• The Journal of the Korea Contents Association
• /
• v.18 no.1
• /
• pp.76-89
• /
• 2018

The purpose of this study is to analyze factors affecting a grade maintenance of long-term care service users. Using 2008-2014 long-term care raw data of National Health Insurance Service(NHIS), the predictors were examined through the logistic regression by long-term care beneficiaries of grade. The results showed that there are differences by 3 factor groups and grade groups(1-3 grade). In socio-demographic factors, in the 1, 3 grade, Individuals 64 or younger presented a much higher probabilities of the grade maintenance than those 85 and over. In the 3 grade, people of living alone, resident of rural area presented a much higher probabilities of the grade maintenance than others. In disease factors, In the 1 grade, people with dementia presented a much higher probabilities of the grade maintenance than other 2, 3grades. In the 2 grade, people with stroke, fracture presented a much higher probabilities of the grade maintenance than others. In the 3 grade, people with cancer presented a much higher probabilities of the grade maintenance than others. In service factors, In the 2, 3grade, people having more renewal numbers presented a much higher probabilities of the grade maintenance than others. In the 1 grade, people who use facility benefits for more days presented a much higher probabilities of the grade maintenance than others. In the 2 grade, people who use in-home benefits for more days presented a much higher probabilities of the grade maintenance than others. Based on the finding of study, implications and future research directions were discussed for policy considerations.

• Asia-pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology
• /
• v.9 no.5
• /
• pp.781-791
• /
• 2019

The purpose of this study was to evaluate the evaluation of long - term care institutions (evaluation rating, evaluation rating, suitability of evaluation index), quality of service of caregivers, Quality satisfaction, life satisfaction, and facility choice. After receiving the IRB, in January and February of 2018, the survey was completed for 79 long-term care institution managers, 381 nursing care workers, and 381 elderly people. The survey carried out an allocation sample reflecting the 2015 long - term care (facility benefit) evaluation results. The results of this study are as follows. First, it is found that the institutional evaluation (evaluation level, change of evaluation level, recognition of suitability of the index) has a greater impact on the quality of life of the elderly, appear. However, the intention of reselecting the facility after discharge was more influenced by the quality of services of caregivers. Therefore, except for the intention to reschedule the facility, it can be said that the evaluation of the National Health Insurance Corporation was partially validated.

• 한국사회정책
• /
• v.25 no.1
• /
• pp.99-123
• /
• 2018

Purpose: This study empirically investigates the utilization and expenditure of health care and long-term care at the last year of life for long-term care beneficiaries in Korea. Methods: This study used National Health Insurance and Long-term Care Insurance claims data of 271,474 LTCI beneficiaries, who died from July 2008 to December 2012. Their cause of death, place of death, health care costs, and the provision of aggressive care were analyzed. Results: Cardio-vascular disease(29.8%) and cancer(15.3%) were reported as their major cause of death, and hospital(64.4%), home(22.0%), social care facility(9.2%) were analyzed as the place of death. 99.3% of subjects used both health care and long-term care during the last 1 year of life. The average survival period were 516.2 days after they were LTCI beneficiaries. The health care expenditure gradually increased near the death, and the last month were three times more rather than the first month. Furthermore, 31.8% experienced some aggressive cares(CPR, blood transfusion, hemo-dialysis, etc.) at the last month of life. Conclusion: The results of this study suggest that it is important to develop the end of life care policies(for example, hospice, advanced care directives) for the LTCI beneficiaries. They might contribute to the improvement of quality of life and the reduction of health care expenditure of the elderly at the end-of-life.

