• 대한치과의사협회지
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• 제53권10호
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• pp.696-704
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• 2015

The coverage of the National Health Insurance for the elderly is expanding to denture and implants. Although the National Long-Term Care Insurance was just being settled, Oral health service was not provided to the Elderly in Long-Term Care Facilities. The long-term care facilities had part-time facility doctors. However, there is no dentist in the long-term care facility because of lack of long-term care insurance-related legislations. The amendments of long-term care insurance-related legislations for the introduction of part-time facility dentists are needed because the elderly in long-term care facility are vulnerable to oral health. For the substantial management of the National Long-Term Care Insurance, the development of oral health service model for the elderly and education materials for the dental team will be needed. Also, adequate dental service fee of the National longterm care insurance will be needed.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제12권1호
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• pp.17-26
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• 2006

The demand for long-term care is continuously on the rise as number of elders among the population increases. Due to the rapid growing demand for long-term care in Korea, there have been discussions for the introduction of new long-term care system into Korean society. The purpose of this study in to analyze changes of elderly care facilities in Japan after the beginning of long-term care system in 2000. The functional and architectural changes of Japanese facilities were researched to be used as references for predicting changes in Korean facilities. In Japan, after the execution of long term care system, the alterative aspect of facilities is divided into some categories; in sum, the change of environment for long term care, the effort to spread specialized facilities in a whole community, and the tendency to complex a variety of function of facilities such as an facility for home care service, and the like.

• 간호행정학회지
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• 제9권3호
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• pp.353-366
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• 2003

Purpose: This study was to define the care time of elderly in long-term care facilities and to compare and analysis the care time by staff and facility types. Method: The data were collected from 530 elderly over sixty, residing in two long-term care hospitals for dementia, three long-term care hospitals for the elderly and two skilled nursing facilities. Care time for individual residents was measured the total time spent by nurses, aides. Result: The average care time measured by nursing staff was 158.6 minutes a day. The average care time for one resident by nurse was 40.4 minutes, and by aides, 118.2 minutes. The difference of the care time showed statistical significance between long-term care facility types(p<0.001) : average care time for dementia hospital(199.1min) was twice as long as that of skilled nursing facility(94.1min). Conclusion: The results of the study showed that the care time differentiates care time provided to elderly in long-term care facilities in Korea. The study suggests the need to emphasize the importance of standardization of level of staff and service programs by the long-term facilities.

• 산경연구논집
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• 제9권10호
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• pp.39-50
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• 2018

Purpose - This study is to propose discriminative management strategies to long-term care facilities based on the empirical analysis after reviewing the effects of social support, perceived by long-term care facility employees, to service orientation. Research design, data, and Methodology - The research model designed social support, job stress, organizational commitment, and service orientation. The survey collected data from 453 customers in a long-term care facility in jeju. The SPSS 18.0 package was used for analysis. Results - First, social support for long-term care facility employees has a negative(-) effect to job stress. Test results, social support factors except appraisal support had a negative impact on job stress. Second, social support has a positive(+) effect to organizational commitment. Test results, informational support, tangible support and appraisal support had significant effects on organizational commitment. However, emotional support had a positive impact on affective commitment and normative commitment. Third, social support has a positive(+) effect to service orientation. Test results had a positive impact. Fourth, job stress has a negative(-) effect to organizational commitment. In the test results, employee's continuance commitment and normative commitment had significant negative effects in job stress. However, affective commitment had no significant impact. Fifth, job stress has a negative(-) effect to service orientation. Test results showed a negative impact. Conclusions - The study implies the following. First, that there should be a change in the social perception of long-term care facilities. 'Long-Term Care Insurance for The Elderly' was enacted to emphasize this responsibility for the elderly problems as a new system. Enactment of this Act was expected to improve the quality of life of the people by stabilizing the elderly life and reducing the burden of families. Therefore, long-term care facility system should be as efficient as possible for making plans for systematic and organizational support. Second, the efforts of facility managers to minimize job stress of employees is necessary. Accordingly, performing spontaneous work is required for a comfortable working environment and management. Third, the systematic education and training to employees for service oriented behavior of the facility will be required in the long term.

