• Journal of Korean Academy of Nursing
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• v.44 no.4
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• pp.418-427
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• 2014

Purpose: Objectives of this study were to investigate the association between efficiency and quality of health care in Long-term Care Hospitals (LTCH) and determine related factors that would enable achievement of both high efficiency and high quality at the same time. Methods: Major data sources were the "2012 Korean Assessment of Propriety by Long-term Care Hospitals" obtained from the Health Insurance Review & Assessment Service. Cost variables were supplemented by a National Tax Service accounting document. First, data envelopment analysis was performed by generating efficiency scores for each LTCH. Second, matrix analysis was conducted to ascertain association between efficiency and quality. Lastly, kruskal-wallis and mann-whitney tests were conducted to identify related factors. Results: First, efficiency and quality of care are not in a relationship of trade-offs; thus, LTCH can be confident that high efficiency-high quality can be achieved. Second, LTCH with a large number of beds, longer tenure of medical personnel, and adequate levels of investment were more likely to have improved quality as well as efficiency. Conclusion: It is essential to enforce legal standards appropriate to the facilities, reduce turnover of nursing staff, and invest properly in human resources. These consequences will help LTCH to maintain the balance of high efficiency-high quality in the long-run.

• The Journal of Korean Physical Therapy
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• v.34 no.2
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• pp.80-89
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• 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
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• v.8 no.4
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• pp.187-197
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• 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.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.2
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• pp.247-260
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• 2018

This study examined the mental health status (depression, cognitive impairment and dementia) and its association with the related factors in the elderly people who were admitted from long-term care insurance. The study subjects were 1,488 people (male 740, female 748) aged over 70 years of age who had been recognized for long-term care insurance services in the years 2011~2014 from the National Health Insurance Corporation. The data collected from the National Health Insurance Corporation set forth a lifestyle questionnaire, itemized health screening tests, and long-term care as recognition data for research purposes. As a result, depression, cognitive impairment, and dementia of subjects increased significantly with age. As a multiple logistic regression result, the risk ratios of depression, cognitive impairment, and dementia, which indicated the mental health status, were significantly higher in women than in men, in the lower body weight group than in the overweight group, in the smoking group than in the non-smoking group, and in the drinking group than in the non-drinking group. These results suggest that the mental health status (depression, cognitive impairment, and dementia) of subjects decreased with increasing age, particularly the group with poor health related behaviors, such as smoking, drinking, and regular exercise, indicating that the mental health condition is lower than in the good group.

• Journal of Korea Entertainment Industry Association
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• v.15 no.1
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• pp.199-206
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• 2021

As the super-aged society is imminent, the number of people with senile diseases is also increasing, resulting in a lack of facilities and policies as a social problem. National Health Insurance Service is being talked about as a realistic alternative to medical coverage. Long-term care hospitals are classified into acute-stage hospitals and long-term care facilities and are acting as an alternative to reducing medical expenses. However, in long-term care hospitals, which are the core of maintenance rehabilitation, the quality of service issues have been raised seriously. Currently, there is a problem of mass production of refugees from rehabilitation due to a problem of the medical system. In particular, in the preceding study in 2015, the status of long-term care hospitals in Jeollabuk-do was the worst. Therefore, using public data, the general status of long-term care hospitals in Jeollabuk-do, status of frequent disease, status of rehabilitation services, and status of occupational therapy services are to be explored.

• Dementia and Neurocognitive Disorders
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• v.16 no.1
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• pp.1-6
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• 2017

The purpose of this study is to examine interventions and supporting systems by dementia stage, take a look at dementia insurance policies in Korea and the United States, and present Korean private insurance programs for dementia patients. According to the study, our suggestions of a design of private insurance products for Korean dementia patients are as follows. First, the products should support people aged 80 and older. Second, new products should include the mild stage dementia in the insurance coverage. Third, non-pharmacological treatments, such as the cognitive stimulation, the cognitive training, and exercises need to be covered through the new private insurance. Fourth, the private insurance should be contained home health care services in its coverage. These suggestions can reduce the dependence of the public insurance, help people choose appropriate treatments for themselves, and give people a good opportunity to improve the effect of dementia treatment and to increase the satisfaction of patients and their families.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.5
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• pp.2338-2348
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• 2013

