• Health Policy and Management
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• v.22 no.3
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• pp.383-402
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• 2012

The purpose of this study is to investigate the factors affecting family caregiver financial burden of out-of pocket expenses for the nursing home service under Long-term Care Insurance System. We conducted a national cross-sectional descriptive survey from July to September 2010 to collect data based on the long-term care benefits cost specification. Total 1,016 family caregivers completed questionnaires. 185 subjects of total were excluded from the data analysis due to being answered by user(18 cases), or caregivers not to pay for services expenditures(122 cases), having a missing data on family caregivers characteristics(45 cases). Finally, 831 subjects were included in the study. The average financial burden was 3.18(${\pm}0.71$). We divided subjects into two groups by level of burden, high-burden group and low-burden group. In the result of the multiple logistic regression analysis, family caregiver financial burden was significantly higher in family caregivers with ages 40 to 49 compared to less than 40, lower educational level, unsatisfaction for long-term care service, high percentage(more than 50%) of cost-sharing and high total out-of pocket expenses(more than 300,000 won) for long-term care services. Also, Family caregivers who are spouse felt higher financial burden compared to son. This study is meaningful as the first attempt to measure family caregiver financial burden for long-term care service and to identify factors affecting the financial burden. Family caregivers felt financial burden of out-of pocket expenses for the nursing home service. The policy makers, the insurer, and the providers need to pay attention to ease family caregiver financial burden.

• Health Policy and Management
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• v.22 no.1
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• pp.145-162
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• 2012

The purpose of this study is to understand magnitude and its related factors of user's cost-sharing for non-covered services in long-term care facilities. We corrected data for 1,016 subjects, based on the long-term care benefits cost specification. Eighteen subjects were excluded from the data analysis due to missing data on family care-givers characteristics. Finally, 998 subjects were included in the study. The average cost of non-covered services per month was 209,093 won and distributed from 0 to 1,011,490 won. There was a significant difference by the characteristics of family care-givers and long-term care facilities. The monthly average cost for meal materials per person was 199,181 won(0~558,000), average cost of additional charge caused by using private bed was 232,992 won (50,000~600,000), and costs for haircut and cosmetics were 8,599 won. For the rest, there were various programs costs(93,328 won), diaper and its disposal cost(109,628 won), purchase cost for daily necessaries(24,435 won) and etc. The related factors for the magnitude of non-covered services expenditures were education level of family care-givers, occupancy rate and location of LTC facilities, and the costs of using private bed, haircut and cosmetics, and various programs among non-covered services. These findings suggest that present level range of LTC facilities users' cost-sharing is wide and it is urgent to prepare the standard guideline for cost and level in non-covered services.

• Journal of Korean Academy of Oral Health
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• v.42 no.4
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• pp.204-209
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• 2018

Objectives: This study was conducted to identify the demand and willingness to pay for oral hygiene services among elderly people with long-term care insurance. Methods: Our study was a cross-sectional analysis. Subjects comprised 126 elderly individuals from long-term home-care centers. A total of 28 centers were selected through convenience sampling from among 78 centers in ${\bigcirc}{\bigcirc}$. For analysis, semi-structured questionnaires that required about 20-30 minutes to complete were used. Analysis was performed using SPSS 23.0 software. Results: The overall demand for oral hygiene services was 44.4%, and willingness to pay was 31.0%. Thirty-three people (58.9%) of elderly those who have demand for an oral hygiene service were willing to pay for the service, and 64 people (91.4%) who did not have a demand were not willing to pay for it. Among those with partial dependence on brushing, 65.6% had demand for oral hygiene services and 50.0% were willing to pay costs. Among basic livelihood beneficiaries, 69.6% were willing to pay for oral hygiene services; general subjects and relievers were less willing to pay. Conclusions: The overall demand for oral hygiene services among elderly people was 44.4%, and the willingness to pay was as low as 31.0%.

• Journal of Korean society of Dental Hygiene
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• v.22 no.1
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• pp.63-72
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• 2022

Objectives: This study was conducted to prepare basic data to propose the necessity and utilization of oral welfare products in the welfare services of the long-term care insurance system, focusing on facility workers working in elderly facilities. Methods: The analysis was conducted on 144 workers working at some local elderly facilities. The questionnaire was constructed by classifying the use of oral welfare tools into 6 questions and the necessity and demand for oral welfare devices into 13 questions. Frequency analysis and technical analysis were performed for data analysis, and one-way ANOVA was performed for differences in the necessity and demand for oral welfare equipment. The statistical significance level was p<0.05. Results: As a result of examining the awareness of the necessity and demand for oral welfare equipment among workers in elderly facilities, the awareness of the necessity of including oral welfare equipment in the items of welfare equipment in the current long-term care insurance system was high at 4.15 points. As a result of analyzing the correlation between awareness of care products and the need and demand for oral welfare equipment, it was confirmed that there was a statistically significant positive correlation (p<0.01). Conclusions: In the long-term care insurance system for the elderly, oral welfare products need to be considered for welfare equipment services. The provision of oral welfare products within the long-term care insurance system for the elderly can provide opportunities and services to select various self-care tools. In addition, it is expected that it will be possible to promote changes in the long-term care insurance system for the elderly and to improve the system in a variety of positive ways.

