• Journal of Korean Public Health Nursing
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• v.30 no.3
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• pp.512-525
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• 2016

Purpose: Ageing in place may improve the quality of life of frail elderly and decrease their costs of services. The purpose of this study was to examine the factors that influence the institutionalization of elderly using home care services in a Korean long-term care insurance system. Methods: This study used the data of '2009 Satisfaction survey of Korean long-term care system'. The survey proceeded to use a sampling data based on region, level of long-term care need, and insurance type among the beneficiaries between August and September 2009. The onset dates of institutionalization of 1,095 participants were ascertained from long-term care insurance claim data. This study calculated the hazard ratio through the Cox Proportional Hazard Model. Results: A total of 176 subjects who were institutionalized in nursing homes were included. There were higher risks in the group that included those who were 85 years and over, had dementia or fracture, used home-visit nursing service, and were not supported by direct family. Conclusion: The results of this study have policy implications to supplement the home care service system and postpone nursing home institutionalization of elderly.

• Journal of Korean society of Dental Hygiene
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• v.20 no.6
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• pp.843-853
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• 2020

Objectives: This study aimed to assess the association between the use of dentures by the elderly and the prevalence of depression by using the original data from the 2017 Community Health Survey as basic data for the promotion of oral health and oral health policy development in the elderly. Methods: The study subjects were 67,835 elderly over 65 years of age. The raw data were collected from 2017 Community Health Survey in Korea Center for Disease Control and Prevention. Results: Among the demographic and sociological characteristics, the higher the age, the lower the educational level, the worse the subjective health level, and the higher the denture use. The higher the age, the lower the education level, the lower the income level, the worse the subjective health level, the more stress they have, the more sleep time, and the higher the prevalence of depression. The association between the use of dentures and the prevalence of depression was 1.071 times higher than that of not using dentures, and it was found that the prevalence of depression was affected. Conclusions: As a result, it was confirmed that the use of dentures influenced the prevalence of depression. Institutional support will be needed to establish a national-level prevention policy that can maintain and promote healthy oral conditions and prevent the need dentures in the elderly.

• Health Policy and Management
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• v.23 no.2
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• pp.132-144
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• 2013

Background: The purpose of this study was to analyze the medical expense change and influencing factors after introducing longterm care insurance system. The study period was 2 years before and after introduction of the system. Methods: We analyzed data collected from two divided group lived in Incheon. Four hundred and eighty-five elderly who received long-term care wage for one year were selected for experimental group. For control group, 1,940 elderly were selected by gender and age stratified random sampling. Difference-In-difference analyses was used for evaluating policy effectiveness. Also multiple regression analyses were conducted to identify the factors associated with total medical expenditures. The control variables were demographic variables, economic status, diseases, and medical examination variables. Results: Difference-in-difference analyses showed that total average medical expenses among long-term patients has decreased by 61.85%. Of these, the hospitalization expenses have decreased by 91.63% and the drug expenses have increased by 31.85%. Multiple regression analyses results showed that total average medical expenses among long-term patients have significantly decreased by 46.5% after introducing the long-term care insurance. The hospitalization expenses have significantly decreased by 148.5%, whereas the drug expenses have increased by 53.6%. And outpatient expenses have increased by 10.4%, but the differences were not statistically significant. Conclusion: The results showed that total medical expenses and hospitalization expenses have decreased after introducing the long-term care insurance. These results could support the opinion that the health insurance spending among long-term patients will be reduced gradually by long-term care insurance through changing medical demand.

• Health Policy and Management
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• v.29 no.1
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• pp.1-3
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• 2019

Suicide is a major problem in Korean health care and a serious social problem. In Korea, 12,463 people (24.3 per 100,000) lost their lives due to suicide in 2017. Although the government has established three National Comprehensive Plan of Suicide Prevention (2004, 2009, 2016), and National Action Plan of Suicide Prevention (2018), the suicide rate is still high. The suicide rate of the elderly is especially high. This is due to the economic vulnerability of the elderly in Korea. Therefore, in order to prevent suicide in Korea, mental health care approach and social welfare approach should be integrated. The intervention of preventing suicide of suicide attempters should include social welfare services as well as mental health program and should be based on community. There are many health problems, including prevention of suicide, which can not be solved only by the efforts of health care. Many health problems are social problems and the integrated approach is needed to solve them. In order to solve many health care problems and improve health, integrated approach of health, social science, and humanities is needed.

