• Title/Summary/Keyword: Korean Long-term Care Insurance

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Validity and Reliability of Cognitive Performance Scale in Long Term Care Hospital in Korea (인지수행척도(Cognitive Performance Scale)의 타당도와 신뢰도)

  • Lee, Ji Yun;Kim, Sun Min;Kim, A Reum
    • 한국노년학
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    • v.30 no.1
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    • pp.81-91
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    • 2010
  • The purpose of this study was to test a validity and reliability of Cognitive Performance Scale(CPS), a cognitive measure generated from 5 items(comatose status, decision making, short-term memory, making self understood, and eating). Method: 393 patients in 2 hospitals for the elderly with dementia were measured with CPS by two nurses independently. The inter-rater agreement was tested by comparing two scores. The CPS score was compared with GDS, which was measured by doctors and nurses, and MMSE score which was drawn from the claim data of Health Insurance Review & Assessment Service. Result: The correlation coefficient between CPS and GDS was 0.742(p<0.0001), CPS and MMSE was -0.794(p<0.0001). The Cronbach's coefficient alpha of CPS was 0.742, Kappa value was 0.772~1.000. The CPS showed high validity and reliability in long term care hospitals of Korea.

Development of Eligibility Criteria for Comprehensive Medication Management Programs in Long-term Care Facilities Using RAND/UCLA Appropriateness Method (RAND/UCLA Appropriateness Method를 이용한 요양시설의 포괄적 약물관리 프로그램의 대상자 기준 개발)

  • Jang, Suhyun;Kang, Cinoo;Ah, Youngmi;Lee, Ju-Yeun;Kim, Jung-Ha;Jang, Sunmee
    • Korean Journal of Clinical Pharmacy
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    • v.32 no.3
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    • pp.260-269
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    • 2022
  • Background: Comprehensive medication management is essential to achieve safe and optimal drug use for the elderly in long-term care facilities (LTCF). This study aimed to develop eligibility criteria for "Comprehensive medication management program in LTCF" using the RAND/UCLA Appropriateness Method (RAM). Furthermore, we attempted to estimate the number of beneficiaries who met the criteria by analyzing the National Health Insurance claims data. Methods: Twelve criteria were selected initially. We composed a panel of 14 experts with expertise in long-term care. We conducted two survey rounds to reach a consensus. Rating for appropriateness and decision regarding agreement were applied per RAM. We analyzed the National Health Insurance data to estimate the number of LTCF residents who met each eligibility criterion. Results: Of the 11 items agreed upon, ten items were determined to be appropriate. In 2018, 83.6% of 165,994 residents of LTCF met one or more eligibility criteria. The largest number of subjects met the "New residents of LTCF" criterion, followed by "Take high-alert drugs" and "Chronic excessive polypharmacy." Since the items evaluated as most appropriate by the expert panel and those with a large number of subjects were similar, we confirmed the external validity of our criteria. Conclusion: It is worth noting that this is the first attempt to establish the eligibility criteria for medication management in LTCF. Further preliminary research is needed to identify the selected subjects' drug-related problems and revise the criteria according to the results.

Measuring Workload of Home Visit Care Activities Using Relative Values (방문요양 행위 업무량의 상대적 가치 측정)

  • Han, Seong-Ok;Park, Eun-Cheol;Kang, Dae-Ryong;Kang, Im-Ok
    • Journal of Preventive Medicine and Public Health
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    • v.41 no.5
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    • pp.331-338
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    • 2008
  • Objectives : The purpose of this study was to measure the workload of home visit care activities and their relative values. This study examined also factors that affect the workload of home visit care activities. Methods : The participants of this study were 126 home-helpers of 50 home visit care agencies at the 2nd Long-term Care Insurance Demonstration Project. The workload of home visit care activities was divided into total work and four dimensions ; physical efforts, mental efforts, stress and time. Home visit care activities consisted of four categories with 24 items. We used magnitude estimation method to measure their relative values of the four dimensions. The participants answered the relative values of each activities based on the reference service. We used the activity for supporting their elderly's evacuation as the reference service. Results : Most of the respondents were over 40 years old female. They consumed most their time supporting elderly's going out. They consumed their highest physical, mental efforts, and stress for activities of coping with emergency situation. The Pearson correlation coefficients showed significant relationships between workload and each dimensions. This study showed that all four dimensions are statistically significant predictors of workload of home visit care activities. Also, we found that the home-helper's career affects the workload of home visit care activities. Conclusions : The workload of home visit care activities could be explained by physical efforts, mental efforts, stress and time.