• 보건행정학회지
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• 제30권4호
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• pp.522-530
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• 2020

Background: In 2008, Korea implemented a new type of social insurance known as "long-term care insurance". We examined the association between ownership of long-term care facilities and the incidence of pressure ulcers after the implementation of "long-term care insurance". This study is a population-based retrospective cohort study from 2006 to 2013. Methods: We used medical claims data from the Korean National Health Insurance Corporate Elderly Cohort Database from 2006 to 2013. These data comprise a nationally representative sample. To avoid confounders, only patients admitted to one long-term care facility and who stayed for >70% of the follow-up time were included; as a result, 3,107 individuals were enrolled. The main independent variable was the operating entity of the long-term care facility (local government, corporate bodies, and private for-profit owners), and the dependent variable was the 1-year incidence of pressure-ulcers. Survival analysis (Cox proportional hazard model) was used as an analysis method. Results: Compared to patients admitted to local government long-term care facilities, patients admitted to private long-term care facilities had a significantly higher 1-year risk of pressure ulcers (hazard ratio [HR], 1.94; 95% confidence interval [CI], 1.29-2.91); the risk was especially high among patients who were cognitively dependent (HR, 2.34; 95% CI, 1.25-4.37). Conclusion: Patients admitted to private for-profit long-term care facilities were more likely to have pressure ulcers compared to those in local government and corporate body long-term care facilities. Appropriate assessment tools and publicly available information, as well as more restricted legal requirements, are needed to improve the care quality and outcomes of patients in long-term care facilities.

• 보건의료산업학회지
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• 제5권3호
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• pp.13-23
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• 2011

This paper investigated the operating environment for the representative of each agency and the facility workers on the basis of analytical result of recognition changes of the operating environment changes under the operating the long-term care insurance. It was described plans to take positive effect on the operating as follows. The first, on the result of regression analysis, the service administrative range takes the biggest effect on the general recognition of executing the long-term care insurance off and on. The affirmative recognition of the service administrative range had the general recognition on the system be positive effect. But the operator of facility asserts that the care manager's professionalism related quality of service be strengthened. The second, on the result of regression analysis, in the financial accounting administrative it is revealed the more positive recognition it is, the more positive effects it has. From the difference verification of an operation size from operation subject, the small operation size and personal facility recognize the long term care insurance positively. On the other side the facilities where the operation size is big recognize the system negatively. The long-term care facility should rearrange a support program newly and the government needs to promote the donation activity, because it is needed to reduce the financial burden of facilities.

• 가정과삶의질연구
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• 제22권4호
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• pp.1-14
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• 2004

Although the proportion of frail elderly among the elderly population has been rapidly increasing, there is little preparation to provide housing alternatives for them in Korean society. Long-term care facility a housing alternative for frail elderly that enables them to receive social and medical care services that enhance the quality of their life. This research was conducted to study the opinions of middle-aged Koreans about long-term care facilities for the frail elderly. This study provides useful suggestions for the development of user-paid long-term care facilities in the near future. A survey questionnaire was administered to 600 adults in their 50s to collect data. The sample was stratified according to region, gender, and housing structure type. The results showed that most of the respondents were aware of long-term care facilities for the frail elderly; but they were relatively unwilling to live in these facilities, as compared to other housing alternatives. However, a larger number of respondents said that as they became very frail, they would be willing to live in these facilities. The respondents expressed a high level of need for user-paid long-term care facilities as an alternative to hospitalization. Also, they wanted to have a variety of long-term care facilities that are designed for different levels of disability. The education level of respondents and their spouses, average monthly income, subjective economic level, and religion were major variables that differentiated significantly the opinions about long-term care facilities for the frail elderly.

