• Journal of The Korea Institute of Healthcare Architecture
• /
• v.17 no.4
• /
• pp.15-23
• /
• 2011

Long-term care Insurance system for the Elderly was started to respond to the aged society on July 2008 in Korea. So responsibility of the care for the old is being changed from the family to the society. The introduction of that insurance system has brought the growth of demand for care service. To improve the level of quality for care service providers in long-term care, the role of care worker in providers is recognized as important. But welfare system for the care worker seems to be poor. So the Seoul Metropolitan Council is preparing an ordinance for the care worker and the purpose of this study is for the ordinance as well. Questionnaires, interviews, documentary surveys were used to carry out this study. The results of this study are summarized as follows. The job stability is the most important thing for the care worker, so local government has to make efforts to promote the job stability of care worker. A welfare center for care workers is needed for the health for care workers in the local government. And the local government has to supervise service providers more strictly and evaluate them in treatments of care worker.

• Journal of The Korea Institute of Healthcare Architecture
• /
• v.20 no.4
• /
• pp.67-80
• /
• 2014

Purpose : Long-term Care Insurance sets up facility standard and installation standard of aged care facilities and decides the presence of minimum number of rooms and its size in care facilities by using systematic instruments. Therefore, most aged care facilities had renovation in expansion and reconstruction following the revised regulations and even facility space structure and space composition are continuously improving. The study is to determine the purpose and trend by comparing before and after space composition of facilities which followed the implementation of Long-term Care Insurance and also to suggest hierarchical space composition suitable for aged care facilities through derived problems and to provide basic materials to plan the most appropriate facility for the aged. Methods : J-graph based on Space Syntax Theory will be schematized through in-site facility survey and before and after facility floor plan. Space composition trend will be analyzed by comparing indexes through S3 program. Results : As a result of 5 cases analysis, the following results were found; the average of whole space depth is increasing due to the Extension, the number of volunteers is decreasing and rooms for geriatric care helpers are being created due to the geriatric care helper introduction duty. Also, there are solariums being created to improve the health of the aged and dispensaries are being placed on every floor with the increase of documentary work for geriatric care helpers. With the policy implementation, care facility space composition and structure are changing with facility standard and it was analyzed that facilities were mostly put under the control of limited number of people in care room and total ground area per person. It was also found that there is increase in care space integration through before and after comparison of whole integration value. This is considered as the important result not only in facility standard satisfaction, but also in care support of geriatric care helpers and the aged, its main users. Implication : In order for elderly care facilities to have quality improvement and to develop as suitable facilities for characteristics of the aged, independent environmental facility standard preparation of elderly care facilities is needed through mutual cooperation of construction fields with regulation and policy related researches.

• 한국노년학
• /
• v.31 no.4
• /
• pp.1047-1065
• /
• 2011

The main purpose of this study is to provide the sustainability and continuous development of Long-term care Insurance in projecting changes of the Long-term care Insurance beneficiary population and Cost. We conducted a transformed cohort-component projection method that are employed for the beneficiary population projection and applied the previous experiences in Japan and German. A transformed cohort-component method means that we also projected the increasing beneficiary of long-term care insurance for using the data of geriatric disease in NHIC and estimated the cost of insurance's financial resources. First of all, beneficiary increase and strategy of extending to level 4 are categorized 2 and the expense account projection are categorized 2. If it is thought experience of Japan and German, The Level 4 extend of insuree is projected 2012 or 2013. With the results of this study, we proposed that extended level 4 insuree include the 40%~90% of geriatric disease in elderly people. The number of beneficiaries in 2011 is expected to reach to about 342,896 and in 2015 is 415,905 on scenario 1. Scenario 2(40%of geriatric disease in elderly people), the number of beneficiaries in 2011 is 342,896 and in 2015 is 483,453. Scenario 3(90%of geriatric disease in elderly people), the number of beneficiaries in 2012 is 545,068 and in 2015 is 565,565. The cost of beneficiaries insurance benefit of scenario 1 are projected from 3,000billion in 2012 to 3,500billion won in 2015. Scenario 2 are projected from 3,100billion in 2012 to 4,000billion won 2015. Finally, The cost of Level 4 extending are need minimum 300billion to maximum 1,400billion won.

