• Journal of Home Health Care Nursing
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• v.27 no.3
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• pp.241-249
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• 2020

Purpose: This study aimed to investigate possible ways to expand the services of home-visit nursing through a review of the progress, achievements, and obstacles of home-visit nursing; a pilot project of an integrated home-service; the application of the Omaha System; as well as a case analysis of providing home-visit nursing services. Method: An integrated review was conducted using various source materials, including laws, previous studies, and a case analysis. Results: In case analysis of providing visiting nursing service, rehabilitation nursing, end-of-life nursing, and dementia care showed high nursing needs. It was necessary that the various home visit nursing services in the intervention area of the Omaha System, administrative services, case management, and center operation activities were all included in the payment systems of long-term care insurance. Conclusion: In the future, home visit nursing services of long-term care insurance should be reborn in the form of a center for integrated case management in the community, which would set long-term goals until the time of a client's death and encompass the realm of human rights for health, quality of daily life, and a dignity of life.

• Journal of Korean Academy of Nursing Administration
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• v.14 no.3
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• pp.229-240
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• 2008

Purpose: To develop the patient classification system based on the resource utilization for reimbursement of long-term care hospitals in Korea. Method: Health Insurance Review & Assessment Service (HIRA) conducted a survey in July 2006 that included 2,899 patients from 35 long-term care hospitals. To calculate resource utilization, we measured care time of direct care staff (physicians, nursing personnel, physical and occupational therapists, social workers). The survey of patient characteristics included ADL, cognitive and behavioral status, diseases and treatments. Major category criteria was developed by modified delphi method from 9 experts. Each category was divided into 2-3 groups by ADL using tree regression. Relative resource use was expressed as a case mix index (CMI) calculated as a proportion of mean resource use. Result: This patient classification system composed of 6 major categories (ultra high medical care, high medical care, medium medical care, behavioral problem, impaired cognition and reduced physical function) and 11 subgroups by ADL score. The differences of CMI between groups were statistically significant (p<.0001). Homogeneity of groups was examined by total coefficient of variation (CV) of CMI. The range of CV was 29.68-40.77%. Conclusions: This patient classification system is feasible for reimbursement of long-term care hospitals.

• The Korean Journal of Health Service Management
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• v.5 no.3
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• pp.13-23
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• 2011

This paper investigated the operating environment for the representative of each agency and the facility workers on the basis of analytical result of recognition changes of the operating environment changes under the operating the long-term care insurance. It was described plans to take positive effect on the operating as follows. The first, on the result of regression analysis, the service administrative range takes the biggest effect on the general recognition of executing the long-term care insurance off and on. The affirmative recognition of the service administrative range had the general recognition on the system be positive effect. But the operator of facility asserts that the care manager's professionalism related quality of service be strengthened. The second, on the result of regression analysis, in the financial accounting administrative it is revealed the more positive recognition it is, the more positive effects it has. From the difference verification of an operation size from operation subject, the small operation size and personal facility recognize the long term care insurance positively. On the other side the facilities where the operation size is big recognize the system negatively. The long-term care facility should rearrange a support program newly and the government needs to promote the donation activity, because it is needed to reduce the financial burden of facilities.

• Health Policy and Management
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• v.21 no.3
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• pp.381-396
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• 2011

This study is to investigate the factors affecting the regional rate of certification for long-term care insurance benefits. Analyzed data were the 253,935 certified beneficiaries (equivalent to 4.9% of total elderly population) as long-term care degree (LTC degree) 1~3 extracted from the applicants for long-term care in the beginning stage of the system from April 15 2008 to July 1 2009. Although the data were collected from individuals, after restructured into regional data and then analysed in the unit of 225 administrative regions for the Korean Long-term Care Insurance. The rate of certification was operated as the percentage of people of LTC degree 1~3 to the elderly population in each region. The average rate of certification among regions was 4.91%, and ranged from 2.20% to 8.32%. In the analysing regression models, most socio-demographic variables, applicants' disease characteristics, regional service infrastructure, and the certification interviewer's characteristics were included. The most influencing variables were the disease factors of applicants, especially dementia or cerebrovascular disease rather than arthritis, osteoporosis, or fracture patients were strong factors for the regional rate of certification. However, advanced studies adding more explainable factors on the regional variance of certification rate would be necessary to provide political agenda and measures for evidence-based certification process with high reliability and validity for a sustainable LTC system in Korea.

• The Korean Journal of Health Service Management
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• v.10 no.2
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• pp.155-166
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• 2016

Objectives : This study confirmed the limitation of long-term care insurance by analyzing media contents. Methods : Articles and reviews were searched with the article searching system (KINDS) from July 2008 to December, 2015. Results : Among the 155 articles examined, 61.1% highlighted the faults of suppliers, and 25.2% indicated the responsibility of the insurer. As for their purpose, 56.8% reported on accidents, and 32.3% provided information. Furthermore, 74.2% reported on negative contents and only 25.8% on neutral contents. The negative contents consisted of requesting false insurance benefits, amending the range and price indicating the very low salaries of the care givers, limitations on the care grade assessment, and problems related with assistive devices. The majority of neutral articles is for providing information. Conclusions : There were many problems starting from the early stage of the insurance. We must pay attention to these problems. Moreover, we should try to handle and prevent these problems with supportive responses from authorities.

