• 대한간호학회지
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• 제33권2호
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• pp.275-283
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• 2003

Purpose: This study was to classify elderly in long-term care hospitals for using Resource Utilization Group(RUG-III) and to consider feasibility of payment method based on RUG-III classification system in Korea. Method: This study designed by measuring resident characteristics using the Resident Assessment Instrument-Minimum Data Set(RAI-MDS) and staff time. The data were collected from 382 elderly over sixty-year old, inpatient in the five long-term care hospitals. Staff time was converted into standard time based on the average wage of nurse and aids. Result: The subjects were classified into 4 groups. The group of Clinically Complex was the largest(46.3%), Reduced Physical Function(27.2%), Behavior Problem(17.0%), and Impaired Cognition(9.4%). The average resource use for one resident in terms of care time(nurses, aids) was 183.7 minutes a day. Relative resource use was expressed as a case mix index(CMI) calculated as a proportion of mean resource use. The CMI of Clinically Complex group was the largest(1.10), and then Reduced Physical Function(0.93), Behavior Problem(0.93), and Impaired Cognition(0.83) followed. The difference of the resource use showed statistical significance between major groups(p<0.0001). Conclusion: The results of this study showed that the RUG-III classification system differentiates resources provided to elderly in long-term care hospitals in Korea.

• 지역사회간호학회지
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• 제19권2호
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• pp.196-204
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• 2008

Purpose: To examine factors affecting long-term care hospital patients' intention of transfer to a nursing home. Method: A questionnaire survey was conducted in Aug. 2007 that included 655 patients from 49 long-term care hospitals. The survey aimed to assess the patients' health status, family status, cost and intention of transfer to a nursing home. Institutional characteristics were analyzed from the nationwide database of Health Insurance Review & Assessment Service. The affecting factors were examined by employing chi-square test and logistic regression using SAS 8.2. Result: Of the subjects, 32.4% had intention of transfer to a nursing home. The intention of transfer to a nursing home was affected by moderate or severe pain, living together with the primary carer, high cost uncovered by insurance, and recognition of nursing home. Conclusion; For appropriate service utilization. a higher level of care is needed to satisfy patients at nursing homes and a balanced fee schedule is needed between long term care hospitals and nursing homes. It is desirable to encourage transfer to a nursing home at which nurses support patients and their families by giving information, coordination, and to make efforts to establish a reference system.

• 한국보건간호학회지
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• 제24권1호
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• pp.5-18
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• 2010

Purpose: The purpose of this study is to understand nurses' perception of visiting nursing services of long-term care insurance. Method: The descriptive survey study involved 188 nurses selected by the convenient sampling of visiting nurses who participated in professional education sessions. Results: Of the 188 participants, 149 (79.3%) were aware of long-term care insurance. Awareness of aspects of long-term care services was 78.7% for facility service, 77.7% for ordinary visiting care service, 85.1% for visiting nursing service and 77.7% for visiting bathing service. Concerning visiting nursing service provision, the majority of the study subjects considered nurse-aid not to be the appropriate route for delivery of services including nasogastric tube exchange, tracheostomy tube management and stitch removal. Conclusion: Continuous evaluation and research on the standards and requirements of the nursing workforce is needed to secure and maintain the high quality of visiting nursing services. Exhaustive studies concerning task division and workforce separation according to nursing services type and level of difficulty should be done to develop the appropriate job description for visiting nursing service staff.

• 대한간호학회지
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• 제34권1호
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• pp.191-201
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• 2004

Purpose: This study aimed to evaluate economic viability of public health center visiting nurse services for the low-income elderly with long-term care needs. Method: The sample consisted of 252 community dwelling elderly who enrolled in public health center visiting nurse services for three months or more. Data was collected on physical (ADL and IADL) and cognitive impairments of the elderly, contents and frequency of visiting nurse services, cost per visit, and costs of alternative services for long-term care. Result: The mean score of ADL and IADL levels of the elderly was 2.80.4904, which indicated these patients were mostly independent. Eighty four percent of the elderly subjects were cognitively intact. Among visiting nurse services supplied, providing assessment was 34%, followed by education and counseling 26%, medication 22%, and referral. The mean cost per visit was 17,824.1 won, which transformed into a total cost per person per year of 161,130.2 won. Comparing the cost of a visiting nurse service with those of other long-term care alternatives, the visiting nurse service was the least costly alternative, followed by an outpatient clinic, hospital based home care, and nursing home. Conclusion: Overall, the results of the study provide evidence of the economic viability of visiting nurse services for the low-income elderly among long-term care alternatives.

• 한국노년학
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• 제36권4호
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• pp.1025-1036
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• 2016

본 연구는 노인요양시설의 사례관리자가 인지하는 조직 내 의사소통 만족과 서비스 질과의 관련성을 규명함으로써 사례관리에 있어 다양한 전문가로 구성된 팀원들간의 원활한 의사소통이 양질의 서비스의 전제조건임을 살펴보고자 하였다. 이를 위해 서울시와 경기도의 30인 이상 규모의 48개 법인시설에 종사하는 사례관리자 104명을 대상으로 설문조사를 진행하였으며, 기술분석 및 다중회귀분석을 통해 두 변인간의 관련성을 규명하고자 하였다. 연구결과 사례관리자가 인지하는 조직 내 의사소통의 만족도가 높을수록 제공하는 서비스의 질이 높은 것으로 평가하는 것으로 나타났다. 이러한 연구결과를 바탕으로 사례관리팀내의 의사소통을 원활히 하기 위한 방안과 다양한 사례관리모델 중 노인요양기관에서는'팀접근'모델이 보다 적합할 수 있음을 제언하였다.

