• Research in Community and Public Health Nursing
• /
• v.27 no.4
• /
• pp.388-398
• /
• 2016

Purpose: To compare the changes in activities of daily living (ADLs) in older adults with stroke in different modalities of long term care (LTC) services, which include home care and institutional care. Methods: This is a comparative study using secondary data from the Korean national LTC insurance. Home care (HC) services users (n=3,494) and institutional care (IC) users (n=1,428) were extracted and compared in terms of ADLs and changes in ADLs to investigate the effects of HC and IC services in LTC. Results: All of the ADLs and LTC services benefit levels for 2 years had improved in both HC and IC services. The ADLs of older adults with stroke who received HC improved, while those who received IC experienced deterioration. The LTC services benefit levels of the HC and IC groups were significantly different after 2 years. Conclusion: The study has found that HC services may lead ADLs better for older adults with stroke. We recommend LTC policy makers to further develop HC and IC service programs to deliver quality LTC services.

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

• The Journal of Korean Physical Therapy
• /
• v.22 no.5
• /
• pp.95-102
• /
• 2010

Purpose: The purpose of this study was to analyze the necessity of home visit rehabilitation therapy by rehabilitation professionals working at social welfare facilities. Methods: The subjects of this study were 227 rehabilitation professionals (social worker, nurse, physical therapist, occupational therapist, speech-language therapist, special education teacher, and staff of institutions for the disabled who were working at community rehabilitation centers. The data were collected over 65 days (2008. 09. 10~11. 14). The results were analysed statistically by the Chi-square test. Results: The results are as follows: Long-term care service was established in Korea by the Ministry of Health in July, 2008. But there are limits to their being able to provide various rehabilitation services for chronic patients and old people. According to a recent survey, almost all rehabilitation professionals (N=227) stated that home visit rehabilitation therapy is necessary. Conclusion: In Korea, the long-term care service has a nursing service and a service supporting physical activities of daily living, but not physical therapy. So, home visit rehabilitation services should include physical therapy, rehabilitation exercise, and pain management.

• Journal of Korean Public Health Nursing
• /
• v.29 no.2
• /
• pp.203-218
• /
• 2015

Purpose: The purpose of this study is to find and suggest ways to invigorate operation of visiting nursing centers. Methods: SWOT analysis was performed based on the status of use of visiting nursing centers and opinion survey on the centers' nursing experts. Results: SO strategy was drawn to improve service satisfaction, develop standardized manuals, and improve the areas of visiting nursing services, and WO strategy was drawn to establish reliability, strengthen promotion or marketing strategy, strengthen management ability, and reinforce the governmental support of visiting nursing services. ST strategy was drawn to recover the functionality of health management, secure competitive advantage, and simplify the issuance of visiting nursing directions, and WT strategy was drawn to provide customized service, establish the cooperative system of related agencies, and adjust fees. Conclusion: For invigoration of visiting nursing centers, people must recognize the importance of the visiting nursing service and institutional standards should be established so that visiting nursing service, which is currently provided as an option according to Standard Long-Term Care Plan, can be provided on a mandatory basis.

• 한국노년학
• /
• v.37 no.3
• /
• pp.549-565
• /
• 2017

A high-quality workforce is essential to delivering the high-quality care for the older people who are beneficiaries of long term care insurance. Providing adequate education and ongoing training opportunities could be one answer that may lead to the ultimate goal of improving the quality of long-term care services. Thus this study aimed to examine a workforce crisis and difficulties that care workers face in current education system, especially in contents and administration aspects and draw out suitable solutions or improvement measures. The focus group interview approach was chosen to reflect opinions of long-term care workers, directors of the education system in long-term care facilities and managers. The findings from the focus group interviews were analyzed by theme and classified into several categories by common subjects:'Training contents', 'Training environment', 'Administrator', 'Compulsory training', 'Care givers supply', 'Working condition'. Also, four content areas were presented as follows:'Job training', 'Dementia care training', 'Administration system', 'Workforce'. The caregivers demand very practical training programmes and trainers with a lot of field experience. Improving the working condition and treatments for them leeds to expand the opportunity of the on-going training.

• Health Policy and Management
• /
• v.8 no.1
• /
• pp.232-265
• /
• 1998

Taiwan has experienced rapid economic growth during the past two decades. As a result, the demand for health care in Taiwan has increased rapidly. To meet the rising demand, Taiwan implemented a National Health Insurance (NHI) program on March 1, 1995. This program now covers more than 96 percent of Taiwan's citizens. Implementation of the NHI in 1995 represents fulfillment of a primary social and health policy goals of Taiwan. The goals of the NHI program is to eliminate financial barriers of health care for the citizens, to improve the quality of care. To achieve these goals, the NHI was designed on the following principles: 1. All Taiwan citizens are compul내교 joined the NHI program by law; 2. The NHI program provides comprehensive services; 3. The NHI is run by one single govt' subsidy; 5. The NHI adopt fee-for-services scheme to pay medical expenses and copayment to avoid abouse of medical services. However, the scheme did not bring in the efficient use of health care C. National Health Council, 1986 NARC, Aging in Japan, International Publication Series 1991;2 Kahana EF. Kiyak HA. Attitude and behavior of staff in facilities for the aged, 1984 Naoki I, John CC. Health polic report japan's medical care system, New England Joumal of Medicine 1995; 333(19) National Economic Research Associates, The Health CAre System in Japan, NERA, 1993. National Federation of health Insurance Societies (KEMPOREM), Health Insurance and Health Insurance Societies in Japan, 1995. Owe Ahlund, Aging and housing in sweden, Paper presented at the International Symposium, Long term Care Facility, 1993. Statisitics Jahrbuch, Statistisches Bundesamt, 1992. Stein S. Linn, MIW. and Stein EM. Patient's anticipation of stress in nursing home care, 1985. U. S. Senate Special Committee on Aging, A Report of the special Committee on Aging, Washing D. C, 1992. U.S. Bureau of the Census, 1994.

