• Journal of The Korea Institute of Healthcare Architecture
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• v.16 no.2
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• pp.55-64
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• 2010

The Japanese elderly welfare policy has focused on facility policy for the aged and preventive care service for healthy elderly people. This paper has conducted a comparative analysis on Geriatric Gealth Services Facility and Special Nursing Home for the Elderly. For this, each service function has been divided into six categories; daily life / nursing and caring / medical service / management / supply / miscellaneous. Then the change in real structure by category has been analyzed through a plan analysis on case facilities. In the Geriatric Health Services Facility, the biggest change was observed in 'livelihood' among six categories. In the Special Nursing Home for the Elderly, 'the nursing and care parts' and 'medical service part' are decreased since 1999. At that time, the facilities started to be individualized and divided into a unit. To pursue home-like care instead of unit care, there was a change in construction planning to help the aged with dementia live a self-sufficient life.

• 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.

• Journal of the Korea Convergence Society
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• v.10 no.9
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• pp.229-236
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• 2019

This is an exploratory study examining factors associated with awareness of the National Long Term Care Insurance in Korea. The researchers also examined the differences in factors based on their age, between the middle-aged group(45-64 years of age) and the elderly group(65 years and older). The 6th wave of Korean Longitudinal Study of Ageing(KLoSA) was used for secondary data analysis. Results indicated that for the middle-aged, gender, volunteer participation, ADL, IADL, and depression were related to their awareness of the long term care insurance. However, for the elderly, social capital factors were significantly related to their awareness of the insurance. Age and depression were also significant factors associated with the awareness level of the long term care insurance among the elderly. Based on the findings, implications for social welfare policy are discussed.

• Journal of The Korea Institute of Healthcare Architecture
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• v.13 no.4
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• pp.25-35
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• 2007

In Germany, community based daycare facilities has been supported by long term care policies since the 1970s. With the legislation of Care Insurance, those policy has been developed further. As the use of daycare facilities decreased and the financial burden for consumers increased, administrators of facilities has been seeking for innovative programs and management methods in order to improve the service. For the same reason, policy makers have been pursuing new regulations of architectural standards of facilities. By looking at legislations (i.e., Law of Care Insurance, Law of Heim, and DIN18025) that stipulate architectural standard of facilities in Germany, this study will identify the development process of architectural change of daycare facilities. In addition, the study aims to contribute to the discussion on the use of day care facilities in Korea in terms of the legislation of Care Insurance soon to be introduced.

• Health Policy and Management
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• v.31 no.4
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• pp.451-461
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• 2021

Background: Readmissions related to lack of quality care harm both patients and health insurance finances. If the factors affecting readmission are identified, the readmission can be managed by controlling those factors. This paper aims to identify factors that affect readmissions of convalescent rehabilitation patients. Methods: Health Insurance Review and Assessment Service claims data were used to identify readmissions of convalescent patients who were admitted in hospitals and long-term care hospitals nationwide in 2018. Based on prior research, the socio-demographics, clinical, medical institution, and staffing levels characteristics were included in the research model as independent variables. Readmissions for convalescent rehabilitation treatment within 30 days after discharge were analyzed using logistic regression and generalization estimation equation. Results: The average readmission rate of the study subjects was 24.4%, and the risk of readmission decreases as age, length of stay, and the number of patients per physical therapist increase. In the patient group, the risk of readmission is lower in the spinal cord injury group and the musculoskeletal system group than in the brain injury group. The risk of readmission increases as the severity of patients and the number of patients per rehabilitation medicine specialist increases. Besides, the readmission risk is higher in men than women and long-term care hospitals than hospitals. Conclusion: "Reducing the readmission rate" is consistent with the ultimate goal of the convalescent rehabilitation system. Thus, it is necessary to prepare a mechanism for policy management of readmission.

• 한국노년학
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• v.36 no.3
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• pp.673-691
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• 2016

As the provision of long-term care policy takes root and with a gradual increase in elderly population, the use of elderly care service has become a growing norm. More than ever, there exists an urgent need for a paradigm shift in the building of an institutional basis for the improvement of care service, from the prevalent practice of 'need based service' toward the concept of 'human rights based service'. A great focus is being shed on care-workers, at the 'front line' of advocating human rights, as their human rights advocacy behaviour is seen as a key variable in providing high quality care service for elders. This study aims to examine how care-workers' individual human rights awareness levels, and the influence of their respective organizations, as an environmental factor, affect their human rights advocacy behaviour. The study includes a comprehensive analysis of the interactions between the regulatory effect of environmental factors (service orientation?) on an organizational level, human rights awareness (individual level) and the service environment (organizational). The analysis sample consisted of 782 registered non-profit corporation of long-term care facilities all over the country in 2014. The findings of the thesis suggest that human rights awareness at individual levels has a significant influence on human rights advocacy behavior. The interaction of human resources management in service orientations was also found to influence human rights advocacy on a significant level. Both human rights awareness at individual level and service orientations at organizational level were thus determined as key variables for improving the human rights awareness of care worker in long-term care facilities in Korea.

• The Korean Journal of Applied Statistics
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• v.27 no.5
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• pp.667-679
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• 2014

National Health Insurance Service(NHIS) provide care-plans for beneficiaries in the long-term care insurance(LTCI) systems that help them use LTC services appropriately. The care-plan includes recommendations for the most adequate type of care (gold standard) for beneficiaries. This study develops a decision-support system to determine the appropriate type of care plan. To develop a model, we used a data set that well-trained assessors in the NHIS investigated as a gold standard for beneficiaries: nursing home care, home-visit care, home-visit bathing, home-visit nursing, or day and night care. The decision-support system was established through a decision-tree model, because it may be easy to explain the algorithm of a decision-support system to working groups and policy makers. Our results might be useful in evidence-based care planning in an LTCI system and contribute to the efficient use of LTC services.

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

• 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.

• Health Policy and Management
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• v.27 no.2
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• pp.103-113
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• 2017

There have been many achievements for 40 years since the introduction of compulsory health insurance. Despite many achievements, it has many challenges in health insurance. Aging, non-communicable disease, and low growth economy are threatening the sustainability of health insurance, and it is time to reform the health insurance. A long-term reform plan will be an absolute necessity for reform of health insurance and health care system. Health insurance and health care reform should be an extremely revolutionary content that completely changes the framework. This reform should deal with the philosophy of health, approach of medical education and doctor training, changing supply of medical service, the innovation of primary medical care, reform of public health system, the management of medical utilization, the integration of medical cure and care services, enhancing the benefit coverage, prohibition of covered and non-covered services, etc. Therefore, it is urgent to form a consensus on the necessity of reform, to establish the health insurance plan on this consensus, and to make efforts to make health insurance sustainable.