• 대한물리치료과학회지
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• 제16권3호
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• pp.43-53
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• 2009

Background: The purpose of this study was to investigate the perception of home care team's home based physical therapy in public health center Method: We surveyed 11 questionnaires for hone care team in health center from 1st to 30th, November in 2008. Results: The person who recognized the exclusion fact of home-based physical therapy in long term care insurance was 64.2% in whole 109 people. About necessity of home-based physical therapy, "absolutely necessary" as the person answer was 43.1%. Home-based physical therapy in the insurance must come to be provided with a precedence was 81.3%. About starting time of hereafter home-based physical therapy "after 1 years" the opinion which was 60.7%. Opinion about operation institution of home-based physical therapy "the pubic hospital or health center" was 52.3%. In composition form of the home-based physical therapy team "with the physical therapist and occupation therapist come together" was investigated with 37.4%. Conclusion: As long term care insurance will be developed, discussion about quality- of-service must be continuous and depth. Relates hereupon, the academic, researchers, and the persons concerned must consider the best quality of life improvement of the citizen and prepare the ground which systemic, rational, and actual on starting of home-based physical therapy in long term care insurance.

• 간호행정학회지
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• 제14권3호
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• pp.229-240
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• 2008

Purpose: To develop the patient classification system based on the resource utilization for reimbursement of long-term care hospitals in Korea. Method: Health Insurance Review & Assessment Service (HIRA) conducted a survey in July 2006 that included 2,899 patients from 35 long-term care hospitals. To calculate resource utilization, we measured care time of direct care staff (physicians, nursing personnel, physical and occupational therapists, social workers). The survey of patient characteristics included ADL, cognitive and behavioral status, diseases and treatments. Major category criteria was developed by modified delphi method from 9 experts. Each category was divided into 2-3 groups by ADL using tree regression. Relative resource use was expressed as a case mix index (CMI) calculated as a proportion of mean resource use. Result: This patient classification system composed of 6 major categories (ultra high medical care, high medical care, medium medical care, behavioral problem, impaired cognition and reduced physical function) and 11 subgroups by ADL score. The differences of CMI between groups were statistically significant (p<.0001). Homogeneity of groups was examined by total coefficient of variation (CV) of CMI. The range of CV was 29.68-40.77%. Conclusions: This patient classification system is feasible for reimbursement of long-term care hospitals.

• 대한가정학회지
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• 제41권6호
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• pp.143-156
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• 2003

The present study was initially designed to figure out the general condition of care giving system for the elderly women who need long term care and the level of their depression according to the conditions of care. And This research is intented to present appropriate policy that could help the establishment of supporting system for the fragile elderly women.1 used the data from <2001 National Study on the Needs for the Long-Term Care Elderly> by Korea Health and Population Institute. The results are as follows: First, Two third of all the respondents had serious problems (2-9 activities limits) in Instrumental Daily Living Ability(DAL). Most respondents reported “low” in satisfaction level related to receiving care, meaning the elderly had negative perception for the care from the family. The elderly expected their children to be as the primary care giver and mostly wanted to live with them in the future. Second, The majority of the long term care elderly women haven't used community service facilities very often and said they are not likely going to use the facilities in the future. Third, The respondents reported high in depression level as to lower satisfaction with their children's support, poorer health condition, more reluctant to use service facilities due to the cost, and fewer friends and neighbors resources around them. Therefore I could say that negative factors for the elderly women's psychological health were having unsatisfactory relationship with intimate people, developing physical illness, being in economic difficulties. That is, receiving less help from close family members, shrinking social network, and experiencing economic hardship would have negative effects on elderly women's psychological health. In the basis of these results, I suggest that in the mean time we shouldn't overlook the importance of the private support when we develop the public elderly support system.

• 한국융합학회논문지
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• 제11권3호
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• pp.237-244
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• 2020

초고령사회에 진입한 일본은 의료 및 복지에 대한 수요증가에 대응하기 위해서 정부의 다양한 정책적 방안들이 논의되고 있다. 특히 개호인력 확보 및 인력양성을 위해 일본정부와 지자체가 1) 인프라 구축, 2) 개호복지사 수학자금 등 대출제도, 3)외국인 유학생 개호인력유입 등 다양한 방면으로 전문 인력 확보 대책을 추진하고 있다. 또한, 교육기관인 대학에서도 커뮤니티케어 교육연구센터를 설립하여 의료, 복지, 교육에 관한 전문인재 육성의 질적 향상을 도모하고, 직업교육을 통해 개호전문인력을 지속적으로 육성하고 있다. 한국도 급속한 고령화와 의료기술의 진보 등 보건의료를 둘러싼 환경이 크게 변화하면서 고령자에 대한 개호 수요가 증가할 것으로 전망되고 있다. 개호요구의 급증에 비해 노동 인구의 감소로 심각한 인력부족을 겪고 있는 일본의 선 경험에 비추어 보건인력 확보에 대한 정책방안의 논의가 이루어져 할 것이다.