• 보건행정학회지
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• 제15권4호
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• pp.136-160
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• 2005

Before introducing the national long-term care insurance in 2008, the want for long term care service has to be estimated and analysed. This study estimates the demand and analyses what determines the want of long term care service. This study investigated data of 3f6 elderlies, that was collected by age stratified random sampling. The elderies resided in Onyang 4 - dong (urban area) and Dogo-myun (rural area) In the city of Asan. The researchers visited the elderlies and their care giver, and assessed their demand for the long term care service and examined physical, mental, socio-economic status by the assessment tools for Korean Long-Term Care System. $64\%$ of the those who are entitled to be served refuse the long term care service. $26.7\%$ of them wants for home care service and $7.9\%$ want facility care service. It is estimated that the want of home care service are three or four times as much as that of facility care service. The demand for long term care service is 5.155 times higher for those who live in rural area (p=0.000), 3.040 times higher for those who do not have spouse(p=0.057), and 3.356 times higher for the people who is in medicaid than medical insurance(p=0.029). However, income(p=0.782), means(p=0.614), living alone(p=0.223), number of family to live with (p=0.341) and age of the elderly(p=0.420) are not related with the demand of long term care service. The assessment tools for Korean Long-Term Care System for need evaluation of the long term care service can reflect the demand well.(p=0.024) If medical care will cover $80\%$ of total cost, the willingness to pay of the out of pocket money of the people with medical insurance is 67,400 Korean Won(66.77 US$) for the home care service and 182,500 Korean Won(180.78 US$) for the facility care service. There is possibility that long term care demand is still small after Introducing the long term care Insurance due to the care given by family members. When developing service delivery system of long term care insurance, rural area has to be given more consideration than urban area because of the higher demand. The people who do not have spouse or are in medicaid have to be given special consideration as well.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제19권1호
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• pp.9-22
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• 2013

Purpose: The aging population is the quickly increasing in Korea. Since 2008, the National Long term Care Insurance, a number of long term care facilities have established during short time in Korea. Especially, the environmental assessment tool is important for managing healing environment in a long term care facility for the elderly. Alzheimer's Garden Audit Tool (AGAT) is used to assess whether a garden incorporates those elements and qualities as healing outdoor space. In this paper, we discuss the benefits, limitations, and future directions of the assessment tool for long-term care facilities. Methods : The AGAT audit was done through content analysis by 5 experts from diverse discipline as post occupancy evaluation of a long term care facility located in suburban area. The expert group was asked to describe their comments for modification and improvement in application of AGAT. Results : The results of this study show that it is necessary to refine the instrument's items to better meet the needs of the criteria and items for Korean culture-friendly tool. Especially, greenhouse elements (various plants, birds etc.), multisensory experiences, users-oriented space, programmed activities in garden, and hazards on pathway has somewhat limitation as measurement to assess outdoor of long-term care facilities in Korea. Implications : Consequently, AGAT could be applicable to evaluate the outdoor space of long term care facility in Korea with culturally sensitive revision.

• 보건행정학회지
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• 제12권1호
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• pp.21-53
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• 2002

The purpose of this study is to measure the resource use of the elderly in long-term care services and to examine the effects of patient and facility characteristics on their use of resources. The data were collected from 510 old people over sixty years of age, residing in five long-term care hospitals and two skilled nursing homes during the period between December 1, 2000 and February 28, 2001. For a full sample, when the first level of RUG(Resource Use Group)-III categories were employed as the proxy of patient severity, facility characteristics, such as location, size and ownership, have large effects on the resource use measured by service intensity, whereas patient characteristics such as severity have little or no effect. The resource use is significantly high if the facility: (1) is located in rural areas (gun): (2) has mare than 200 beds; (3) is a long-term care hospital; (4) is private; and (5) has a low percentage of medical aid patients. The analysis of the resource use in each RUG-III categories, for which ADL(Ability of Daily Living) were employed as the prosy of patient severity, shows a similar result. The loose relationship between the needs of residents and the resource use seems to be closely associated with the ineffective reimbursement system for providers. The current reimbursement system has no provision for quality improvement and reimburses facilities simply according to their types: fee-for-service for long-term care hospitals, and monthly-flat-rate or full-coverage-national-aid for skilled nursing facilities. It will be necessary to develop a more reasonable reimbursement system that takes patient's severity into account and gives incentives for long-term care providers to offer cost-effective services.