• Journal of Home Health Care Nursing
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• v.14 no.2
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• pp.98-105
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• 2007

Home health care system in Korea has been classified into three types of home care programs based on different laws and regulations; for example, home health care nursing(HHCN) is based on medical laws, visiting health care nursing (VHCN) is based on long-term health care insurance, and visiting health care(VHC) is based on the regional health care act. HHCN in Korea has taken on an important role under the mandate of the national health care system since 2000. VHCN will commence its role under the long term health care insurance system in 2008. The strengthening of VHC commanded health promotion and prevention for vulnerable families in the community in 2007. This is an important turning point for increasing quality management for home health care program; it suggests certain possibilities for building a foundation for further changes in the service delivery structure. Accordingly, the home health care policy makers in Korea have a major function and role that consists of developing an agenda and alternatives for policy making in a systematic manner and clearly presenting implementation strategies for elderly health care system.

• 한국사회정책
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• v.25 no.3
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• pp.103-130
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• 2018

The study aims to analyse Korean Long-Term Care Insurance system in terms of caring justice on the premise that elder care should be included in discussions and policies of care. Caring justice means an ideal of equal sharing duties and rights of care by all citizens. Four dimensions of caring justice(decommodification, defamilialization, degenderization and elderly participation and power) were established for the analysis. The results of the analysis were presented that Korean Long-Term Care Insurance system was maintained by commodificated and gendered care services attempting defamilialization with the exclusion of elderly beneficiaries, which represented typical caring injustice. Policy suggestions were made to realize caring justice: improving the status of caring labour by achieving proper service price and public employment, reorganization of life cycle based caring system integrating children, disabled adults and elders, and developing user-centered long-term care system to guarantee participation and choice of people in caring relationships.

• Korean Journal of Social Welfare
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• v.58 no.1
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• pp.31-58
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• 2006

The purpose of this article is to analyze the structure and characteristics of the care manager systems of the long term care insurance in Japan's social welfare institution. In order to realize such purposes, this paper develops the discussion process as follows. Firstly, this paper examines the developmental processes and contents of the long term care insurance system and the care plan services which are the services to aid the utilization of long term care services. Secondly, this paper describes the care manager which conducts the role of care plan services intentively. Thirdly, this paper makes the research framework which is formulated as the legislative views about the care manager on the long term care insurance act, task systems, recruitment and retraining systems, and research data of care manager. Summarizing the contents of care manager's circumstances and characteristics about the long term care insurance, the results are explained as follows. that is to define care manager's status as the components of care plan center, to control indirectly the activities of care manager's care plan by operating care service center and care plan center in equal corporate, to set role and task ambiguously, to recognize care manager's role as the attributed role of care service center, to give licence and qualification in local government. Therefore, it's difficult to realize care plan depending on speciality and neutrality for the service user. The essential parts for the reform of care manager systems may be to separate care service center and care plan center and to redefine the task and role of care manager, the role and task of which should be put on care plan services.

• The Korean Journal of Applied Statistics
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• v.31 no.6
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• pp.693-706
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• 2018

It is very important to support the elderly with disability ageing in place. Assisting devices can help them to live independently in their community; however, they have to be used appropriately to meet care needs. This study develops an assisting device recommendation system for the beneficiaries of long-term care insurance that include algorithms to decide the most appropriate type of assisting device for beneficiaries. We used long-term care (LTC) insurance data for grade assessment including 8,084 beneficiaries from July 2015 to June 2016. In addition, we collected standard care plans for assisting devices, that power-assessors made, considering their performance and ability that could subsequently be matched with grade assessment data. We used a decision-tree model in data-mining to develop the model. Finally, we developed 15 algorithms for recommending assisting devices. The findings might be useful in evidence-based care planning for assisting devices and can contribute to enhancing independence and safety in LTC.

• Health Policy and Management
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• v.23 no.1
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• pp.90-100
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• 2013

Background: This study examined the relationships of dementia, stroke, and combined multimorbidity with long-term care utilizations among older people in South Korea. Methods: A nationally representative sample of 10,130 older adults who used long-term care services in 2010 were analyzed. We used the 5% sample of aged 65 years or older linked with National Health Insurance Corporation registry data of long-term care insurance system. The sample was categorized into three groups: dementia only (47.6%), stroke only (36.3%), and both dementia and stroke (16.1%). We estimated the use of institutional care, home care, and total expenditure of long-term care services, adjusting for the severity of each function (such as daily life, behavior or cognitive change, nursing care needs, and rehabilitation care needs) and sociodemographic characteristics. Results: Having dementia symptoms was positively associated with the use of institutional care services, on the other hand, having stroke symptoms was positively related with the use of home care. The total long-term care cost was higher in the group of having both dementia and stroke. Conclusion: Older persons with dementia symptoms and stroke symptoms have different patterns of long-term care utilization, and the multimorbidity increased the overall expenditure of long-term care utilization. These findings imply a need for differentiated management strategy targeting physically and cognitively impaired older persons, and special concerning for persons with multimorbidity conditions for long-term care insurance program in Korea.