the introduction of the long-term health insurance for the elderly: Focused on demographic, sociologic and physical characteristics [master's thesis]. [Seoul]: Yonsei University;2010. 76 p.
  18. Lichtenberg FR. Is home health care a substitute for hospital care?. Home Health Care Services Quarterly. 2012;31(1):84-109. http://dx.doi.org/ 10.1080/01621424.2011.644497
  19. Tomita N, Yoshimura K, Ikegami N. Impact of home and community based services on hospitalization and institutionalization among individuals eligible for long-term care insurance in Japan. BMC Health Services Research. 2010;10:1-13. http://dx.doi.org/10.1186/1472-6963-10-345
  20. Teng YH, Teng JJ, Lee MY, Hsieh MH, Chen YJ, Lin JY, et al. Determinants of emergency medical utilization among the elderly population in Taiwan: A national longitudinal cohort study. Archives of Gerontology and Geriatrics. 2013;56(2):364-369. http://dx.doi.org/10.1016/j.archger.2012.10.012
  21. Park JH, Choi ID, Kwon JH, Kang IO, Lee EM. Home services activation plan through the use of long-term care benefit behavior analysis. Seoul: National Health Insurance Corporation;2009 December. Report No.: 2009-30.
  22. Ikegami N. Impact of public long-term care insurance in Japan. Geriatrics and Gerontology International. 2004;4(s1):S146-S148. http://dx.doi.org/10.1111/j.1447-0594.2004.00182.x.
  23. Neufeld E, Hirdes JP, Perlman CM, Rabinowitz T. Risk and protective factors associated with intentional self-harm among older community-residing home care clients in Ontario, Canada. International Journal of Geriatric Psychiatry. 2015;30(10):1032-1040. http://dx.doi.org/10.1002/gps.4259
  24. Tanuseputro P, Chalifoux M, Bennett C, Gruneir A, Bronskill SE, Walker P, et al. Hospitalization and mortality rates in long-term care facilities: Does for-profit status matter?. Journal of the American Medical Directors Association. 2015;16(10):874-883. http://dx.doi.org/10.1016/j.jamda.2015.06.004.
  25. Byeon DH, Hyun HJ. Importance and performance of visiting nurse services provided under the long term care insurance system for the elderly. Journal of Korean Academy Community Health Nursing. 2013;24(3):332-345. http://dx.doi.org/10.12799/jkachn.2013.24.3.332
  26. Chin YR, Hong WL. Changes on hospital-based home care services utilization after long-term care insurance launch. Journal of the Korean Gerontological Society. 2011;31(2):371-380.
  27. Lee JS, Han EJ, Kang IO. The characteristics and service utilization of home nursing care beneficiaries under the korean long term care insurance. Journal of Korean Academy Community Health Nursing. 2011;22(1):33-44. https://doi.org/10.12799/jkachn.2011.22.1.33
  28. Park JY, Lee YH, Kwon JH, Lee EM, Lee HY, Kim YH. Development of integrated care model for LTC and medical service. Development Report. Seoul: National Health Insurance Corporation;2010 October. Report No.: 2010-18.

Cited by

  1. 뇌졸중 이환 노인의 일상생활수행능력 변화에 미치는 영향: 장기요양 재가 서비스와 시설 서비스를 중심으로 vol.27, pp.4, 2016, https://doi.org/10.12799/jkachn.2016.27.4.388
  2. 뇌졸중 이환 노인의 일상생활수행능력 변화에 미치는 영향: 장기요양 재가 서비스와 시설 서비스를 중심으로 vol.27, pp.4, 2016, https://doi.org/10.12799/jkachn.2016.27.4.388
  3. A Phenomenological Study on the Fall Experience of the Korean Elderly Living Alone vol.18, pp.1, 2016, https://doi.org/10.22284/qr.2017.18.1.66
  4. Effects of home-visit nursing services on hospitalization in the elderly with pressure ulcers: a longitudinal study vol.27, pp.5, 2016, https://doi.org/10.1093/eurpub/ckx110
  5. 재활병동 간호사의 재활간호 직무수행도, 위임, 직무중요도 및 교육요구도 vol.20, pp.2, 2017, https://doi.org/10.7587/kjrehn.2017.79
  6. Association between Unmet Healthcare Needs and Unmet Long-term Care Needs among the Korean Elderly vol.38, pp.4, 2016, https://doi.org/10.15709/hswr.2018.38.4.40
  7. Demand and willing to pay for oral hygiene service in long-term care insurance of elderly vol.42, pp.4, 2018, https://doi.org/10.11149/jkaoh.2018.42.4.204
  8. The Level of Performance, Frequency and Educational Needs of Nursing Activities in Long-term Care Hospital vol.21, pp.2, 2016, https://doi.org/10.7587/kjrehn.2018.110
  9. 우리나라 가정방문간호의 현황과 향후 과제 vol.44, pp.1, 2019, https://doi.org/10.5393/jamch.2019.44.1.028
  10. 재가장기요양기관 방문간호사의 간호 경험 vol.19, pp.11, 2016, https://doi.org/10.5392/jkca.2019.19.11.603
  11. 노인장기요양 방문간호 현황 및 추이 vol.25, pp.2, 2016, https://doi.org/10.14370/jewnr.2019.25.2.157
  12. 노인장기요양보험 방문간호사의 재직의도에 영향을 미치는 요인 : 전문직업성, 직무만족도, 회복탄력성을 중심으로 vol.20, pp.12, 2019, https://doi.org/10.5762/kais.2019.20.12.322
  13. 노인장기요양인력 확보 방안: 간호사와 간호조무사 중심으로 vol.27, pp.1, 2020, https://doi.org/10.22705/jkashcn.2020.27.1.64
  14. Critical Thinking Disposition, Job Competency, and Educational Needs of Home Visiting Nurses in the Long-term Care Insurance vol.23, pp.1, 2016, https://doi.org/10.17079/jkgn.2021.23.1.54
  15. Examination of the Educational Needs of Home Visit Nurses: A Cross-Sectional Descriptive Study vol.18, pp.5, 2016, https://doi.org/10.3390/ijerph18052319
  16. A Study on the Status of Application of Health Insurance Fees for Nursing Activities of Nurses in Rehabilitation Unit vol.24, pp.1, 2021, https://doi.org/10.7587/kjrehn.2021.1
  17. 농어촌 지역의 대상자 중심 통합방문형 간호서비스 모형 개발 vol.35, pp.1, 2016, https://doi.org/10.5932/jkphn.2021.35.1.5