• Health Policy and Management
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• v.22 no.4
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• pp.522-537
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• 2012

The purpose of this study was to analyze the level of the cognitive function and activities of daily living of the beneficiary older adults at home based on Korean Long-term Care Insurance System. A cross-sectional descriptive survey was conducted from November 2010 to May 2011, the final respondents were 1,026 beneficiary older adults taking home visit care covered in Korean long-term care insurance system. The questionnaire included general characteristics of subjects, cognitive function, ADL(Activity of daily living). The data was analyzed using the SPSS 20.0 version. There was significant difference in cognitive function and ADL between 1st Grade, 2nd Grade and 3rd Grade of long-term care classification. The correlated factors of cognitive function were ADL, long-term care grade, disability of arm and leg, limitation of joint, bed sore and tube feeding. The correlated factors of ADL were cognitive function, long-term care grade, disability of arm and leg, bed sore and tube feeding. This study suggests that cognitive functions have to be mainly considered in long-term care grade. It is necessary to make an effort to develop long-term care grade in Korean long-term care insurance system an cognitive function improvement program for the beneficiary older adults. Above all things government will be seriously contemplating of revise contents for long-term care grade to provide quality of care for the older adults.

• Health Policy and Management
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• v.20 no.4
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• pp.126-138
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• 2010

Objectives : The purpose of this study is to evaluate the effects of assistive products usage on activity of daily living for the beneficiary older adults people in Korean long-term care insurance system. The study subjects were divided to assistive products users and non-users among the beneficiary older adults based on Korean long-term care insurance system to compare function improvement of the activity of daily living. Methods : In national wide 12 community elderly care center enrolled the National Health Insurance Corporation, The numbers of 281 beneficiary older adults(long-term care Grade I: 66, Grade II: 58, Grade III: 157) participated in this study. This survey assessment tool for activity of daily living was used the long-term care assessment instrument of the physical functions in the law of Korean long-term care insurance. The function items of Activity of daily living were included in clothing, washing, tooth brushing, bathing, eating, posture converting, stand sitting, move sitting, out of room, using toilet, controlling of stool, controlling of urine, washing hair. According to independence to complete dependence functioning level, remarks pointed 1 to 3 points. The data were analyzed by chi-square, two-way anova using SPSS V. 12.0. Results : The results appeared that the mean score of the functions in activity of daily living of assistive products users was a 27.60, and that of non-users was a 30.66. Assistive products were not effected in Grade I and II recipients, but that effected in Grade III recipients. Conclusion : Preparing for activation of assistive products based Korean long-term care insurance system, the result application as follows is possible. The usage of assistive products could improve the function of daily living activity in older adults. Related to Grade III beneficiary elderly people were improved function in activity of daily living by using assistive products, it is necessary to extend coverage the non-eligible elderly people in Korean long-term care insurance system.

• The Korean Journal of Health Service Management
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• v.8 no.1
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• pp.51-64
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• 2014

The purpose of this study was to investigate the relationship among staffing, occupancy rate, upward level change of long-term care need, and evaluation grade of facility. Data were obtained from National Health Insurance Corporation Database. Occupancy rate and evaluation grade were highest in National/public operating facilities, while they were worst in individual operating facilities. The percents of A or B grade in evaluation grade (by newly enforced law) is highest in National/public operating facilities. Multiple regression analysis showed that upward level change of care needs was very weakly associated with the number of doctors. Evaluation grade showed a weak and significant association with occupancy ratey(by old-version law)(r=.20, p<.01), upward level change of care need in group home(r=.23, p<.01) Staffing in facility did not show significantly consistent association with upward level change of care needs, evaluation grade, and occupancy rate.

