• Journal of the Health Care and Life Science
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• v.11 no.2
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• pp.351-360
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• 2023

2018 aged patient dataset (HIRA-APS), 33,821 patients admitted to long-term care hospitals were classified by major disease groups to identify the characteristics of medical use and provide effective policy data. First, it is necessary to operate specialized long-term care hospitals such as dementia, rehabilitation, hospice, and recovery specialization tailored to the characteristics of the patient's disease group. Second, the paralysis group, cerebrovascular disease group, and dementia group were the longest LOS and the cognitive impairment group is the longest by patient classification group, requiring medical demand and quality management for long-term patients. Third, the musculoskeletal disease group was the highest normal discharge, and support for the post-discharge home program is required in paralysis and cerebrovascular disease.

• Health Policy and Management
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• v.20 no.1
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• pp.19-36
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• 2010

Fee for long-term care insurance in Korea are determined in proportion to resources utilized according to severity rather than based on categorization of beneficiaries in consideration of the characteristics of resource utilization. This adoption is based on the assumption that as beneficiaries of long-term care insurance, characteristically, demands social services rather than needs medical treatments, the characteristics of beneficiaries and the quality of utilized resources are comparatively homogenous. Therefore, the proposition is that the size of resource consumed by beneficiaries in the same grade is identical. However, even in the same grade, the level of utilized resources is different depending on the characteristic of beneficiaries. In this regard, this study is to examine whether there are differences in the volumes of utilized resources depending on the characteristics of beneficiaries even in the same grade. We analyzed time study data for 2003, 2005, 2006 which conducted by the Korea Institute for Health and Social Affairs. To look at differences in the volumes of utilized resources, we identified characteristics of beneficiaries that influence utilized resource volumes and categorized services provided by facilities into the rehabilitation treatment category, the problematic behavior category, and the physical malfunction category. Then, we examined each service in consideration of service difficulty levels and wage weights. The result of examination showed that differences in utilized resource volumes exist in all three grades depending on the characteristics of beneficiaries. Especially, in the first grade with a high level of seriousness, utilized resource volumes were different for those three service categories and the problematic behaviour category considered dementia was found to consume the largest volume of resources. Moreover, there was the inversion phenomenon of utilized resources volumes between the grades. This result indicates that utilized resource volumes are different even in the same grade depending on the characteristics of beneficiaries and it is required to consider case-mix for reflection of the volumes of utilized resources depending on the characteristics of beneficiaries.

• Health Policy and Management
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• v.10 no.4
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• pp.99-115
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• 2000

This study was conducted to get a resonable set of budget allocation to public health programs. Matrix Delphi technique was used to obtain the logic of study results and eventually to form a human model which could predict opinion of professionals on budget allocation. Thirty-two professionals in academic and governmental area responded to Delphi survey. Questionnaire was developed using matrix formation, and the matrix was formed by 6 decision criteria on budget allocation and 26 public health programs. The decision criteria are as following: size of problem(morbidity), severity of problem, social equity, importance of prevention, technical feasibility and efficiency of programs. Severity of problem dropped out of the model because it had significant correlation with the size of problem. A total score of each program was obtained by weighting the relative importance of each criteria which also were given by survey respondents. These total scores indicate that the most important public health program is vaccination for infants and children in terms of budget allocation. Monitoring communicable diseases, mental health program, and anti-smoking program are the next. In addition, respondents were asked of the desirable budget size of each program. The result was rearranged by multiple regression model using the scores of each decision criteria. In this process, the current budget size of central government was provided to the respondents, and included in the model. h set of desirable budgets modified using tile model was obtained. Considering the current size of budget, tile results of the model is very different from that of the total score. Managing dementia is ranked the first. Health promotion program for the elderly, rehabilitation of the disabled and monitoring communicable diseases are the next. The need to increase the budget of vaccination for the infants and children was not found as so high. The matrix structure in Delphi survey gave us the precise basis to make optimal decision, and made it possible to develop an opinion predicting model. However the plentifulness and diversity of professional opinions were not fully obtained due to the limited number of decision criteria.

• 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.

• The Journal of the Convergence on Culture Technology
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• v.9 no.1
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• pp.443-448
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• 2023

Over the past five years, the number of patients with sleep disorders has increased by about 250,000 from 840,000 in 2017 to 1.09 million in 2021. In addition, sleep disorder is a factor that causes dementia risk factors, and furthermore, the population with sleep disorder is a very important policy issue in terms of stable health insurance financial management in the future in terms of national health management in the super-aging trend. Therefore, this study aims to establish an efficient treatment environment in medical institutions responsible for the current status of polysomnography and effective reimbursement policies for the recently increasing population with sleep disorders, and appropriate sleep management policies for future sleep disorders through correct implementation. We are trying to find out the actual condition and improvement plan through interviews with related organizations and experts.

