• Journal of East-West Nursing Research
• /
• v.25 no.2
• /
• pp.157-165
• /
• 2019

Purpose: This study aims to provide basic data for the development of measures and promoting home health nursing by examining the current status and trends in home health nursing for long-term care (LTC) insurance beneficiaries. Methods: Secondary data, including annual LTC insurance statistics reports for 2010-2017 and LTC manpower data, were used to compute current status and trends in the provision of home health nursing. Results: Beneficiaries of home health nursing under LTC insurance, insurance-covered costs for home health nursing, home health nursing provider, and home health nursing providing institution only accounted for 3% of all insurance-covered home care services, and were on a consistent decline since 2010. In particular, vulnerable rural regions with high proportion of individuals had poor infrastructure in terms of home health nursing institutions and manpower, but had a higher home health nursing utilization rate compared to urban regions. Conclusion: In addition to measures to support home health nursing service beneficiaries, policy measures are needed to support home health nursing service personnel and institutions. Furthermore, programs to cultivate the expertise of home health nurses and improve quality of home health nursing services should be developed in order to promote home health nursing utilization in vulnerable rural regions.

• Health Policy and Management
• /
• v.21 no.1
• /
• pp.115-131
• /
• 2011

Several common issues are encountered by countries - Germany, Japan, and the United States - that adopted long-term care (LTC) system. First, the demand for LTC and its associated costs have steeply risen following the implementation of the LTC policy. Second, ensuring the quality of services have been difficult. Third, the coordination of services among providers and between LTC and medical care has been inadequate. Learning from their experience, we suggest ways to improve the LTC system in Korea. The basic approach aims for efficiency over equity in the system. This would require promoting provider competition and consumer choice. We propose several policy options according to the major stakeholders. For consumers, cash benefits at fixed rates and personal savings accounts are feasible options to self-contain the demand and cost of services. On the insurer's side, creating an environment of multiple insurers will engender competition, leading to cost savings and quality care. For providers, delivery of quality services through competition, cost-containment through capitated reimbursements, and coordination of services through integrated delivery system can be achieved. From the assessors' perspective, establishing an information system to monitor the activities of insurers and providers would be important, empowering consumers with information to choose cost-effective service providers. In summary, the suggested approach would provide cost-effective LTC services by guaranteeing consumer choice and promoting major stakeholder accountability. Further studies are needed to test the feasibility of this model in ensuring quality LTC in Korea.

• Journal of The Korea Institute of Healthcare Architecture
• /
• v.19 no.4
• /
• pp.19-28
• /
• 2013

Purpose: The purpose of this study to assess long-term care facilities in Seoul and certificate Seoul-type elderly care facilities. After certification, Seoul city can provide certificated facilities with budget and support to improve service quality. Methods: Questionnaires to elderly care facilities experts and field surveys to facilities in Seoul have been conducted for the data collection. Results: The result of this study can be summarized into three points. The first one is that a direction of operation for Seoul-type elderly care facilities is to improve manpower and provide special program for enforcing quality assurance. The second one is that this study provide index of evaluation for Seoul-type elderly care facilities. The indexes include management, facility environment and safety, service delivery process, and service results. The third one is that management plan for this policy should be carried out. The management plan include demonstration project, opinion research. Implications: Seoul-type elderly care facilities can have positive effects on quality of service. For the introduction of this policy, Seoul city and autonomous Gu have to make careful preparations for this policy.

• Journal of Korean society of Dental Hygiene
• /
• v.20 no.4
• /
• pp.457-467
• /
• 2020

Objectives: This study confirms the current status of visiting oral health-care services for the elderly to draw policy implications for revitalization of the visiting oral health care services in the future. Methods: First, a survey was conducted on health centers about the current status of the elderly visiting oral health-care service and how to revitalize it. Next, the number of oral hygiene services provided to the elderly was checked in the long-term care insurance system. Results: Oral health education (100%) was the most common practice in visiting oral health-care service for the elderly, and the most difficult thing in providing services was the lack of dental hygienists (38.9%). The status of oral health-care services in the long-term care insurance system for elderly revealed that the total number of service claims has been confirmed to be zero since the introduction of the system. Conclusions: Despite the existence of a system that provides elderly visiting oral healthcare services, to revitalize it, the law must be amended to secure a dental hygienist as the main agent of the activity and to further take responsibility for autonomous authority and performance.