• 한국노년학
• /
• v.30 no.4
• /
• pp.1359-1375
• /
• 2010

Expecting the expansion of the elderly population under long-term home care with the coming of the aged society, this study purposed to propose a prevention and self-reliance support model and to get practical implications for minimizing dependency on care benefits and enhancing the effectiveness of prevention and self-reliance support. Research methods employed for this study were: first, reviewing theoretical literature for clarifying the concept of prevention and self-reliance support in providing long-term care benefits for the elderly; second, identifying factors hindering prevention and self-reliance support through analyzing standard long-term care use plans and documents related to long-term care benefits at elderly welfare centers to which the research subjects belonged; and third, surveying care benefit users on factors hindering their use of prevention and self-reliance support and their needs in the use of care benefits. Based on the results of the three types of qualitative research, we proposed directions for prevention and self-reliance support modeling and suggested practical implications for enhancing the effectiveness of prevention and self-reliance support. For this study, we collected documentary materials and conducted in-depth interviews with the participants with the consents and cooperation of managers and professional social workers at day care centers and elderly welfare centers in D City. According to the results of this study, literature review suggested that long-term care prevention and self-reliance support should be provided in a way of 'strengthening user-centered support systems,' which support elderly long-term care beneficiaries' right to lead a life as the subject of their own life. Document analysis found the absence of benefits related to health and medicine and lack of social support systems for prevention and self-reliance support, and the results of in-depth interviews suggested the necessity to strengthen services related to elderly long-term care beneficiaries' prevention and self-reliance, and the keen needs of the long-term care elders for prevention and self-reliance included: ① loneliness, anxiety, fear; ② missing for and worry about children and people; ③ moving, outing; ④ health and medical services, rehabilitation programs; ⑤ desire to use day care; ⑥ inconvenience of house structure; ⑦desire for meal menus; and ⑧ the occurrence of disuse syndrome. Based on these results, we suggested the base of prevention and self-reliance support modeling with three axes: ① strengthening user-centered support systems; ② strengthening support systems connected to health and medicine; and ③ strengthening social support systems.

• Research in Community and Public Health Nursing
• /
• v.33 no.1
• /
• pp.1-12
• /
• 2022

Purpose: This secondary data analysis study evaluated the effects of ICT enhanced home-visit nursing in long-term care insurance on health-related quality of life among community-dwelling older adults. Methods: This study included data of 131 older adults who had experienced a pilot service for ICT enhanced home-visit nursing. ICT enhanced home-visit nursing refers to a method of sharing health records and teleconference between a visiting nurse and a doctor during the home-visit nursing services to community-dwelling older adults. Health-related quality of life and influencing factors were analyzed by t-tests, logistic regression analysis using the Stata 17/SE program. Results: After a pilot service for ICT enhanced home-visit nursing, their health-related quality of life increased. The teleconferencing method had a significant effect on the increase in health-related quality of life. Conclusion: The findings indicate a pilot service for ICT enhanced home-visit nursing can be applied to the domestic community-based healthcare service model in terms of health management. In the future, the advanced service model of a pilot service for ICT enhanced home-visit nursing in which subjects conduct detailed for each health problem, and a well-designed evaluation system should be developed.

• Journal of dental hygiene science
• /
• v.20 no.1
• /
• pp.1-8
• /
• 2020

Given that the demand for dental care for elderly individuals is expected to increase according to demographic changes, long-term roadmaps for the current health insurance system should be actively planned. The study aimed to investigate the health insurance system in Korea, compared to that of Japan, and suggest directions for the work of dental hygienists to provide basic data on efficient improvements in the health insurance system. Based on the collected data, the website was used to collect additional related data from Korea and Japan. The most common cause of death in Korea was malignant neoplasms, and most patients were hospitalized for diseases and disorders of the musculoskeletal system and connective tissue. Dental care covered by Korean medical insurance for individuals aged 65 years or older was treatment oriented, such as dentures and implants, while in Japan, treatment-intensive items, such as visiting a dental hygienist for guidance and provision of home-care professional oral hygiene treatment, were covered. The percentages of remaining teeth in Korea and the percentage of remaining 20 teeth were 68.9% in those aged 65 to 74 years and 51.2% in those aged 75 to 84 years in Japan. A strategy for promoting oral health among elderly individuals should be established, and a multilateral intervention approach is required to prevent oral problems from leading to deterioration of whole-body health. The role of dental hygienists in providing comprehensive assessment to elderly individuals is important. In order to provide systemic oral care, it is necessary to introduce oral care systems according to the national policy.

• 한국사회정책
• /
• v.20 no.2
• /
• pp.97-129
• /
• 2013

This study aims to investigate causes of the emergence of so-called 'family-care workers' in the Long-term Care Insurance system in Korea. The LTCI system introduced in 2008 financially support the utilization of formal care services for the eligible elderly with care needs by paying for services of their care workers. Interestingly, 38.4 percent of payments for the in-home services were claimed by family members registered as qualified long-term care workers in 2012. We interviewed ten family care workers in depth and analyzed the needs of the aged and their families to explain the emergence of family care workers. The emergence of family-care workers is an inevitable result of choice by family members who face a dual burden of living and caring; be the additional choice following discharge the duty to support the elderly; be the alternative choice to fulfill unaccepted needs for services. These results suggest the needs for a comprehensive public provision of both income and social service support for the aged and an introduction of financial support for family care complementing the formal care support in the LTCI in Korea.