• The Journal of the Korea Contents Association
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• v.18 no.1
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• pp.76-89
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• 2018

The purpose of this study is to analyze factors affecting a grade maintenance of long-term care service users. Using 2008-2014 long-term care raw data of National Health Insurance Service(NHIS), the predictors were examined through the logistic regression by long-term care beneficiaries of grade. The results showed that there are differences by 3 factor groups and grade groups(1-3 grade). In socio-demographic factors, in the 1, 3 grade, Individuals 64 or younger presented a much higher probabilities of the grade maintenance than those 85 and over. In the 3 grade, people of living alone, resident of rural area presented a much higher probabilities of the grade maintenance than others. In disease factors, In the 1 grade, people with dementia presented a much higher probabilities of the grade maintenance than other 2, 3grades. In the 2 grade, people with stroke, fracture presented a much higher probabilities of the grade maintenance than others. In the 3 grade, people with cancer presented a much higher probabilities of the grade maintenance than others. In service factors, In the 2, 3grade, people having more renewal numbers presented a much higher probabilities of the grade maintenance than others. In the 1 grade, people who use facility benefits for more days presented a much higher probabilities of the grade maintenance than others. In the 2 grade, people who use in-home benefits for more days presented a much higher probabilities of the grade maintenance than others. Based on the finding of study, implications and future research directions were discussed for policy considerations.

• The Journal of the Korea Contents Association
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• v.20 no.7
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• pp.149-160
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• 2020

The purpose of this study is to analyze factors affecting a grade maintenance of the non-graded group by LTCI(Long-Term Care Insurance, NHIS). The predictors were examined grade maintenance of the non-graded group(non-grade of A, B, C). The results were as follows: this study found that predisposing factors of the grade maintenance of non-graded of LTCI were significantly related to age, sex, death. Enabling factors of the grade maintenance of non-graded of LTCI were significantly related to household state, income level. Need factors of the grade maintenance of non-graded of LTCI were significantly related to dementia, grade of first grading, retry of applying for long-term care assessment. Based on the finding of study, implications and future research directions were discussed for policy considerations.

• 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.

• Journal of Korean society of Dental Hygiene
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• v.9 no.1
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• pp.169-180
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• 2009

This study grasped recognition on a system of long-term care insurance for the elderly targeting dental professionals who are working at dental hospitals and clinics where are located in Daejeon Metropolitan City. It developed and utilized materials available for educating the care staff in a system of long-term care insurance for the elderly and the dental professionals who participate in the oral hygiene service. It carried out the effective duty performance for the elderly in a situation of long-term care protection. Thus, the purpose of this study was to contribute to the early settlement in a system of long-term care insurance for the elderly. The following conclusions were obtained as a result of having carried out self-administered questionnaire research targeting 238 people from August 1 to August 30 in 2008. 1. In the general characteristics of the research subject, the present working place was indicated to be 22.7% for dental hospital, 71.8% for dental clinic, and 5.5% for others. As for the main duty field, the medical treatment & cooperative duty was indicated to be the highest with 61.8%, and was statistically significant(p=0.000). 2. The necessity for a system of long-term care insurance for the elderly was indicated to be 77.7% for 'necessary' and 1.7% for 'unnecessary,' and was statistically significant(p=0.016). 3. In the item of dividing the service of long-term care insurance for the elderly, the dental hygienists showed higher recognition than non-dental hygienists, and indicated significant difference(p=0.010). 4. As for recognition on a system of long-term care insurance for the elderly in dental professionals who responded as saying of 'knowing name and contents' about a system of long-term care insurance for the elderly, the recognition level was high in recognition of subjects' age(p=0.000), division in services(p=0.012), contents in at-home care service(p=0.000), execution in oral-hygiene service(p=0.004), procedure of using the long-term care insurance for the elderly(p=0.016), item of judging grade of long-term care insurance for the elderly(p=0.013), medical charge by service according to judging grade of long-term care insurance for the elderly(p=0.015), burden of cost for a system of long-term care insurance for the elderly(p=0.011), qualification of care staff(p=0.002), and contents of oral-hygiene service(p=0.027), and showed significant difference. 5. The service of long-term care insurance for the elderly and the oral-hygiene service indicated the statistically significant correlation. Accordingly, all of dental professionals need to make a desperate effort to improve dental professionals' knowledge on a system of long-term care insurance for the elderly enough to be required a system of long-term care insurance for the elderly. The more systematic and standardized professional education and materials are thought to be needed to be developed aiming at the success in oral-hygiene service within a system of long-term care insurance for the elderly, by strengthening professionalism in dentists and dental hygienists.