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

• Health Policy and Management
• /
• v.32 no.4
• /
• pp.347-355
• /
• 2022

Background: Since November 2019, long-term care hospitals have been able to provide patients with discharging programs to support the elderly in the community. This study aimed to identify both patient- and hospital-level factors that affect successful community discharge from long-term care hospitals. Methods: A multilevel logistic regression model was performed using hospitals as a clustering unit. The dependent variable was whether a patient stayed in the community for at least 30 days after discharge from a long-term care hospital. As for the patient-level independent variables, an agreement between a patient and the family about discharge, length of hospital stay, patient category, and residence at discharge were included. The number of beds and the ratio of long-stay patients were selected for the hospital-level factors. The sample size was 1,428 patients enrolled in the discharging program from November 2019 to December 2020. Results: The number of patients who were discharged to the community and stayed at least for 30 days was 532 (37.3%). The intraclass correlation coefficient was 22.9%, indicating that hospital-level factors had a significant impact on successful community discharge. The odds ratio (OR) of successful community discharge increased by 1.842 times when the patients and their families agreed on discharge. The ORs also increased by 3.020 or 2.681 times, respectively when the patients planned to discharge to their own house or their child's house compared to those who didn't have a plan for residence at discharge. The ORs increased by 1.922 or 2.250 times when the hospitals were owned by corporate or private property compared to publicly owned hospitals. The ORs decreased by 0.602 or 0.520 times when the hospital was sized over 400 beds or located in small and medium-sized cities compared to less than 200 bedded hospitals or located in metropolitan cities. Conclusion: The results of the study showed that the patients' and their family's willingness for discharge had a great impact on successful community discharge and the hospital-level factors played a significant role in it. Therefore, it is important to acknowledge and support long-term care hospitals to involve active in the patient discharge planning process.

• 한국노년학
• /
• v.30 no.3
• /
• pp.855-869
• /
• 2010

The purpose of this study is to identify how to efficiently integrate long-term care facilities into geriatric hospitals. We conducted a survey on the current operations of facilities and medical services of 2009 of 192 long-term facilities and 168 geriatric hospitals in Korea between October and November. Technical statistics and chi-square test were conducted on the collected data using the SPSS 13.0/Win program. There was a difference between the two facility types in terms of the co-payment levels of the food services. Both types selected the budget deficit as their major management problem. Ease of access and the surrounding environment were critical factors used to select the location of both types of facilities. Facility users benefited from the discounted co-payments of both facility types. However, facility users wanted more frequent visits and support from their family members during their stay at the facilities. It was discovered that users in the long-term care facilities stayed longer, that is until they died, compared to their counterparts in geriatric hospitals. The two types of facilities provided their services totally separately to users. Users of the two types of facilities are poorly supported and cared for by their families. This study suggests that setting reasonable service fees, paying caretakers, introducing an integrated facility, strengthening facility assessment standards, introducing the family doctor system, and introducing the handling of long-term care insurance by geriatric hospitals would allow the integration between long- term care facilities and geriatric hospitals to be beneficial.

• 한국사회정책
• /
• v.25 no.2
• /
• pp.57-91
• /
• 2018

Despite the rapid growth of social care, understanding of care is segmental and caring is still marginalizing. The socialization of caring is actually a 'half-socialization' that is the result of injustice surrounding caring. Therefore, it is necessary to approach the problem of caring in terms of justice. In this paper, I discuss the limitations of social justice based on John Rawls 's social contract theory in the discussion of caring justice through feminists'writings on caring ethics. And then applying Nancy Fraser' s three scales of Justice-redistribution, recognition, and representation, the concept of caring justice has been newly constructed. The concept of caring is defined as a unified concept of caring including the aspect of the social rights of the care recipient as well as the labor rights of the care provider. Based on the analysis of care justice, we derive the ideal types of care policy and then evaluate the long-term care policy for the elderly, which is the central axis of Korean care policy. The results of this study are as follows: First, it is necessary to strengthen the labor rights of care providers especially for the socialization of care responsibilities and the proper allocation of social resources. Second, a service delivery system and care culture are needed to ensure the relational autonomy of care-receivers and care-givers for caring ethics and individualization of care. Third, the issue of care should be treated as the central agenda of politics in order to distribute care responsibility democratically and to distribute legitimate resources. This requires a paradigm shift from marginalization of care to mainstreaming of care. Ultimately, we should aim for a Caring Society.

• The Journal of Korean Physical Therapy
• /
• v.34 no.2
• /
• pp.80-89
• /
• 2022

Purpose: In Japan, the long-term care insurance and health insurance acts have stipulated the visiting rehabilitation system to provide support at the national level. The prior case of Japan would provide guidelines for seeking a suitable policy direction in South Korea. This study aims to examine the historical transition process of the visiting rehabilitation system in Japan, and the issues that emerged in the process of the institutionalization of this system. Methods: To examine the historical transition process of the system, the regulations announced by the government and their reports were reviewed. The relevant issues were qualitatively analyzed based on the opinions of scholars, therapists, and interested organizations that were reported in published papers on the topic. Result: The visiting rehabilitation system has been implemented in the following chronological order: The Health and Medical Service Act for the aged (1982-2006), the Health Insurance Act (1988-), and the Long-term Care Insurance Act (2000-). Currently, visiting rehabilitation is provided through hospitals, clinics, visiting nursing stations, etc. The following issues came to the fore in the process of the institutionalization of the system: (1) the complexity of the system, (2) the necessity of changing perceptions into a life model approach, (3) insufficient service provision by therapists, (4) the lack of human resources and an education system, (5) the lack of awareness of care managers and doctors about visiting rehabilitation, and (6) the necessity of quality enhancement through a team approach. Conclusion: It is deemed worthwhile to refer to the visiting rehabilitation system in Japan and the issues that emerged in the process of institutionalizing the system while seeking a policy direction for a similar system in South Korea.

• 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.