• 한국콘텐츠학회논문지
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• 제19권1호
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• pp.587-597
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• 2019

우리나라 인구의 빠른 고령화와 일상생활이 어려운 노인들이 증가하여 사회적 연대를 위한 노인장기요양 제도가 실시되었다. 제도 도입 후 나타난 장기요양제도의 구조적 문제 해결을 요구하고 있으며 기관 및 급여유형별로 통합된 요양서비스 제공체계, 노인의료-요양의 연속성 부족에 따른 요양병원-시설 간 기능정립 문제 등도 제기되고 있다. 이 연구에서는 문제점을 개선하기 위하여 입소정원, 종사인력, 제공서비스와 관련한 연구문제를 설정하였으며 FGI를 실시하였다. 연구결과 지역 내 노인 인구와 인정자 수, 노인성 질환자수 등 장기요양 수요를 반영, 지역별 적정 기관 및 인력 수급 정책 방향 제시하고, 지자체별 목표와 수급계획을 수립하여, 장기요양기관 지정요건 절차 강화 및 지정 갱신제 등 인증제도 도입이 검토되어야 하며, 남성요양보호사 육성 및 수가 인상 등을 통한 종사자 처우개선을 통하여 원활한 인력수급이 필요하다고 보았다. 급식비의 보험적용과 유관기관과의 연계를 통한 프로그램 확대제공, 원활한 입소관리를 위한 의료외 사고 중재기구가 필요하다고 나타났다.

• 한국노년학
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• 제29권3호
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• pp.917-933
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• 2009

본 연구는 새롭게 도입된 노인장기요양보험제도 체계 내에서 공적보호서비스(시설보호서비스와 재가보호서비스)를 이용하게 되는 요인과 두 서비스유형간의 선택을 결정하게 되는 요인을 밝히고자 한다. Andersen의 행동모델에 기반하여 노인장기요양서비스 이용형태를 결정하는 소인요인과 자원요인, 욕구요인의 영향을 검증하는 연구모형을 구성하였으며, 노인장기요양보험 2차 시범사업의 서비스 이용권리가 있는 요양 1~3등급의 노인 5,497명의 서비스 이용자료와 개인적 특성 자료를 활용하여 다항 로지스틱 회귀분석을 실시하였다. 주요 분석결과는 다음과 같다. 첫째, 서비스 이용의 본인부담금을 나타내는 소득수준에 따라 서비스 이용형태에 차이가 나타났다. 국민기초생활보호대상자, 일반소득계층, 차상위계층의 순으로 서비스 이용이 높았으며, 재가보호서비스에 비해 시설보호서비스의 이용이 높게 나타났다. 둘째, 군지역에 비해 대도시와 중소도시가 시설보호서비스 또는 재가보호서비스를 이용할 확률이 높으며, 특히 중소도시의 경우 재가보호서비스보다는 시설보호서비스 이용이 높은 것으로 나타났다. 셋째, 요양 1~2등급이 3등급에 비해 시설보호서비스 또는 재가보호서비스 이용이 높으나, 등급에 따른 서비스 이용 유형간 차이는 나타나지 않았다. 넷째, 일상생활수행능력(ADL), 수단적 일상생활수행능력(IADL), 인지기능과 문제행동의 기능이 나쁠수록 시설보호서비스 이용이 높으며, 재가보호보다는 시설보호를 이용하는 것으로 나타났다. 그러나 간호처치영역은 기능상태가 나쁠수록 서비스 이용이 적고, 재활영역의 기능상태는 통계적 유의미성을 나타내지 못하였다. 이와같은 연구결과를 통해 현 노인장기요양보험제도의 본인부담금의 조정과 지역별 균형적인 서비스인프라 구축의 필요성을 제기하며, 또한 요양등급판정체계의 재검증의 필요성을 제기하는 바이다.

• 가정∙방문간호학회지
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• 제14권2호
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• pp.98-105
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• 2007

Home health care system in Korea has been classified into three types of home care programs based on different laws and regulations; for example, home health care nursing(HHCN) is based on medical laws, visiting health care nursing (VHCN) is based on long-term health care insurance, and visiting health care(VHC) is based on the regional health care act. HHCN in Korea has taken on an important role under the mandate of the national health care system since 2000. VHCN will commence its role under the long term health care insurance system in 2008. The strengthening of VHC commanded health promotion and prevention for vulnerable families in the community in 2007. This is an important turning point for increasing quality management for home health care program; it suggests certain possibilities for building a foundation for further changes in the service delivery structure. Accordingly, the home health care policy makers in Korea have a major function and role that consists of developing an agenda and alternatives for policy making in a systematic manner and clearly presenting implementation strategies for elderly health care system.

• 한국보건간호학회:학술대회논문집
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• 한국보건간호학회 2004년도 제1회 지역사회간호, 보건간호, 가정간호, 연합학술대회
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• pp.79-90
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• 2004

• 가정∙방문간호학회지
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• 제27권1호
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• pp.64-81
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• 2020

Purpose: The purpose of this study was to identify manpower acquisition strategies of nurse and nurse aide in long-term care Method: The study was proceed using following three stages: to explore workforce status and labor environment with database analysis, literature reviews, to explore the best practices, practical experiences with expert interviews, with focus group interview, to identify problems and present acquisition strategies Results: Acquisition strategies were increasing of pay, improvement of working condition, development of practical educational program, diversification of entry paths, establishing clear roles for nursing staffs, diversification of training program. Conclusion: We found that the acquisition strategies of nurse and nurse aide can be as an useful methods to increase manpower in long-term care for higher quality of services and care.

• 보건의료산업학회지
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• 제8권1호
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• pp.51-64
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• 2014

The purpose of this study was to investigate the relationship among staffing, occupancy rate, upward level change of long-term care need, and evaluation grade of facility. Data were obtained from National Health Insurance Corporation Database. Occupancy rate and evaluation grade were highest in National/public operating facilities, while they were worst in individual operating facilities. The percents of A or B grade in evaluation grade (by newly enforced law) is highest in National/public operating facilities. Multiple regression analysis showed that upward level change of care needs was very weakly associated with the number of doctors. Evaluation grade showed a weak and significant association with occupancy ratey(by old-version law)(r=.20, p<.01), upward level change of care need in group home(r=.23, p<.01) Staffing in facility did not show significantly consistent association with upward level change of care needs, evaluation grade, and occupancy rate.