• Health Policy and Management
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• v.32 no.4
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• pp.389-399
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• 2022

Background: This study aimed to analyze changes in medical utilization and cost before and after long-term care (LTC) implementation. Methods: We used the National Health Information Database from National Health Insurance Service. The participants were selected who had a new LTC grade (grade 1-5) for 2015. Medical utilization was analyzed before and after LTC implementation. Segmented regression analysis of interrupted time series was conducted to evaluate the overall effect of the LTC implementation on medical costs. Results: The total number of participants was 41,726. A major reason for hospitalization in grade 1 was cerebrovascular diseases, and dementia was the top priority in grade 5. The proportion of hospitalization in grade 1 increased sharply before LTC implementation and then decreased. In grade 5, it increased before LTC implementation, but there was no significant difference after LTC implementation. As for medical cost, in grades 1 to 4, the total cost increased sharply before the LTC implementation, but thereafter, changes in level and trend tended to decrease statistically, and for grade 5, immediately after LTC implementation, the level change was decreasing, but thereafter, the trend change was increasing. Conclusion: Long-term care grades showed different medical utilization and cost changes. Long-term care beneficiaries would improve their quality of life by adequately resolving their medical needs by their grades.

• Physical Therapy Korea
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• v.29 no.2
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• pp.94-105
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• 2022

Background: As South Korea enters an aged society, the government has emphasized the need for a soft landing of the older adults into the community after the acute and recovery periods under a national policy of "community care." However, the institutionalization of community rehabilitation services to implement this is insufficient. Japan had already entered an aged society when the Long-Term Care Insurance System was introduced in 2000. Thus, the case of Japan's institutionalization of the system is expected to have implications for us in supplementing a suitable system for the aged society. Objects: This study compared the institutionalization process of the Long-Term Care Insurance System in South Korea and Japan and the services currently being implemented in each country. Methods: To examine the institutionalization process and services of the system, related legal rules and regulations, government reports, and articles were reviewed. To examine the operation status of the system, statistical data provided by each country's government were analyzed. Results: Japan recognized the importance of community rehabilitation even before the enactment of Long-Term Care Insurance. Thus, community rehabilitation services, such as home-visit rehabilitation and health facilities, were already stipulated in the law. Under such institutional legacy, Long-Term Care Insurance was able to establish a service system, which balanced welfare and health-related services, including various types of services with enhanced rehabilitation functions. In South Korea, rehabilitation policies were not much considered in the process of institutionalizing the system; thus, it was composed mainly of services focusing on care and recuperation. Conclusion: In order to realize community care, rehabilitation services need to be developed in Long-Term Care Insurance System in various forms such as home-visit services, daily services, short stay, and facility services.

• Therapeutic Science for Rehabilitation
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• v.12 no.1
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• pp.65-78
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• 2023

Objective : The typical decline in function due to aging includes limitations in vision, hearing, cognitive function, and activities of daily living. Therefore, this study evaluated the mediating effect of cognitive function on the relationship between vision and hearing and activities of daily living. Methods : The participants in this study were 36,767 persons from the long-term care database on older adults provided by the National Health Insurance Sharing Service. The extracted variables were: (i) independent variables: visual and hearing; (ii) dependent variables: basic and instrumental daily living activities; and (iii) mediator variables: cognitive function. Regression analysis was performed evaluate the mediating effects of the extracted variables. Results : Cognitive function showed a mediating effect of 30% on the relationship between vision and basic daily life activities and 42% in the relationship with instrumental daily life activities. The mediating effect was 50% in the relationship between hearing and basic activities of daily living, and 53% in the relationship with instrumental activities of daily living. Conclusion : Prevention programs for functional decline due to aging are in progress in Korea. Based on the results of this study, establishing a prevention program would help promote successful aging.

• 한국노년학
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• v.27 no.2
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• pp.459-472
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• 2007

This research has its purpose of developing a tool to assess the needs of the Korean elderly at home population and to provide adequate services by evaluating their physical, psychological, and socio-environmental aspects. This developed tool is composed of two hundred questions and has the advantage of combined physical, psychological and social environmental situation assessment of the elderly at home. The tool also contains not only the objective view of the professionals, but also the subjective appeals of the elderly at home population so that it can reflect their substantial desires. The assessment tool was developed over 21 months from July, 2004 to March, 2006 and this period can be divided into three different stages. In the first stage, collecting of questions for the desire-focused assessment of the elderly by literature investigation and researching foreign source materials was carried out, and this ultimately developed assessment tool was applied to the long-term care insurance pilot project in the second stage. In this process, we revised some insufficiencies of this tool after we applied to elderly of 250 from the pilot project and other 200 elderly from this research team. For the last stage, the tool was completed by using inquiries of the focused group and the group of professionals to ensure its reliability and validity. In the process of developing the tool, the total of 200 questions under 13 subcategories was selected. The 13 subcategories are basic information, subjective appeals, information of the main helper, use of services, house environment, condition of health, condition of rehabilitation, daily living(ADL, IADL, defecation, assistance), social maintenance, behavioral disability, medical health, living habits, and strength. This tool is on the purpose to assess thoroughly the desires that the elderly at home population has and to provide the best service they need.