• Health Policy and Management
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• v.34 no.3
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• pp.249-260
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• 2024

Background: The Republic of Korea's aging population escalates medical and long-term care costs. While prior research has suggested that long-term care might reduce these costs, these studies had limitations in their subjects and duration, making it difficult to generalize the results. This study aims to evaluate cost changes between the long-term care group and the general older adults group after addressing these limitations. Methods: A cohort was derived from the 2015 national population using stratified sampling. Subsequently, 15,114 individuals (7,557 in each group) were identified through 1:1 propensity score matching. The study employed a difference-in-differences analysis to explore variances in medical costs and long-term care benefits post-utilization of long-term care services. Results: Compared to the general older adults group, the long-term care group experienced a reduction in monthly per capita total medical costs by 56,459 Korean won (KRW). Although costs at tertiary and general hospitals increased, those related to long-term care hospitals decreased by 90,687 KRW. Including long-term care benefits, overall expenditures increased by 948,038 KRW. Conclusion: The analysis reveals that the long-term care group faces higher medical costs in acute care than the general older adults group, emphasizing a greater need for medical services within this group. To meet the increasing medical demands of the long-term care group, a collaborative strategy linking community resources, healthcare, and long-term care facilities is imperative. Additionally, developing and implementing preventive health habit management strategies for middle-aged and older adults is essential to diminish the future requirement for long-term care.

• Journal of the Korean hospital association
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• v.37 no.5
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• pp.100-104
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• 2008

• The Korean Journal of Applied Statistics
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• v.27 no.5
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• pp.667-679
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• 2014

National Health Insurance Service(NHIS) provide care-plans for beneficiaries in the long-term care insurance(LTCI) systems that help them use LTC services appropriately. The care-plan includes recommendations for the most adequate type of care (gold standard) for beneficiaries. This study develops a decision-support system to determine the appropriate type of care plan. To develop a model, we used a data set that well-trained assessors in the NHIS investigated as a gold standard for beneficiaries: nursing home care, home-visit care, home-visit bathing, home-visit nursing, or day and night care. The decision-support system was established through a decision-tree model, because it may be easy to explain the algorithm of a decision-support system to working groups and policy makers. Our results might be useful in evidence-based care planning in an LTCI system and contribute to the efficient use of LTC services.

• Journal of Internet of Things and Convergence
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• v.8 no.2
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• pp.13-24
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• 2022

In order to explore the context of fraudulent claims and the measures for preventing them targeting the long-term care institutions for the elderly, which is increasing every year in Korea, this study conducted the text mining analysis using the media report articles. The media report articles were collected from the news big data analysis system called 'BIG KINDS' for about 15 years from July 2008 when the Long-Term Care Insurance for the Elderly took effect, to February 28^th 2022. During this period of time, total 2,627 articles were collected under keywords like 'elderly care+fraudulent claims' and 'long-term care+fraudulent claims', and among them, total 946 articles were selected after excluding overlapped articles. In the results of the text mining analysis in this study, first, the top 10 keywords mentioned in the highest frequency in every section(July 1^st 2008-February 28^th 2022) were shown in the order of long-term care institution for the elderly, fraudulent claims, National Health Insurance Service, Long-Term Care Insurance for the Elderly, long-term care benefits(expenses), elderly care facilities, The Ministry of Health & Welfare, the elderly, report, and reward(payment). Second, in the results of the N-gram analysis, they were shown in the order of long-term care benefits(expenses) and fraudulent claims, fraudulent claims and long-care institution for the elderly, falsehood and fraudulent claims, report and reward(payment), and long-term care institution for the elderly and report. Third, the analysis of TF-IDF was similar to the results of the frequency analysis while the rankings of report, reward(payment), and increase moved up. Based on such results of the analysis above, this study presented the future direction for the prevention of fraudulent claims of long-term care institutions for the elderly.

• 한국노년학
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• v.31 no.2
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• pp.259-276
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• 2011

If frail elderly could use home care services adequately, quality of their life might improve and their costs of service would be decreased. The purpose of this study is to examine the factors on institutionalization of elderly using home care services in Korean long-term care insurance system. This study used the data of '2009 satisfaction survey of Korean long-term care system'. The survey proceeded using sampling data by region, level of long-term care need, and insurance type among beneficiaries from August 2009 to September 2010. The onset dates of institutionalization of 1,230 participants were ascertained from long-term care insurance claim data. This study calculated hazard ratio through Cox Proportional Hazard Model. The results showed that if elderly using home care services suffer a fracture, the hazard ratio of institutionalization is higher significantly. Although not significant, if older persons have more items of damaged cognitive functions, the hazard ratio of institutionalization is higher. The results have policy implications to supplement of home care service system and postpone institutionalization of elderly.

