• Health Policy and Management
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• v.27 no.2
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• pp.139-148
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• 2017

Background: The purpose of this study is to investigate family caregivers' opinions about out-of-pocket payment for long-term care (LTC) facilities, and find the differences in the opinions for family caregivers of all different levels of income. Methods: We used the data of the study on out-of-pocket payment in national long-term care insurance, including 1,552 family caregivers with the elderly in long-term care facilities. Results: The average out-of-pocket payment per month was 511,635 Korean won and distributed from 230,750 to 1,365,570 Korean won. The amount of out-of-pocket payment might be affected by not co-payment but the cost of non-covered service. There were differences in them for family caregivers of all different levels of income. Opinions were surveyed about 5 issues. By levels of income, there were differences in their opinions about 3 issues, the financial burden on LTC, the necessity of reducing out-of-pocket payments, and to be willing to pay more for a high quality service. But there were not different opinions about the interruption of LTC service and staying with LTC facilities. Conclusion: These findings suggest that the range of out-of-pocket payment for LTC facility is wide and it can be a burden to lower income group. It should be to prepare the policies to ease the financial burden and support the appropriate LTC use.

• Journal of Korean Public Health Nursing
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• v.5 no.1
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• pp.70-95
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• 1991

The ageing problem of the population has been emerging in Korea since 1970's so that it is expecting the elderly 65 years and over among the total population from $4.5\%$ in 1988 to be $6.3\%$ in year 2000. This study was conducted to provide secure policy development in coming years for the aged on medical and health care aspects based on the examining current status of the aged problems and health care policies and systems. The study divided into four parts; The first part examined the medical insurance program and public assistance program of the health services in relation to the aged. The second part emphasized on reduction of medical care cost for the aged. The third part studied the regular health check-up program and health education for the aged. The fourth part examined the chronic disease management programs for the aged and strategies of the health care service quality improvement and specialized programs. The following recommendations made as the results of the study. 1. At present, the medical insurance program and public assistance program for the medically indigent is not appropriate to the elderly because it is a part of general medical insurance program so that Health Security Law for the Aged is proposed. 2. Medical cost will be increased due to the high occupancy rate of hospital beds and long stay of the elderly so that it is recommended to develop an early discharge program, home health care program, Health hospice and an althernative programs. 3. At present, a regular health check-ups for the elderly is not included in medical insurance program so that it is recommended to be included in the insurance program and at the same time health education program thoroughly developed for the aged. 4. To make proper medical and nursing services on chronic diseases for the elderly, it is recommended manpower development, specialized clinics or hospitals, nursing homes and an equivalent long term care facilitices should be established on the community based and a research institutions also to be related to supper the care programs.

• The Korean Journal of Health Service Management
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• v.10 no.3
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• pp.159-171
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• 2016

Objectives : This study was performed to investigate the characteristics and ADL(Activities of Daily Living) associated factors of elderly inpatients in long-term care hospitals. Methods : Data were collected from the nationwide data of 'Survey of Patients (2013-2014)' administerd by the Ministry of Health & Welfare. The data included in this study consisted of 27,606 cases of elderly inpatients in long-term care hospitals. Results : The survey scores for the elderly inpatients were as follows: 57.6% 'Needed much and total help' with ADL, followed by 26.6% who 'Needed much help', and 15.8% who 'needed minimal supervision' in long-term care hospitals. The ADL score was high in the following categories: women, old age, referred visit, health insurance type, not-recovered & death, transferred, corporate hospitals, small hospital size, low number of physicians per 100 beds, and high number of nursing staff per 100 beds. The inpatients with 'diseases of the nervous system', 'diseases of the circulatory system' and 'diseases of the genitourinary system' were more likely to have high ADL scores. Conclusions : The results of this study suggest that long-term care hospitals should provide active and proper care for patients with high ADL scores and improve medical personnel training as well provide more medical care.

• Journal of Korean Public Health Nursing
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• v.24 no.2
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• pp.211-225
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• 2010

Purpose: This comparative study analyzed information systems including manpower, contents of service, clients, and costs among four nations. Methods: A literature review of relevant publications from Korea, United States, Japan, and Germany supported the use of several plans to activate home nursing care services under the long-term care insurance system in Korea. Results: Korean home nursing care services require quality improvements. The results indicated that a rule is necessary that rations simple visiting service and home nursing care services under the long-term care insurance system, that an integrated management system for elderly care is required, and that the revised delivery of services needs to establish and reflect on various factors to estimate the value in a home visiting nursing care cost system. Conclusion: The data should be valuable in establishment of home nursing care services under the long-term insurance system in Korea.