• Journal of Information Technology Applications and Management
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• 제28권3호
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• pp.23-30
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• 2021

Korea currently provides long-term care benefits for the elderly with poor functionality, but most of the service providers are private businesses. This is the time when quality management of care services is required, which is just around the corner of the super-aged era. In this study, we would like to look at the case in which 'A company', which operates a long-term care institution, attempted to make voluntary changes ahead of social demands. The company tried to transform the social needs of quality management by judging them as opportunities, not threats, and establishing an integrated database of centers. First, the company processed data and built a cloud-based database system. Second, the company automatically linked data from existing systems for the efficiency of data utilization. Third, the company pursued visualization for the convenience of data utilization. This allowed the company to make data-driven strategic decisions internally. This is expected to increase sales as it will soon lead to securing new customers and pioneering new markets. It is also significant in that it can provide best practices for the long-term care industry.

• 보건행정학회지
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• 제32권3호
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• pp.258-271
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• 2022

The rapidly aging trend of Korea is a major factor that threatens the sustainability of the long-term care insurance system. Therefore, looking at how Japan and Germany mitigated the financial burden when they managed similar long-term care insurance systems will provide important implications for improving the Korean system in the future. The study was conducted using the literature review method, and the "country" was set as a unit for the case analysis. The three countries selected are Korea, Japan, and Germany. Recently in Korea, the insurance premium rates of all subjects have been rapidly rising, which can exacerbate the issue of intergenerational equity. On the other hand, Japan has responded to the aggravating finances for long-term care insurance due to aging by raising coinsurance for selected groups like the wealthy elderly. Germany is selectively raising the insurance premium rates by additionally increasing the premium rate for childless recipients. A more preventive and quality-oriented care service plan can be promoted by referring to the recent changes in Japan and Germany. In addition, a more effective and selective increase in payment burden in Japan and Germany could be considered in response to a recent equity issue in Korea.

• 근관절건강학회지
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• 제28권2호
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• pp.111-120
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• 2021

Purpose: This study was a descriptive research to identify the relationships among burden from behavioral psychological symptoms of dementia, dementia attitude, emotional labor and nurse's caring behavior as well as to clarify factors that affect caring behavior of nurses in long-term care hospital. Methods: For the research, this study collected data from July 8 to July 20, in 2019 with 214 nurses who worked at 10 long-term care hospitals in Chungbuk. The data were analyzed using descriptive statistics, t-tests, Mann-Whitney U test, ANOVA, Pearson's correlation coefficient, stepwise multiple regression with the SPSS 23.0 program. Results: Factors influencing caring behavior of nurses in long-term care hospital were dementia attitudes (β=.549, p<.001), burden from behavioral psychological symptoms of dementia (β=.242, p<.001) and marital status (β=.134, p=.017). These factors explained 33.9% of caring behavior (F=37.35, p<.001). Conclusion: Dementia attitudes were confirmed to be the main variable influencing nurse's caring behavior. Therefore, to improve the caring behavior of dementia patient, it is considered that the development of programs to improve dementia attitudes and in-depth understanding regarding the behavioral and psychological symptoms of dementia is necessary.

• 보건행정학회지
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• 제30권1호
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• pp.92-99
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• 2020

Background: The purpose of this study is to analyze the effect of the income support allowance policy for the care workers on wage level. Methods: The analysis data was constructed using database (DB) of long-term care institution, DB of long-term care personnel status, and DB of health insurance qualification and contribution possessed by National Health Insurance Services. We analyzed the wage status of care workers 2009 to 2016 through basic analysis. We used the difference-in-difference analysis method for the workers who worked in the same institution from 2012 to 2013, The effects of the income allowance policy on wage increase were analyzed. Results: As a result of the net effect of the income support allowance policy, the monthly average wage of the care worker increased by 25,676 won and the hourly wage increased by 478 won. As a result of the analysis, it can be confirmed that the income support allowance policy has achieved some of the goals of raising the wage level of the care workers, and the effect of raising wages for other occupations in the long-term care business can be confirmed. Conclusion: The low wage problem of long-term care workers such as care workers is not the only problem in Korea. In other countries, there are various wage support policies for employees. In particular, it is necessary to refer to the improvement in the treatment of care workers in Japan and wage pass-through in the United States. In addition to wages, there is a need to promote policies to provide employment motivation through efforts to improve their social status and improve their job status and career development for employees in long-term care facilities.

• 대한치위생과학회지
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• 제6권1호
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• pp.13-25
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• 2023

연구배경: 본 연구는 비정형 빅데이터를 활용하여 노인장기요양보험의 직접적 서비스 인력인 요양보호사의 서비스질 관리를 확인하고자 수행되었다. 연구방법: 요양보호사의 서비스질과 관련된 소셜 비정형 데이터를 텍스톰을 사용하여 수집·분석하였다. 데이터를 크롤링하여 수집된 상위 50개 키워드들 간의 빈도분석, TF-IDF, 중심성 분석, 의미연결망분석과 CONCOR 분석을 실시하였다. 연구결과: 빈도분석 결과 상위권에 속한 키워드는 '요양서비스' '요양보호사', '서비스질', '요양보호', '장기요양기관', '향상', '어르신', '처우', '개선', '필요' 였으며, 연결중심성과 위세중심성 분석결과도 거의 동일한 순위로 확인되었다. CONCOR 분석결과 4개의 그룹으로, 요양서비스질 개선, 요양서비스 운영, 요양서비스 제도, 요양보호사의 심리적인 부분에 대한 인식이 높은 것으로 나타났다. 결론: 본 연구는 요양보호사의 서비스질과 관련한 인식을 의미있는 그룹으로 제시하였으며 이는 요양보호사 서비스질 향상을 위한 다각적인 방향성 수립에 기여할 것으로 판단된다.