• Research in Community and Public Health Nursing
• /
• v.10 no.1
• /
• pp.106-120
• /
• 1999

Japan has been prepared for aging society from 1970. In 1970, the percentage of distribution of population of 65 years old and over was 7.1%. It is similar to present percentile of the elderly in Korea. Therefore, it will be needed to study about home care and home visiting nursing in Japan at present. This study was aimed to prepare the fundamental documents for home care nursing in Korea and to know the background of new health care system of Long-term Care Insurance in Japan, by studying home care and home visiting nursing in Japan. With the continuing aging of the population, especially the increase in the number of latter stage elderly, it is predicted that there will be an increase in the number of the elderly who are bedridden and suffering senile dementia. To ensure that these people will be able to continue living in the communities and homes they are accustomed to, surrounded by their families and neighbors, Japan substantially improve and expand in-home services. There were also long-term effort to reach the level of services outlined in the Gold Plan and the New Gold Plan within the decade between FY 1991 and FY 1999 in the field of health care and welfare. Under this plan, the most noticeable change was occurred in home care, home was permitted as the field of care and visiting nursing was established in law. Through this 10- Year Strategy for Promotion of Health and Welfare Services for the Aged, many problems have been improved and solved, but some problems remained such as inadequate service supply and consumption of medical insurance for the elderly. Japan will be a society composed 25% of elderly people of total population in 2020, and it will be soon faced with a shortage of welfare and medical facilities and manpower. As for equalizing the benefits and cost burdens, and other future arrangements for health care and welfare, Long-term Care insurance system was established in 1994. This system will be enforced from April 2000 and use present facilities and services. To know home care and home visiting nursing in Japan, we need to consider present conditions well and to take notice of changes and measures to cope with an aging society continuously.

• Korean Journal of Community Nutrition
• /
• v.18 no.2
• /
• pp.142-153
• /
• 2013

The purpose of the study was to examine nutritional management and nutritional care demands of home-visit care service and the nutritional status of serviced elderly. The survey was carried out from $5^{th}$ to $21^{st}$ of January, 2011 among 37 In-Home Service institutions. The number of elderly surveyed by 143 care helpers was 281. Analysis was performed for 203 subjects (male: 44, female: 159). The age distribution was from 50 to 99 years. The grading by long-term care insuranceshowed 18,2% on level 1 and 2, and 81.8% on level 3. For the disease treatment, the proportion of implementing diet treatment turned out to be very low. The proportion of subjects living with their children was 45.3%, and living alone was 29.1%. The proportion of home-visit care among types of In-Home Service was 70%. Subjects who needed additional necessary diet management service turned out to be 40.9%. Diet management was the most necessary services from all levels. MNA (specifiy MNA) scores were significantly (p < 0.001) associated with BMI, mid-arm circumference (MAC), calf circumference (CC), intake problems, and weight loss during the last 3 months. For studied elderly, 45.3% were malnourished, and 46.8% were at the risk of malnutrition by MNA score. Based on the result of this survey, the nutritional care was not systematic on the In-Home Service. Prevention and management of the disease was much better than the treatment to improve the quality of life. We conclude that nutrition management is necessary for the elderly. To improve nutritional status of elderly in home care services, systematic nutrition management should be implemented.

• The Korean Journal of Applied Statistics
• /
• v.22 no.6
• /
• pp.1229-1237
• /
• 2009

In the long-term care insurance(LTCI) system, the question of how to provide the most appropriate care has become a major issue for the elderly, their family, and for policy makers. To help beneficiaries use LTC services appropriately to their needs of care, National Health Insurance Corporation(NHIC) provide them with the individualized care plan, named the Long-term Care User Guide. It includes recommendations for beneficiaries' most appropriate type of care. The purpose of this study is to develop a recommending system for care plan(Res-CP) in LTCI system. We used data set for Long-term Care User Guide in the 3rd long-term care insurance pilot programs. To develop the model, we tested four models, including a decision-tree model in data-mining, a logistic regression model, and a boosting and boosting techniques in an ensemble model. A decision-tree model was selected to describe the Res-CP, because it may be easy to explain the algorithm of Res-CP to the working groups. Res-CP might be useful in an evidence-based care planning in LTCI system and may contribute to support use of LTC services efficiently.

