• 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.

• 한국노년학
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• v.32 no.2
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• pp.593-609
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• 2012

The study was performed to identify the functional status change of beneficiaries of Long-Term Care Insurance and its related factors. We conducted the logistic regression with 17,652 beneficiaries during August and September in 2008. As a result, activities of daily living(ADL), behavioral changes, rehab, instrumental activities of daily living(IADL) and cognitive function, followed by nursing care area were improved in a greater degree. For the institutional service, level-1 beneficiaries was significantly improved in rehab area and level-2 beneficiaries was improved in ADL. For the home-visit care service of in-home services, level-1 beneficiaries was improved in ADL, level-2 beneficiaries was improved in ADL and rehab area, level-3 beneficiaries was improved in ADL, cognitive function and behavioral changes. For the day-and-night care service, level-1 beneficiaries was improved in ADL, IADL, behavioral changes and rehab area, level-2 beneficiaries was improved in behavioral changes, level-3 beneficiaries was improved in cognitive function and behavioral changes. For the short-stay service, level-3 beneficiaries was improved in behavioral changes. By the above results, there was a difference in a functional improvement by level and used services. Therefore, government need to provide the personalized service system based on the objective and comprehensive understanding for health and functional status of beneficiaries.

• The Korean Journal of Applied Statistics
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• v.22 no.6
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• pp.1229-1237
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• 2009

In the long-term care insurance(LTCI) system, the question of how to provide the most appropriate care has become a major issue for the elderly, their family, and for policy makers. To help beneficiaries use LTC services appropriately to their needs of care, National Health Insurance Corporation(NHIC) provide them with the individualized care plan, named the Long-term Care User Guide. It includes recommendations for beneficiaries' most appropriate type of care. The purpose of this study is to develop a recommending system for care plan(Res-CP) in LTCI system. We used data set for Long-term Care User Guide in the 3rd long-term care insurance pilot programs. To develop the model, we tested four models, including a decision-tree model in data-mining, a logistic regression model, and a boosting and boosting techniques in an ensemble model. A decision-tree model was selected to describe the Res-CP, because it may be easy to explain the algorithm of Res-CP to the working groups. Res-CP might be useful in an evidence-based care planning in LTCI system and may contribute to support use of LTC services efficiently.

• 한국노년학
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• v.30 no.4
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• pp.1359-1375
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• 2010

Expecting the expansion of the elderly population under long-term home care with the coming of the aged society, this study purposed to propose a prevention and self-reliance support model and to get practical implications for minimizing dependency on care benefits and enhancing the effectiveness of prevention and self-reliance support. Research methods employed for this study were: first, reviewing theoretical literature for clarifying the concept of prevention and self-reliance support in providing long-term care benefits for the elderly; second, identifying factors hindering prevention and self-reliance support through analyzing standard long-term care use plans and documents related to long-term care benefits at elderly welfare centers to which the research subjects belonged; and third, surveying care benefit users on factors hindering their use of prevention and self-reliance support and their needs in the use of care benefits. Based on the results of the three types of qualitative research, we proposed directions for prevention and self-reliance support modeling and suggested practical implications for enhancing the effectiveness of prevention and self-reliance support. For this study, we collected documentary materials and conducted in-depth interviews with the participants with the consents and cooperation of managers and professional social workers at day care centers and elderly welfare centers in D City. According to the results of this study, literature review suggested that long-term care prevention and self-reliance support should be provided in a way of 'strengthening user-centered support systems,' which support elderly long-term care beneficiaries' right to lead a life as the subject of their own life. Document analysis found the absence of benefits related to health and medicine and lack of social support systems for prevention and self-reliance support, and the results of in-depth interviews suggested the necessity to strengthen services related to elderly long-term care beneficiaries' prevention and self-reliance, and the keen needs of the long-term care elders for prevention and self-reliance included: ① loneliness, anxiety, fear; ② missing for and worry about children and people; ③ moving, outing; ④ health and medical services, rehabilitation programs; ⑤ desire to use day care; ⑥ inconvenience of house structure; ⑦desire for meal menus; and ⑧ the occurrence of disuse syndrome. Based on these results, we suggested the base of prevention and self-reliance support modeling with three axes: ① strengthening user-centered support systems; ② strengthening support systems connected to health and medicine; and ③ strengthening social support systems.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.11
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• pp.7463-7473
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• 2015

This study aims to analyze the effect of long-term care utilization on health care utilization of the national health insurance elderly. This study is a secondary data analysis of the long-term care insurance data that comprised of total 21,213 long-term care insurance with the level 1 elders who received either service or non-service. This study evaluated the impact of long-term care service on the probability of health care utilization experience and costs of health care utilization. The total medical cost, geriatric hospital's medical cost, inpatient day and geriatric hospital's inpatient day by 2007-2009 were significant factor influencing the long-term care utilization. This study suggests long term care system should proper medical service linkage system. The current long-term care insurance system should more resource allocation on long-term care utilization to increase the efficiency of insurance system.

• 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.

• 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.

• 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.24 no.1
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• pp.145-159
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• 2011

National long-term care insurance started in July, 2008. We try to make up for weak points and develop a long-term care insurance system. Especially, it is important to upgrade the rating model of the category of need for long-term care continually. We improve the rating model using the data after enforcement of the system to reflect the rapidly changing long-term care marketplace. A decision tree model was adpoted to upgrade the rating model that makes it easy to compare with the current system. This model is based on the first assumption that, a person with worse functional conditions needs more long-term care services than others. Second, the volume of long-term care services are de ned as a service time. This study was conducted to reflect the changing circumstances. Rating models have to be continually improved to reflect changing circumstances, like the infrastructure of the system or the characteristics of the insurance beneficiary.

• The Journal of the Korea Contents Association
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• v.19 no.1
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• pp.421-429
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• 2019

The purpose of this study is to examine factors affecting the wage of home care workers in Incheon. For this study, 306 home care workers in Incheon were analyzed. Personal factors, work environmental factors, and regional factors were entered in the analytic model. Results showed that education level, license, employment status, work hours, and service types were associated with the wage of home care workers. Also, factors related to the supply and demand of long-term care (i.e., the number of long-term care facilities per 100 care workers, the number of long-term care facilities per 100 benefit recipients, the number of care workers per benefit recipients) were positively associated with the wage. Policy implications are discussed.