• Research in Community and Public Health Nursing
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• v.25 no.4
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• pp.237-247
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• 2014

Purpose: The purpose of this study was to examine the social determinants of health (SDH) associated with health-related quality of life (HQOL) among the community-dwelling elderly, based on the conceptual framework of the Commission on Social Determinants of Health (CSDH). Methods: A survey was conducted with 199 elders aged 65 years or older sampled through convenient sampling. Data were collected through face to face interviews by trained interviewers using a structured questionnaire, which included scales of the residential area, social support, sense of community, social network, health behaviors, and HQOL. Data were analyzed by ANOVA and stepwise multivariate regression. Results: Major SDH affecting HQOL included the participants' residential area, sense of community, and health behavior. The HQOL of the elderly residing in the B area with a low rate of basic livelihood security recipients was higher than that of those residing in other areas. Conclusion: CSDH framework was useful to determine the factors associated with HQOL among the community-dwelling elderly. In addition to their health behavior, their sense of community was found to be a SDH of HQOL, indicating the need of health promotion programs tailored to the characteristics of residential areas and strategies to enhance involvement in community activities.

• Health Policy and Management
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• v.29 no.4
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• pp.454-468
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• 2019

Background: Supporting the elderly population is presented as a social issue, and it affects age discrimination, which forms a negative perception and avoids the elderly. Since age discrimination lowers the quality of life of the elderly and hinders social unity, it may be important to research related factors. This study examined the physical function as a factor that influences discrimination experiences and aimed to identify the relationship between physical function factors and discrimination experiences. Methods: In this study, we analyzed 20,225 elderly from the 2014 and 2017 survey of living conditions and welfare needs of Korean older persons, conducted nationwide among older than 65 years. Physical function factors are activities of daily living, instrumental activities of daily living, sight discomfort, hearing discomfort, chewing discomfort, and leg strength as factors of interest. We performed multivariable logistic regression that reflected survey characteristics, adjusting for socio-demographic factors, health related factors, and social-support factors. Results: The number of elderly who faced discrimination experiences was 1,175 (5.8%). The results showed that the odds ratio of facing a discrimination experience in the dependent group was significantly higher compared to the independent group when being transferring out of the room (4.05; 95% confidence interval [CI], 1.50-10.88) and difficulty in hearing (1.25; 95% CI, 1.05-1.49). Even with respect to chewing ability, which was significant in models 1 and 2, they face more discrimination experiences (1.30; 95% CI, 1.11-1.53). Conclusion: These research results indicate that an important strategy for preventing age discrimination is to understand the physical function conditions of the elderly and promote the physical functions of the elderly related to transferring, hearing, and chewing; it is necessary to develop a practical intervention plan that considers these aspects.

• Health Policy and Management
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• v.19 no.1
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• pp.81-96
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• 2009

The expansion of long-term care hospitals (LTCHs) is expected to contribute to meeting the long-term care needs of the elderly with chronic diseases in a rapidly aging society. It is also expected to increase efficiency of health resource use and decrease elderly health expenditures by transferring patients from acute care hospitals (ACHs) to LTCHs. This study aimed to empirically examine how the expansion of LTCHs had influences on the length of hospitalization of the elderly in ACHs. Panel regression analysis was employed as an analytic tool using data of the National Health Insurance and the National Statistical Office from 2002 to 2006. The expansion of LTCHs was measured as location quotient (LQ) of LTCHs, denoting the share of LTCHs in a large city or province relative to the share of LTCHs at the national level. In addition, per capita GRDP (gross regional domestic product) and the proportion of population over 65 were included as control variables. The main findings are as follows. First, it was observed that LQ of LTCHs showed a statistically significant negative association with the length of hospitalization of the elderly in ACHs. Second, the negative correlation was evident among general hospitals with over 100 beds while it was not among hospitals with less than 100 beds. Third, LQ of LTCHs had more influences among the elderly over 85. In conclusion, the expansion of LTCHs seems to contribute to decrease in the inpatient cost of the elderly in ACHs and to increase efficiency in the utilization of health resources.

