• The Journal of the Korea Contents Association
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• v.17 no.5
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• pp.366-375
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• 2017

The purpose of this study is to analyze the use of hospital, hospitalization, medical service, discharge and power of medical care patients who are concerned about moral hazard. We conducted focus group interview with 3 medical care patients and their families and 5 workers who had worked for more than 4 years in a nursing hospital. The main results and implications are as follows. First, admission to nursing hospitals was mostly based on the linkage between the medical institutions and the competition to attract the patients rather than the choice of the patients. Second, the main cause of the long-term hospitalization of medical assistance patients was the lack of social protection measures such as absences of residence and care giver, although there are factors that cause moral hazard such as low self-pay. Third, most of the patients were in need of treatment, but they were admitted to the hospital even though their needs were not higher than those of the health insurance patients. Fourth, the rehabilitation service is the mainstay of the medical service of the nursing hospital, and the roles of nursing staff and care givers are important. Fifth, medical care patients are paying medical expenses for nursing hospitals due to cost of living and family support, but they are exempted from the hospital expenses or the burden of their own expenses in the hospital. Sixth, public institutions and social welfare institutions have not managed continuously since commissioning patients to nursing hospitals and have neglected the connection with community services after discharge.

• 한국사회정책
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• v.25 no.1
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• pp.125-159
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• 2018

The purpose of this study is to analyze the factors affecting service use intention of long-term care among the disabled. This study conducts a longitudinal study using the modified Andersen model by the disabled age groups of the 50-64 group and the 65 over group. This study examined random effects panel logit analysis for the 50-64 group and the 65 over group by age variations. The results have shown that there are different factors Influencing factors for each specific age group of the disabled(50-64, 65 over). The results were as follows: there are differences of factors between the 50-64 group and the 65 over group. This study found that predisposing factors of the service use intention of long-term care were significantly related to age, residential area, education status, existence of spouses. Enabling factors of the service use intention of long-term care were significantly related to long-term care service recognition, saving, personal salary income level, housing status. Need factors of the service use intention of long-term care were significantly related to chronic diseases, psychological health, IADL. So, there are a need for a policy considerations such as service for the mid-old age disabled by age groups. Finally, implications and future research directions were discussed based on the finding of the study.

• 한국사회정책
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• v.25 no.1
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• pp.287-320
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• 2018

This study aimed to analyze the characteristics and problems of the quasi-market for welfare technology in the long-term care service area in South Korea. The qualitative interviews to the developers of welfare technology were conducted. The main results are as follows. First, the long-term care insurance (LTC) in South Korea has helped to create the limited amount of the effective demands for welfare equipments with low technology. Second, the systemic features of the LTC, however, have constraint the quantitative expansion as well as qualitative growth of the quasi-market for welfare technology. The low level of financial support combined with strict regulations has obstructed qualitative competition in the market. Third, they tend to develop the standardized and minimum welfare equipments for the serious needy for long-term care instead of welfare technology promoting independency of the elderly. Based on the results, this study provided the predictions for the growth of welfare technology and suggested some policy implications.

• The Journal of the Korea Contents Association
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• v.18 no.11
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• pp.581-593
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• 2018

The purpose of this study is to examine the effect of the medical service quality of the nursing hospital on the inpatients' satisfaction, reuse intention and to verify the mediating effect of the inpatients' satisfaction. The subjects of this study were 255 male and female inpatients in Hiroshima in Japan. The collected data were used as a model of path coefficients obtained through analysis of covariance structure and hypothesis test. As a result of verification, level of medical team and medical service, reception, facility and fee of the medical service quality of the nursing hospital perceived by the inpatients showed a statistically significant positive correlation with the inpatients' satisfaction. The inpatients' satisfaction showed a statistically significant positive correlation with their reuse intention. The level of medical team and medical service, reception, facility and fee of the medical service quality of the nursing hospital perceived by the inpatients shows a statistically no significant positive correlation with the reuse intention. But, they show a statistically significant positive correlation with the reuse intention with the mediating effect of the inpatients' satisfaction. Finally, the result of this study is to confirm the effect of the medical service quality on the inpatients' satisfaction, reuse intention of the nursing hospital. In this process, it is meaningful to verify the role and function of medical service quality of the nursing hospital.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.2
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• pp.250-258
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• 2019

The purpose of this study is to investigate the work environment of nurses in long-term carer hospitals and to help in their work environment improvement through these results. A cross-sectional survey was conducted. A convenience sample of 179 subjects including staff nurses and nurse managers over head nurses working in long-term care hospitals located in Gwangju city were recruited. The data were collected from July to December 2015. A structured questionnaires were used as a study instrument, and included questions regarding subjects' general characteristics, hospital-related characteristics, and work environment. All statistical analyses were performed using SPSS ver. 22.0. The results showed that 73.2% of subjects were working in hospitals established by individuals. The most of long-term care hospitals accepted accreditation program. The ratio of nurses to nurse aiders of was 1:2. The numbers of off duty was 8 days, and average annual salary was 2,500~3,000 ten thousand won in nurses of long-term care hospitals. Based on these results, work environment of nurses of long-term care hospitals was not good. Therefore, the results suggest qualitative research to investigate deeply how to recognize on work environment like this for nurses of long-term care hospitals.