• 한국노년학
• /
• v.29 no.1
• /
• pp.149-175
• /
• 2009

The purpose of this research is to analyze the overall problems at the moment of October 2008, and then to find the improvements of home-help services of the Long-Term Care Insurance(LTCI), which has been revealed many problems since it was released in July 2008. The research uses the literature survey which analyzes 2nd-hand materials studied by other people already, and survey research was executed from active social workers in the area of LTCI. Based on the policy analysis framework of Gilbert and Specht, all the data are analyzed in the scopes of client·benefit(service)·finance·transferring system. This research has found the problems in each scope of home-help services of the LTCI. Firstly, the client system has some problems in mismatching between registered and service clients, estimating client number, and judging service levels. Secondly, the service system reveals deficiency in professionality of social workers, service quality lowering by loose qualification criteria on workers, non-reasonable limitation of service time available, and the same fare system applied to visiting-help service in spite of different levels. Thirdly, in financing system, clients need to pay additional money to get extra services such as meal, hair cutting, bathing etc., due to government financial support stopped, some organizations have to reduce services and replace full-time workers to part-time ones, which makes the service quality worse. Lastly, in the transferring system, the management system for service quality is not well prepared. There are too much competion because of allowing too many home-help service organizations and care worker academies. The suggestions that this research has found to improve the policy are as follows. ① It is desirable to make the registered clients the service ones as many as possible in the long term perspective. ② The LTCI organization requires more workers and higher professionality. ③ Many elderly people who are not eligible now require connection system to be more served. ④ Management system and service manual for care worker are to be developed. ⑤ Laws related to the service contents and process should be modified, the proportion of client charge needs to adjust. ⑥ Home-help service organization licensed by the LTCI needs to be financially supported publicly. ⑦ Monitoring system to home-help service organization needs to be strengthened. ⑧ Evaluation tools to home-help service organization and workers is required. ⑨ Specification to open the home-help service organization needs to be more strict.

• Journal of Korea Ship Safrty Technology Authority
• /
• s.32
• /
• pp.46-56
• /
• 2012

해양사고 예방 또는 해양사고 시 2차 피해 감소를 위한 관점에서 안전수역, 안전항구 및 최적 수리장소의 제공 또는 제공되는 장소까지 안전한 수로의 안내는 해양선진국으로 갖추어야 할 핵심 해사안전 서비스의 하나로 볼 수 있다. Erika호 해양사고와 같은 중대사고로 큰 손해를 겪은 국제사회는 피난처의 중요성을 깨닫고 여러 해를 거친 검토 끝에 피난처의 제공목적, 선장과 구조자의 책임지침 등을 담은 IMO Res. A.949(23) 및 A.950(23)과 같은 피난처 관련 지침을 제정하게 되었다. 이 지침을 바탕으로 덴마크, 미국, 캐나다, 남아프리카에서는 MAS 체제, 잠재적 피난처(PPOR, Potential Places of Refuge), 국가비상계획 포함 등의 방법으로 피난처를 지정하여 활용하고 있었다. 위의 요소들을 고려할 때, 우리나라 연안을 통항하는 선박들에 대한 최적의 피난처를 지정하기 위해서 연안해역 및 항만의 자연환경, 해상 및 기상조건, 과거 해양사고통계 및 분석자료, 항적도 및 교통량 등 해상교통환경의 평가를 위한 기초자료가 수집되어야 한다.

• 한국노년학
• /
• v.31 no.4
• /
• pp.871-884
• /
• 2011

Standard Long-term care(LTC) Utilization Plan is a kind of care plan, which aims to help beneficiaries and their family choose services to meet their care needs. The objective of this study is to determine the relationships among family caregivers' perceived quality, overall satisfaction and utilization in Standard LTC Utilization Plan. Data were gathered from family caregivers with beneficiaries who have used community service in long-term care insurance system. A national cross-sectional descriptive survey was conducted in December 2008, using proportionate quota sampling. Finally, 351 family caregivers completed questionnaires which included demographic characteristics, perceived quality(9 items), overall satisfaction(1 item) and utilization(2 items). Path analysis was conducted to find a causal relationship. This study shows firstly, the quality of Standard LTC Utilization Plan was categorized into three dimensions, that is, assessment of care needs, recommended care plan, and management of monthly benefits. Secondly, reliability and validity of quality items were satisfied. Finally, in the effect of perceived quality and satisfaction for utilization, assessment of care needs(indirect effect, path coefficients=0.077) and overall satisfaction(total effect, path coefficients=0.324) were statistically significant. The findings of this study would be helpful in developing the strategies, which is needed to improve the role of Standard LTC Utilization Plan.