Effects on Long-Term Care Hospital Staff Mixing Level after Implementing Differentiated Inpatient Nursing Fees by Staffing Grades (간호등급제가 요양병원의 간호인력 확보수준에 미치는 영향)

  • Kim, Donghwan;Lee, Hanju
    • Journal of Korean Academy of Nursing Administration
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    • v.20 no.1
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    • pp.95-105
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    • 2014
  • Purpose: The purpose of this study was to examine trends in number of nursing staff and skill mix. Methods: Nursing staff and skill mix were measured using the number of nursing staff including nurse aids and registered nurses per bed. Descriptive and panel data regression analyses were conducted using data on long-term care hospitals which included yearly series data from 2006 to 2010 for 119 hospitals. Results: The number of nursing staff per bed increased significantly but percentage of registered nurses decreased significantly from 2007 to 2010. The regression model explained this variation as much as 34.9% and 43.8%. Conclusion: The results showed that in long-term care hospitals there were more nurse aids employed instead of registered nurses after the implemention of differentiated inpatient nursing fees. Thus clarifying the job descriptions for nurses and nurse aids is needed and appropriate hospital incentive policies should be implemented.

Factors influencing the composite quality score from the quality assessment program for long-term care hospitals (요양병원의 입원급여 적정성 평가 결과에 미치는 영향 요인 분석)

  • Lee, Sang-Kab;Seol, Jin-Ju;Lee, Kwang-Soo
    • Korea Journal of Hospital Management
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    • v.25 no.3
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    • pp.78-86
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    • 2020
  • Purposes: This study purposed to identify factors influencing the composite quality score from the quality assessment program for long-term care hospitals Methodology: The study variables was obtained from HIRA(Health Insurance Review and Assessment Service): the composite quality scores and hospital variables such as number of doctors, nurses, beds, medical technicians, medical equipments, administrative region, ownerships from 3rd (2010) to 7th (2018) quality assessment program. National Statistical Portal(www.kosis.go.kr) provided the number of senior citizens aged over 65 in city·county·district area. SAS 9.4 was used for the data processing and used to analyze the data. Findings: The results showed that composite quality score increased past 9 years. Hospital variables such as number of doctor, nurse, medical technicians, bed and public hospitals had significant positive relationship with the composite quality score. Administrative region(district) showed higher scores compare to that of city. Compare to the score of quality assessment year(2010), as the assessment year move to 2012, 2013, 2015, 2018, results showed higher significant positive coefficients. Practical Implication: Continuously improve the performance of long-term care hospitals, current quality assessment program are needed to update their system such as adopting indicators measuring the service process, or compensating the cost for quality assessment program. It will enable to provide more reasonable and accurate performance assessment scores.

Home care services: crisis and prospects (가정간호: 위기와 전망)

  • Song, Chong-Rye
    • Perspectives in Nursing Science
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    • v.6 no.1
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    • pp.55-65
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    • 2009
  • The Korean government introduced Home Care Services System to cut medical cost and make efficient use of limited medical resources because of increasing chronic diseases and the growing population of the elderly. The Korean government established measures to control the use of insurance services by restricting the number of nurse's visits to patient's home and by asking the patients to shoulder the transportation fee of nurses during the visit. Factors such as oversupply of hospital facilities, low price of home care services, high insurance coverage for hospital services and increased nuclear family set up resulted in the limited use of home care nursing services. The introduction of long-term care insurance in 2007 brought the decrease in the number of home care agencies and these agencies are facing a crisis today. The increase in chronic diseases and growing population of the elderly recently resulted in the need to control the high medical cost. Home care services for early discharge patients and chronic-severe disease patients will contribute in the reduction of medical cost at the same time improves the quality of patient's life. To catch up with the demands of the nation, accessibility to home care services should be improved and policies such as the expansion of home care services insurance coverage and promotion of establishing home care agencies should be considered.