• Health Policy and Management
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• v.29 no.4
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• pp.496-501
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• 2019

Background: In this study, wage status and wage determinants of care workers were analyzed. Methods: The analysis used database (DB) of long-term care institutions, DB of long-term care institutions, DB of long-term care workers, DB of health insurance qualification, and contribution possessed by National Health Insurance Services. We analyzed the wage status of the care workers from 2009 to 2016 through basic analysis and estimated the factors affecting the wage of the long-term care facilities' care workers using pooled ordinary least squares. Results: The monthly average wage of care workers was raised from Korean won (KRW) 1.37 million in 2009 to KRW 1.52 million in 2016, and the working hours were shortened by 20 hours from 207 hours to 187 hours. Hourly wages increased by KRW 1,329 from KRW 6,831 in 2009 to KRW 8,160 in 2016. The average monthly wage of care workers was affected by gender, age, years of employment, monthly working hours, establishment type, city size, institutional size, the grade of the institution, and management status. In particular, the wage level of the care workers was high when the larger the size of the institution, the better the management status (fill rate), the establishment type is "government and local government" and "corporation," the institutional rating is high, and the facility manager has the first grade of the social worker license. Conclusion: The government should consider aggressive policies to improve the treatment of care workers as well as the quality of long-term care services so that there will be more long-term care facilities that are guaranteed social publicity above a certain level.

• Journal of Preventive Medicine and Public Health
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• v.43 no.4
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• pp.319-329
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• 2010

Objectives: This study was performed to determine the levels of quality of life (QOL) according to the grade of long-term care service for the elderly people who were admitted from long-term care insurance, and to reveal its association with the physical and mental functioning such as the Activity of Daily Living (ADL), the Instrumental Activity of Daily Living (IADL), the Center for Epidemiologic Studies Depression Scale (CES-D), and the Mini-Mental State Examination-Korean version (MMSE-K). Methods: The interviews were performed during the period from March 1 to May 31, 2009, for 958 elderly people in urban and rural areas. The questionnaire items included various indices such as the ADL, IADL, CES-D, and MMSE-K, as independent variables and the index of QOL, as the dependent ones. For statistical analysis, t-tests were used for the mean scores of QOL according to gender and the grade of long-term care services, and Spearman's correlation was used for each variable. The effects of physical and mental functioning for QOL were assessed by covariance structure analysis. The statistical significance was set at p<0.05. Results: The mean scores of QOL among all the subjects was $55.4{\pm}15.62$ (Grade I: $49.7{\pm}14.17$, Grade II: $56.8{\pm}14.62$, Grade III: $59.4{\pm}16.36$), and it was lower according to the higher grade of long-term care insurance. In terms of the correlation matrix of the QOL and the physical and mental function factors, the QOL showed positive correlation with the ADL, IADL and MMSE-K, while it had negative correlation with depression. On the analysis of covariance, mental functioning (depression and the MMSE-K) had a greater influence on the level of QOL than the physical functioning (ADL and IADL). Conclusions: The level of the QOL in the elderly people who were admitted from long-term care insurance was lower according to higher the grade of long-term care insurance. Also, the mental functioning (depression and MMSE-K) was more influential on the level of the QOL than the physical functioning (ADL and IADL).

• Korean Journal of Adult Nursing
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• v.20 no.2
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• pp.251-268
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• 2008

Purpose: This study aimed to develop the first standardized education & training program for education of senile long-term care managers to improve the quality of senile long-term care service. Methods: The study developed programs through literature review, specialists' conference and interview with the linear approach from February, 2007 to May, 2007. Results: Senile long-term care managers should have qualification of 51 items in knowledge, 35 items in technology and 17 items in attitude. Total 8 subjects were education & training subjects of senile long-term care managers and the study proposed targets of each subject and education & training level divided into top, middle and bottom. Total education & training hours were composed of 70 hours in theory, 50 hours in practical technique and 40 hours in social welfare practice in agencies. Conclusion: The study will contributed development of the first education & training programs for education of senile long-term care managers. Therefore, the study proposes that the study will be applied to a systematical education & training course through program verification after applying real programs to senile long-term care managers and that it is necessary to develop the standardized education & training program for higher senile long-term care managers.