• Fire Science and Engineering
• /
• v.29 no.5
• /
• pp.96-103
• /
• 2015

This study investigates the socio-economic and clinical characteristics associated with emergency medical transport use by the elderly based on 2008~2011 Korea Health Panel data. A model of emergency medical transport use was analyzed, and the results indicate that use of 119 ambulances and private ambulances by the elderly accounted for 46.8% of all users, and 35.1% of their emergency room visits. Statistically significant factors associated with emergency medical transport use were gender (OR = 2.19, 95% CI = 1.51-3.17), relationship to household (OR = 2.19, 95% CI = 1.45-3.32), insurance type (OR = 1.41, 95% CI = 1.10-1.82), handicap (OR = 1.44, 95% CI = 1.14-1.83), reason for emergency department visits (OR = 1.53, 95% CI = 1.20-1.97), and treatment after emergency medical service completed (OR = 3.45, 95% CI = 2.80-4.25). The increased elderly population in an aging society will lead to a surge in demand for emergency patient transport services, and emergency medical services that are tailored to the elderly need to be developed accordingly.

• Korean Journal of Schizophrenia Research
• /
• v.23 no.1
• /
• pp.38-44
• /
• 2020

Objectives: Dehospitalization of long-term inpatients with schizophrenia can be difficult because of complex factors such as chronic symptoms and low family and social support. The aim of this study was to identify factors related to dehospitalization and readmission of long-term inpatients with schizophrenia. Methods: This retrospective study reviewed the medical records of patients discharged from a psychiatric hospital in Yongin, South Korea, from February 1, 2016, to July 31, 2017. Patients who were hospitalized for over 3 months were divided into two groups: readmission (n=47) and dehospitalization (n=55). Differences in sociodemographic and clinical factors were analyzed between the two groups. Results: Regarding sociodemographic characteristics, female sex, familylessness, discharge to nursing homes, and discharge after symptom improvement were more prevalent in the dehospitalization group, whereas male sex, having a sibling as next of kin, and discharge because of other problems were more prevalent in the readmission group. Among clinical characteristics, hospital stay was longer in the readmission group. Conclusion: In this study, patients without a family showed a tendency to not be readmitted when they were discharged to nursing homes after symptom improvement. Expansion of social welfare support may encourage dehospitalization of long-term inpatients with schizophrenia.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.19 no.4
• /
• pp.203-210
• /
• 2018

The UK is famous for being the first country in Europe to adopt the policies of marketisation regarding social welfare. Numerous other countries, including social democratic countries, have followed suit, and South Korea has also adopted the marketisation of care through the introduction of long-term care insurance. The aim of this study is to examine recent reforms concerning adult social care market in the UK, and to determine policy recommendations to further develop the Korean long-term care insurance market. Findings show that the UK has actively regulated and managed the care market. In particular, after the sudden bankruptcy of nursing homes, the CQC systematically analyzes the risks of bankruptcy of big service providers in terms of financial conditions and quality of services according to the six steps detailed in the Care Act 2014. If some service providers experience high levels of risk, the CQC reports results to local authorities in order to manage the risk of bankruptcy of these service providers. Such reforms in the UK suggest a number of policy measures for South Korea in which the problems of long-term care market are prevalent, including increased system management, introduction of a new inspection system, the expansion of public-based inspection organizations, and disclosure of information by the National Health Insurance Corporation.

• Journal of dental hygiene science
• /
• v.17 no.4
• /
• pp.375-381
• /
• 2017

The study aimed to investigate the effects of differences between personal income and social deprivation on the association between cardio-cerebrovascular disease (hypertension, stroke) and periodontal disease. This study used 12 years of cohort data from the Korea National Health Insurance Service covering the years 2002 to 2013. Among the patients aged more than 40 years who had received treatment for periodontal disease 224,067 and 284,730 who had not received treatment for hypertension and stroke, respectively, were included in the analysis. The Kaplan-Meier analysis revealed differences in the rate of treatment for cardio-cerebrovascular disease (hypertension, stroke) according to regional differences, the rate of treatment increased as the composite deprivation index value increased. The difference in treatment rates for cardio-cerebrovascular disease (hypertension, stroke) according to income was found to be higher in the treatment group with low income. This study empirically proved that the association between systemic disease and periodontal disease varies depending on personal income and the regional socioeconomic deprivation level. This shows that the clinical influence of periodontal illness on systemic disease differs according to the personal socio-demographic characteristic and residential area and that an individual's characteristic (income and the regional) needs to be considered along with the patient's clinical intervention in the disease treatment process.