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What Caused the Emergence of Ethnic Contents in Japanese Elderly Care Services? : Interaction between Ethnic Movement and Social Welfare Policy (일본 노인복지서비스에 있어 새로운 민족적컨텐츠 등장의 배경과 요인에 대한 연구:민족운동과 복지정책과의 관계)

  • Lee, Hyunsun
    • The Journal of the Korea Contents Association
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    • v.18 no.5
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    • pp.167-174
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    • 2018
  • Japanese state has continuously tried to adapt itself to the social demands coming from rapidly greying population. Japanese government introduced the new social insurance system of elderly care, i.e. Long term Care Insurance with epoch-making changes in the Japanese welfare system. The most important aspects of the new system can be summarised as follows: 1) social insurance system of obligatory entry with paying premiums and co-payment 2) emphasis on the customer choice, competition, flexibility, free-market, relaxation of the regulation. This characteristics brought unexpected results of the emergence of ethnicity-centred contents of welfare services. As a selling point in freemarket and as a countermeasures against expected ethnic disadvantages, the Korean ethnic organisations brought the ethnic elements resulting in the diversified Japanese welfare services.

A Study on the Typology of Social Insurance Policy Instruments in Korea (우리나라 사회보험 정책수단의 유형에 관한 연구)

  • Noh, Shi-Pyung
    • Journal of the Korea Society of Computer and Information
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    • v.19 no.5
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    • pp.109-117
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    • 2014
  • This study tries to find the policy instruments that have used in the process of social insurance policy implementation. The results can be summarized as follows: First, in case of compulsory policy instrument, the government uses the regulation, public enterprise and government insurance in the process of implementing of all the social insurance policy. Second, in the case of mixed policy instrument, the government use the user' contribution in the process of implementing of all the social insurance policy but the subsidy was used in the process of implementing of the medical, pension, unemployment and long-term care insurance for the aged policy. Also, the information and discipline was used in the process of implementing of unemployment insurance policy and the partnership was used in the process of implementing of long-term care insurance for the aged policy. Third, in case of voluntary policy instrument, the government uses the family and community in the process of implementing of almost the whole social insurance policy.

A Study about the current infra-structural status of the aged care worker to improve the quality of long-term care in Germany (독일 노인장기요양보험의 서비스 질 향상을 위한 인프라 구축 현황에 대한 연구)

  • Lee, Sang-Myung
    • 한국사회정책
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    • v.19 no.3
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    • pp.49-83
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    • 2012
  • Currently in Germany, there is talk of 'state of emergency care', which is addressed to the problems of quality assurance in aged care and shortage of aged care workers. In order to solve this problem in the aging German society, the federal government has set itself the goal of providing high qualified care givers through a systematic and on a high level of professional training opportunities. Various projects and measures have been carried out to improve the reputation of the primarily care profession in society and for the purpose of attracting especially young trainees for the aged care professions. The present work considers training and qualifications in the long-term care sector in Germany; it points out both the characteristics of aged care education and the learning content in the aged care education and attempts to highlight what roles and perception of tasks contained therein.

A Study on the Improvement Direction through the Present Status of Nursing Home - Focus on the Nursing Home in Chungcheongbuk-do - (노인요양시설의 건축현황 및 개선방향에 관한 연구 - 충청북도 노인요양시설을 중심으로 -)

  • Lee, Wan-Geon
    • Korean Institute of Interior Design Journal
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    • v.19 no.3
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    • pp.242-250
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    • 2010
  • Recently, the long-term care insurance for the elderly was carried out according to the elderly is increased rapidly and the formation of sympathy that a nation and society try commonly to share health and welfare promotion of the elderly. The purpose of this study is to analyze the present status of nursing home after that the long-term care insurance is enforced in chungcheongbuk-do and to utilize as basic data. The study limited its survey to those facilities that refer to the Ministry of Health and Welfare data, that had the capacity of more than 50 people. The result are as followings. Firstly, most of the nursing home were located on the outskirts of the city. But it must be constructed in the city center if the recent deinstitutionalization trend is reflected. Secondly, notwithstanding the provisions of the Elderly Welfare Law, if the Livability and amenity are considered, the plan of a single or a twin room is needed. The ondol(溫突) system bedroom for the safety of the elderly had to be planned and for the color planning of a bedroom, a heating, the furniture, the form of a door, corridors, etc. should be partly improved. The fastener in which it is appropriate for the main exit, a stair, an elevator, the lighting device, and etc. is needed and the installation of a wandering path for the dementia patient and etc. is required. Thirdly, most of the dining room arranged on the first floor but it is not nearly used and it used for employee or the other use. Therefore, we have to consider the system in which it can deliver the meal to a bedroom. If the smell of the elderly and etc. is considered, the sufficient height of the floor should be reflected for the ventilation equipment. Lastly, The improvement of the existing law are required.