• The Korean Journal of Health Service Management
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• v.2 no.1
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• pp.125-136
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• 2008

Government came to enforce long-term care insurance system in preparation for the rapid aging society. Whether this system is successful or not depends on the professionalism of long-term care-givers who are professional population in charge of care service. Currently in the early stage of enforcement, such problems as a race cutting fee resulted from numerical increase of educational facilities, insolvent operation, degradation of education level resulted from unprofessional instructor, are pointed out. As a mean of manpower-training on long-term care insurance system, this study is to research public-private-university network model of the Academy of Continuing Education attached to Ko Sin University which is the case of Yong Do Gu Busan city. Networking between the vision and development strategy of Yong Do Gu on continuing education city, education system on community manpower-training supported by Ko Sin University, and service field of welfare for the elderly can not only contribute to the professionalism of long-term care-givers but also play an ideal role in manpower-utilization and arrangement of community. Through this networking, high quality of education level and circumstance, using the existing infra, manpower-training and utilization for continuing education of Yong Do Gu can be accomplished. Additionally, the connection with facilities related with welfare for the elderly can contribute to professionalism and accountability of manpower-networking.

• The Journal of the Korea Contents Association
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• v.11 no.11
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• pp.231-240
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• 2011

This study of the elderly in the future expansion of long-term care insurance as a priority landing at the introduction of physical therapy services aim to provide baseline data and long-term care insurance for him, the elderly that provides physical therapy services under the elderly property of a physical therapist recognition system for the investigation was conducted. As a result, the perception of the elderly long-term care insurance was higher by 88.1% of the higher needs, but also the absolute need for more than 40 years of age the response was higher with 60.3 percent. In addition, the number of visits that care should be priced higher relative to the 59.7 percent was the highest opinion. Visit of physical therapy services include the most important therapeutic approach to life and 40% was the highest forum, visit the Nursing Center as a service principal points that you need to visit the rehab center, accounting for 69.4 percent opinion. The expected effect of physical therapy visits conducted in a 50-point scale showed an overall average 41.44 points and 42.48 points, especially over the age of 40 appear in the overall expected effect was higher.

• 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.

• Journal of the Korea Convergence Society
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• v.7 no.6
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• pp.259-266
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• 2016

The purpose of this study is to explore the feasibility of establishing the elderly protection system for the elderly in the local community, and to explore the linkage model and action strategy. In Korea, there is a need to build a comprehensive elderly care system so that elderly people can have appropriate counseling and support programs in the community, as the elderly increase their diverse needs (leisure, housing, employment). In this study, we set up a linkage model of elderly care system and suggested two ways to practice it. First, it is suggested that it is desirable to focus on the formation of the elderly protection system in the community, and divide the practice process into three stages: organization, practice, and organization. Second, it is necessary to apply the long-term care professional manpower which can play a central role such as care manager and nursing care provider in order to apply the community organizing model of the elderly protection system and stable operation of long-term care insurance for the elderly. In addition, a social welfare council and a private network should be established to form a social welfare council, the establishment of related legal provisions, and the education of care managers. Therefore, it is necessary to establish basic data through this study, to establish diverse strategies and plans for the elderly protection system, and to promote it in a phased manner.

• Journal of Korean society of Dental Hygiene
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• v.17 no.5
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• pp.705-719
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• 2017

Objectives: The purpose of this study is to look into the health insurance systems and application in Korea and Japan in order to improve elderly people's quality of life. Their quality of life can be improved by upgrading the long term care systems; and extending treatment and prevention. Methods: This study is to examine long term care systems articles through content analysis in the National Health Insurance Service. Data were collected from the printed Internet and analyzed. Results: A part-time dentist system in elderly care facilities has trouble in taking care of old people's oral health due to both lack of time and operational difficulties. It is urgent to arrange dental experts who can permanently stay in care facilities and to build systems which can be managed periodically and continually. Conclusions: As having staff training for the efficiency and using the manpower in care facilities (care workers), it is necessary to solve the unequal medical service in oral health care for the elderly in Korea.

• Journal of Korean Public Health Nursing
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• v.24 no.2
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• pp.285-301
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• 2010

Purpose: The study was aimed at qualitatively enhancing and promoting a home visiting nursing program established in Korea on July 1, 2008, as part of the Long-Term Care Insurance for the Elderly program. Methods: Structural, procedural and consequential aspects of home visiting nursing care wereclassified on the horizontal axis by applying the standard notions for the evaluation of medical care (Donabedian, 1998). At the same time, the home visiting nursing care service support system and the service provision system weredivided on the vertical axis with reference to the accreditation standards for home visiting nursing care organizations suggested by the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO, 2008). The data were collected from June 4, 2008 to October 27, 2008, and were analyzed using SPSS ver. 15.0. Results: Twenty-two (proposed) standards, centered on the standard elements under the conceptual framework of the study, were developed, and comprised structural aspects (n=10), procedural aspects (n=6) and consequential aspects (n=6). Those criteria and indicators underwent two content validity surveys among groups of home visiting nursing care research and training experts. The research produced 22 proposed standards, 50 proposed criteria and 166 proposed indicators. Conclusion: The home visiting nursing care standards developed pursuant to the Long-Term Care Insurance for the Elderly Act and the applicability of these standards need to be verified by home visiting nurses. These proposed standards should prove useful in developing an assessment tool to encourage the qualitative enhancement of visiting nursing care in Korea.