• Journal of The Korean Digital Architecture Interior Association
• /
• v.12 no.2
• /
• pp.5-13
• /
• 2012

After elderly long term care insurance implementation (July 1, 2008), the elderly medical and welfare facilities covered by medical insurance continuously increases 30 to 63% sanction annually. Rapid growth of senior citizen welfare facilities arises in a poor residential environment issues. In most cases, it is the legal minimum criteria tailored for 4 persons accommodated in nature, such as the hospital. Therefore, 'Hometown-style traditional Korean House' is needed to rest comfortable for elderly people. Research goal is to provide direction and design materials by developing a type of architectural planning for the elderly welfare facilities unit care of the atmosphere of a traditional Korean House. The following two elements are applied to the elderly welfare facilities. Senior citizen welfare facilities in the main living space are applied to modern residential space of the elderly-friendly atmosphere of a traditional Korean House. It is applied for the Korean lifestyle and residential culture are through an analysis of Japan's leading development unit care system.

• 한국노년학
• /
• v.29 no.3
• /
• pp.917-933
• /
• 2009

This study examined the factors affecting forms of long-term care service use by elderly and the forms of use are classified facility care service, home care service, and unused. It is used data from the 2nd pilot program for the Long Term Care Insurance scheme and it is analysed 5,497 cases. Multi-nominal regression is used. According to the results, women use formal service more than man do, and wowen use facility care than home care. Those who eligible for National Basic Livelihood Security System(NBLSS) are shown to have higher use of formal care(especially facility care) than the middle income class, and the low income class than the middle income class has lower use of formal care. In addition, higher the family care is available, lower the taking part in the service. The big cities and mid sized cities than rural are used the formal service and moreover mid sized cities are used facility care than home care. Furthermore, the level of care need is determinants of service use and function of ADL, IADL, and abnormal behavior is also determinants of formal service(especially facility care). But nursing need and rehabilitation need are not determinants of formal service use. Based on the results, the recommendations are developed and implemented for the improvement the elderly long-term care insurance.

• 한국노년학
• /
• v.29 no.1
• /
• pp.177-194
• /
• 2009

Korea government has launched long-term care insurance from 2008. However, one of the most important issues, whether or not providing cash benefit, is still unresolved. In this paper, in order to provide policy guidelines for the long-term care insurance, I attempt to estimate the Willingness-To-Accept (WTA) of the cash subsidy for informal care by using Double Bounded Dichotomous Choice method, a branch of Contingent Valuation Method (CVM). In doing so, I also estimated the determinants of the preference for cash benefit. Data were obtained from face-to-face survey interviews with 300 informal care-givers at three major general hospitals in Seoul, Korea. The questionnaire was constructed with two scenarios (mild/severe symptom). The results from logistic regression analyses and the estimation of WTA indicate that informal care-givers are willing to accept the cash benefit as low as 628 thousands won for mild fragile elderly and 1,072 thousands won for severe fragile elderly. The strength of this paper is that I estimated the WTA of the cash benefit by reflecting the changes in preferences of informal care-givers. The analytic results from the this paper suggest that the cash benefit in long-term care insurance is indispensible in achieving the goal of the long-term care system.

• The Korean Journal of Health Service Management
• /
• v.8 no.4
• /
• pp.187-197
• /
• 2014

The purpose of this study was to examine the influence of long-term care insurance(LTCI) settlement on life satisfaction of female caregivers for the elderly. In September of 2013, we conducted a survey of 300 female subjects over 65 years old living in Jeonju. For empirical verification, ${\chi}^2$, t-test and regression under control of socio-economic variables were applied to determine whether LTCI settlements changed the level of life satisfaction of female caregivers. First, the results showed that caregivers who were not covered by LTCI had higher healthy life satisfaction than those covered with LTCI. Second, life satisfaction of female caregivers is higher when income and education levels are higher. Third, LTCI settlement did not affect five sub factors of caregivers' life satisfaction. The results suggested that LTCI policy should cover not only the insured but also caregivers'physical and mental aspects.