This study was performed to determine the levels of physical functioning and to reveal its association with socio-demographic characteristics, health status and health related behaviors in the elderly people admitted long-term home care insurance. The interviews were performed, during the period from December 1, 2011 to March 31, 2012, to 618 home care elderlies admitted long-term care insurance dwelling in Daejeon city. As a results, the distribution of impaired ADL and IADL group of all subjects were 45.6% in ADL, and 48.4% in IADL. in consequently, the rate of impaired IADL group was higher than that of impaired ADL group. In logistic regression analysis, the adjusted odds ratio of the impaired ADL and IADL group were significantly increased in the group of male, living with spouse or family, bear for living expenses with son and daughter, health insurance, irregular exercise, seldom with frequency of going out, seldom with activity of hobbies, Subjective health status is good, and disability of body, visual acuity, hearing ability and mastication ability is good, and without urinary incontinence and amnesia. In conclusion, the level of physical functioning in the elderly people admitted long-term home care insurance was decreased in IADL than ADL. And the level of ADL and IADL were related with the various variables of socio-demographic characteristics, health status and health related behaviors.

• Journal of Korean Public Health Nursing
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• v.29 no.3
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• pp.551-564
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• 2015

Purpose: Th study is to explore the working conditions and factors related to job satisfaction of nurses in long-term care facilities for the elderly. Methods: A total of 127 nurses working long-term care facilities, from June to November 2014, completed questionnaires. Face to face interviews were conducted. The questionnaire consists of a total of 32 questions, including 5 questions related to general characteristics, 15 questions related to working conditions, and 12 questions related to job satisfaction(likert scale of 1 to 5). Results: The majority of nurses were employed in institutional care facilities, in urban area, and in privately owned facilities. On average, employed nurses worked 170.7 hours per month. Only 40.9% of them got more than two million won for their monthly salary. They were satisfied with the nature and worth of their work and the workplace relationship, but not with their wages and promotion opportunity 40.2% of nurses reported satisfaction with job. In multiple logistic regression analysis, age was a statistically significant influencing factor on general job satisfaction. Conclusion: The findings suggest that policies must be to improve nurses' working conditions, for wages, and to support them with education and training for skills development.

• The Journal of Korean Academy of Prosthodontics
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• v.46 no.1
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• pp.83-91
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• 2008

Statement of problem: The introduction of "The Long-term Care Insurance System" (a public nursing care insurance scheme) is scheduled from July in 2008. Lately, the importance of oral health care had increased. Introduction and establishment of the methodology (nursing care procedure) based on professional dental knowledge is inevitable. Purpose: The purpose of this study was to rouse recognition of the importance of dental care in the long term elderly care in nursing homes, with implementation of the new insurance law. Material and methods: Visited two institutions for the elderly, Yudang Village and Sungjiwon located in Suwon city to investigate the present conditions in terms of (1) the detailsof the institution, (2) the activities concerning with dental care in the institution, and (3) the consciousness and recognition regarding dental care of the staffs. Results: In two institutions, under the present conditions, oral cleaning (including the cleaning of denture) for residents was operated with no professional advices and limited professional dental care. It was found that there was very little awareness of aspiration pneumonia. The members of staff however, did recognizethe necessity of professional maintenance and management of oral care in daily nursing care, and that many residents hold dental problems. They were very eager in introducing the methodology (nursing care procedure) in dental care in nursing homes.

• Health Policy and Management
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• v.26 no.1
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• pp.39-50
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• 2016

Background: This study examined patient and hospital factors related to long-stay admissions in long-term care hospitals (LTCHs) among older people in Korea. Methods: We analyzed health insurance claims data, entitlement data, and institutional administrative data from the National Health Insurance Service databases between 2010 and 2012. At the patient level, we compared characteristics of patients staying in LTCHs for over 180 days (the long-stay group) with those staying in LTCHs for less than 90 days during a calendar year. At the hospital level, we examined the general characteristics and staffing levels of the top 10% of hospitals with the highest proportion of patients whose length of stay (LOS) was 180+ days (the hospitals with long-stay patients) and compared them with the top 10% of hospitals with the highest proportions of patients whose LOS was less than 90 days (hospitals with shorter-stay patients). Results: The long-stay group accounted for about 40% of all LTCH patients. People in the group were more likely to be women, aged 80+, living alone, and experiencing more than two health conditions. Compared to the hospitals with shorter-stay patients, those with long-stay patients were more likely to be occupied by patients with behavior problems and/or impaired cognition, owned by corporate or local governments, have more beds and a longer period of operation, and deliver services with lower staffing levels. Conclusion: This study found long-stay older people in LTCHs and those in LTCHs with high proportions of long-stay older patients had several distinct characteristics compared to their counterparts designated in this study. Patient and hospital characteristics need to be considered in policies aiming to resolve long-stay admissions problems in LTCHs.