• Journal of the Korea Society of Computer and Information
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• v.20 no.6
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• pp.141-150
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• 2015

The aim of this study is to analysis the efficiency of the Long-term Care facilities as well as make counterproposals to conduct of efficient management for the Long-term Care facilities. The data of professionals states of Long-term Care facilities and wages state of Long-term Care facilities from regions in 2014. To analyse the data, the number of professionals and facilities are an input variable whereas the size of number and wages are the output variables. The results showed as below. First, according to the CCR test, Kangwon, Gyeonggi, GyeongNam, Deajeon, Seoul, Ulsan, Incheon, Jeju, and Chong Buk showed significance, but Daegu and Busan showed no significance. Second, the BCC result showed that Kangwon, Gyeonggi, GyeongNam, Deajeon, Seoul, Ulsan, Incheon, Jeju, and Chong Buk has efficiency whereas Daegu and Busan has no efficiency. The result of excess efficieincy analysis confirmed 133.5% in Jeju as the highest area, 37.54% of the highest efficiency of the care provider, and 28.61% of imporvable possibility with doctor's number. The realization of increasing numbers, the ensure of the doctor's number, and consolidating of the care provider's the espertise are required for the future.

• The Korean Journal of Applied Statistics
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• v.28 no.6
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• pp.1063-1073
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• 2015

In the long-term care insurance (LTCI) system, National Health Insurance Service (NHIS) provide counseling services for beneficiaries and their family caregivers, which help them use LTC services appropriately. The purpose of this study was to develop a Target Selection Model for the Counseling Services based on needs of beneficiaries and their family caregivers. To develope models, we used data set of total 2,000 beneficiaries and family caregivers who have used the long-term care services in their home in March 2013 and completed questionnaires. The Target Selection Model was established through various data-mining models such as logistic regression, gradient boosting, Lasso, decision-tree model, Ensemble, and Neural network. Lasso model was selected as the final model because of the stability, high performance and availability. Our results might improve the satisfaction and the efficiency for the NHIS counseling services.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.12
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• pp.5816-5825
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• 2012

As the society has been ageing, senile dementia increase rapidly. Thus social costs of dementia treatment and management increase exceedingly. There is a desperate need of finding out improvements.. For example, foreign countries come with the solutions about this issue by establishing national strategy about Dementia, setting effective Dementia Management in national level and preparing legal systems. Older Welfare Act, Long Term Care Insurance Act for the Aged and Dementia Management Act exist as legal system of improvements. Improvement about this issue is needed due to more effective Dementia management and pushing ahead policies. First of all, the government needs to include dementia checkup into the list of national health insurance checkup toward senior citizen of older than 65-year-old. Secondly, as one of the characteristics of dementia, when more symptoms of dementia appear, there is less effect of treatment. Therefore, in order to reduce the social costs of Dementia, the government needs to promote Dementia prevention industry and early checkups. Thirdly, there is a need of setting a class judgement standard appeasement policy and expansion of using target. The reason of processing this statement is that there are difficulties of satisfying the needs of senior citizens due to current conformity of long-term pay recuperation according to laws of welfare.

• Journal of rehabilitation welfare engineering & assistive technology
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• v.7 no.2
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• pp.125-132
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• 2013

This research is focused on improvement of satisfaction of the assistive products, which is used by long term care elderly people. We investigated 1,200 long-term cared elderly and this survey was conducted by care-giver. The average satisfaction of the assistive products are in convenience 3.43, in function and effectiveness 3.33, in safety and secure 3.29 and in adequacy cost compared to effectiveness 2.69. Total average satisfaction of utilization is 3.19. Satisfaction with the use of assistive products in using motivation does not show a statistically significant difference, but in selection factors is a difference to be statistically significant. In conclusion, expert-consulting should be enhanced for the improvement of satisfaction and the provision of assistive products should be expanded in long-term care insuance schemes. Also, the rational index and evaluation method of the satisfaction of the assistive products should be developed through continuous studies.

• The Korean Society of Law and Medicine
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• v.18 no.2
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• pp.195-218
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• 2017

The increase in medical expenses for convalescent hospitals is increasing abnormally, which puts enormous burden on the National health insurance finances. This is a phenomenon that has been associated with the social phenomenon of rapid aging. The fact that the convalescent hospitals are paid the fixed amount per day for hospitalization became the incentive for some hospitals to use the patients as means of making money. And these hospitals intend to get regular care or take medicines at other hospitals in order to reduce medical expenses, even when the medical fee is paid. In order to prevent such financial leaks, the Health Insurance Review and Assessment Service adjusted the patient group for inpatients in a hospital with the above behavior, and then cut the cost of medical care benefits. However, Above decision was canceled by the court on the grounds that there was no basis rule. However, based on the above case, I think that it can be an opportunity to draw up the problem and to improve of the Medical Fee System of hospital. The modified medical fee system can strengthen the medical function of the convalescent hospital. In addition, it seems reasonable to exclude admission for "physically disabled group". Even if admission is allowed for the physically disabled group due to social needs, it should be excluded from the National health insurance for the fianacial soundness and the sustainability of the system.