• Health Policy and Management
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• v.31 no.1
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• pp.46-55
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• 2021

Background: Patients with the chronic physical illness are more likely to experience depression, and the accompany of chronic physical illness and depression is particularly high in middle-aged and elderly women. Considering that depression is associated with somatization and the decline of therapeutic compliance when accompanied by chronic physical illness, middle-aged and elderly women who experience depression among chronic physical illness may increase their use of medical services. This study is to identify the effect of depression on the use of medical services, especially among middle-aged and elderly women with chronic physical illness. Methods: This study used the 2016 Korean Health Panel. For analysis, it used T-test, negative binomial regression, and multivariate regression combining propensity score matching. Results: First, depressive groups had a higher number of medical service utilization and total medical expenditure than the non-depressive group. Second, depression significantly increased medical service utilization (β=0.17, p=0.04) at the 5% significance level. Also, depression significantly increased total medical expenditure (β=0.37, p=0.08) at the 10% significance level. Conclusion: For those who have chronic physical illness among middle-aged and elderly women, the experience of depression was confirmed to be a factor affecting the use of medical services. In the end, it is important to come up with policy countermeasures for middle-aged and elderly women accompanied by depression and chronic physical illness.

• Journal of Korean society of Dental Hygiene
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• v.18 no.2
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• pp.217-226
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• 2018

Objectives: The purpose of this study is to find out differences in oral health status, defined as their oral health and oral health quality of life among the elderly depending on their income and education levels. Methods: This study used 922 senior citizens over 65 from the data (2015) of the 6th National Health and Nutrition Survey (NHNS). The regression analysis was adopted to identify factors affecting their oral health status which has effect on their oral health quality of life. The statistical package SPSS 21.0 was employed. Frequency analysis, chi-squared analysis and regression analysis were used, and the significance level or Cronbach's alpha value was 0.05. Results: Depending on income levels, there were differences in their oral health status as to whether they use oral hygiene products, take dental examinations, join private health-insurances, and delay dental treatments or not. And educational levels also made significant differences in their oral health status as to whether they smoke, drink alcohol, how many times they brush teeth a day, whether they use oral hygiene products, take dental treatments, and join private health-insurances. Regression analysis on the relationship between their oral health status and the oral health quality of life showed that there were significant differences depending on whether they take dental treatments, delay dental medical treatments, smoke, take oral examinations, how many times they brush teeth a day, and whether they use oral hygiene products, or join private health-insurances. Conclusions: The study shows that a comprehensive plan is needed to raise attention on proper oral health-care and ultimately to improve the quality of life by considering the daily number of tooth brushing, oral hygiene product use, regular dental treatments, and other medical uses.

• Journal of Korean society of Dental Hygiene
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• v.8 no.4
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• pp.1-10
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• 2008

The purpose of this study was to compare the oral health status of elderly people living in nursing home with private home in Busan, Kimhae and Jinju in Gyeongnam province for development oral healthy policy of elderly people. 253 elderly subjects aged more than 65 in a hall for the aged and special medical treatment hospital are made up questions. The date was analysed using the SPSS 13.0 program. The obtained result were as follows. 1. 39.5 percent elder people recognize that their subjective oral health is not good. In the case of above three times in brushing tooth a day, 29 percent people are less their oral health is good. As the number of times of brushing tooth decreases, the percent feeling their oral status good decrease(p<.05). 2. The respondents who have visited the dentist within one year are less than people with no visit. Also the percent having a mind that their oral health status is good is higher in the respondents having scaling than them without scaling(p<.05). The respondents who answer that their diet is not bad is most in the ratio of people feeling subjective oral health status good(p<.001). 3. The portion of people feeling their oral status not healthy is highest in the respondents without tooth(p<.05). 4. Among the respondents answering their subjective oral health is not good, the some problem of conversation due to no tooth or denture and relation with others is issued each(p<.001). This study suggests that perceived toothbrusing frequency and periodic scaling with oral health among the elderly. The finding of this study will helpful to policy makers to design plants to increase the oral health related quality of life among the elderly.