• 한국사회정책
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• v.25 no.1
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• pp.99-123
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• 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.

• 한국사회정책
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• v.24 no.1
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• pp.67-95
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• 2017

This study compared policies of elderly abuse of long-term care facilities on WHO, Main countries for improvement of Korean policy. So, This study reviewed policies of elderly abuse of long-term care facilities on WHO, Main countries. So, This study reviewed risk factors that may increase the potential for abuse of an older person can be identified at individual level, care-woker levels, socio-cultural levels and facilities levels. The results of the study were as follows: First, The openness of long-term care facilities are emphasized on many countries. There are a need for a policy considerations such as policies of Ombudsman, Adult guardianship for visiting facilities, external monitoring. Second, There was a difference of facilities infrastructure and workers of treatment condition long-term care facilities each other countries. So It is important to improve facilities infrastructure and workers of treatment condition. Third, It is necessary to consider traits of elderly in long-term care facilities. Especially, it is required to manage dementia elderly and elderly on night time in long-term care facilities. Finally, implications and future directions of policies of elderly abuse of long-term care facilities were discussed based on the finding of the study.

• Journal of the Korea Convergence Society
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• v.12 no.7
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• pp.273-282
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• 2021

Nursing home plays a role in providing elderly care in the context of China's rapid population aging, but little understanding of the efficiency of the nursing homes. In this paper, we investigated the efficiency in nursing homes using Data Envelopment Analysis (DEA) and Malmquist index (MPI) for the modeling of the number of nursing home beds, fixed assets, and medical personnel as input variables, and the number of elderly people of self-care, the number of elderly people of partial self-care, the number of bed-ridden elderly people and the income of nursing homes as output variables. Stratification analysis showed that the top two provinces in the DEA-CCR yield were Beijing and Shanghai in the five-year survey period. Four provinces (Beijing, Jiangsu, Shandong, and Shanghai) scored 1.00 in terms of DEA-BCC yield. The MPI analysis showed that Hainan ranked the highest five-year average in the included provinces. In terms of resource utilization, internal management, operation scale, and other aspects, the nursing homes in the provinces with high-efficiency evaluation results show high efficiency and technological progress, whereas the areas with low-efficiency evaluation showed a feature of the improving technical efficiency.

• 한국노년학
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• v.31 no.4
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• pp.999-1014
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• 2011

The purpose of this study is to examine the effects of long-term care insurance(macro-system) on family relationship(micro-system)s' change based on ecosystems theory. Data come from the second(2007) and the fourth(2009) Korean Welfare Panel Study(KWPS). Experimental group is the beneficiary using long-term care insurance and the member of household in their households, and control group is the non-beneficiary not using long-term care insurance and the member of household in their households. The main findings of difference-in-difference model analysis are as follows. First, the ecosystems theory is a theory examining the correlation between long-term care insurance and family relationship. Second, the effects of long-term care insurance is not income effect but independent effect. This result shows that the meaning of family has faded away and family relationship has been weaken and that long-term care insurance has not complete characteristics as a social insurance. Thus, system reforms of long-term care insurance is highly needed for system comprehensiveness, coverage, adequacy, and service accessibility and is changed into family-friendly social policy.

• Research in Community and Public Health Nursing
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• v.19 no.2
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• pp.196-204
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• 2008

Purpose: To examine factors affecting long-term care hospital patients' intention of transfer to a nursing home. Method: A questionnaire survey was conducted in Aug. 2007 that included 655 patients from 49 long-term care hospitals. The survey aimed to assess the patients' health status, family status, cost and intention of transfer to a nursing home. Institutional characteristics were analyzed from the nationwide database of Health Insurance Review & Assessment Service. The affecting factors were examined by employing chi-square test and logistic regression using SAS 8.2. Result: Of the subjects, 32.4% had intention of transfer to a nursing home. The intention of transfer to a nursing home was affected by moderate or severe pain, living together with the primary carer, high cost uncovered by insurance, and recognition of nursing home. Conclusion; For appropriate service utilization. a higher level of care is needed to satisfy patients at nursing homes and a balanced fee schedule is needed between long term care hospitals and nursing homes. It is desirable to encourage transfer to a nursing home at which nurses support patients and their families by giving information, coordination, and to make efforts to establish a reference system.