• Journal of Korean Academy of Nursing
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• v.32 no.3
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• pp.344-354
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• 2002

This study is a fact-finding research to understand the status of visiting nursing services operated by health centers in Korea and it aims to provide basic information for policy development on operation and management of visiting nursing services in health centers. Method: This study investigates the results of visiting nursing services in 242 health centers from Jan. 10 through Dec. 30, 2000, where 3,106 visiting nurses were employed by the public work program. Result: In 2000, 129,401 new household as service recipients was identified and that was 0.9% of Koreas total households (15,137,000), and 5.8% of low income households (2,242,000). The highest high risk group was dementia patients(aver. 55.2/1,000 person). Average number of households visited by visiting nurse were 4.5 households per day and the first-visited houses per visiting nurse were 1.1 households per day. The re-visiting rate was 71.3%. Total 4,059,130 service items were provided and assessment ranked the highest with 33.7%. The satisfaction level of clients on the nurses was an average of 3.17 points in the scale of 4 and the nursing service was a 2.60 points in a scale of 3. Conclusion: Visiting nursing service should continue to provide comprehensive healthcare services in cost-effective ways while cooperating with others

• Journal of Digital Convergence
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• v.11 no.10
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• pp.585-592
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• 2013

This study was done to investigate the effects of cinema therapy on schizophrenia patients' depression and self esteem. The research design was a nonequivalent control group pretest-posttest design. Participants were recruited from two mental health facilities in J city(20 in the experimental group and 20 in the control group). The research was carried out from March to April, 2010. The cinema therapy was conducted seven times. After the cinema therapy, depression of schizophrenia patients in experimental group was lowered compared with that of patients in control group, and the difference was statistically significant (t=-4.17, p<.001). After the cinema therapy, self esteem of schizophrenia patients in experimental group was improved compared with that of patients in control group, and the difference was statistically significant(t=5.77, p<.001). The results indicate that the cinema therapy was a useful program leading positive effects on depression and self esteem in schizophrenia patients.

• Journal of Digital Convergence
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• v.16 no.12
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• pp.427-440
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• 2018

This study was a descriptive correlation investigation that assessed the caring burden of caregivers who care for dementia and examined the effects of the burden on the somatic symptoms and health perception. The subjects were 174 caregivers and data collection was conducted from April 1 to 30, 2018. The data were analyzed t-test, one-way ANOVA, Pearson's correlation coefficient, and multiple regression analysis. A Scheffe test was used for post-analysis. The caring burden and somatic symptoms were found to be mid-high and moderate, respectively. The health was perceived to be not good, and the subjective awareness of well-being appeared to be low. The caring burden showed a positive correlation with the somatic symptoms(r=.157, p<.05), and the somatic symptoms showed a positive correlation with the perceived health(r=.220, p<.01). As a result of the study, caregiving burden of caregivers showed the factors influencing their physical and mental health status, it is suggested to carry out research to find out whether there is a difference in burden of care according to the working place of caregiver. In addition, it is necessary to develop a tool to measure the burden of caregivers and to carry out repeated research.

• Journal of Digital Convergence
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• v.17 no.2
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• pp.293-301
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• 2019

The purpose of this study is to redefine 7 social exclusion factors and to derive association between social exclusion factors and depression of middle and older elderly, focused on gender differences. The elderly aged over 50 years old were extracted from the data of the Korean Longitudinal Study of Ageing (KLoSA) in 2016. The data was analyzed by descriptive analysis, chi-squared test, and binary logistic regression analysis, using SAS 9.4. As a result, the elderly who were excluded from labor, residence, health, and relationship were found to be associated to depression. In addition, male with resident exclusion were associated with depression compared to non-excluded. Therefore, it is necessary to improve the local community programs in which elderly people can participate in labor and cultural activity. It is necessary to improve labor and culture exclusion by increasing the participation opportunities of various cultural programs. In addition, it is needed to establish specific guidelines for eliminating the social exclusion of overall elderly.

• Journal of Digital Convergence
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• v.19 no.3
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• pp.471-482
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• 2021

We aimed to provide evidences for developing non-pharmacological intervention in older adults with Mild Cognitive Impairment(MCI) by integrated literature review. The final 16 papers were selected as a result of an integrated literature analysis. All of them are focused on strengthening cognitive activities, while Korean studies have often merged emotional activities such as music therapy and laughter therapy rather than physical activities such as exercise therapy, international studies have combined physical activities rather than emotional activities. The effects of non-pharmacological intervention differed according to the outcome variables. The primary variables were cognitive function and depression, and secondary variables were found to have effects on physical function, activities of daily living (ADL), and self-efficacy. This study contributes to a multidisciplinary approach that can be applied in the clinical field through the development of various non-pharmaceutical intervention for the prevention of dementia in the older adults with MCI.