• Journal of Korean Academy of Nursing
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• v.40 no.3
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• pp.349-358
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• 2010

Purpose: The purpose of this study was to estimate nursing costs and to establish appropriate nursing fees for long-term care services for community elders. Methods: Seven nurses participated in data collection related to visiting time by nurses for 1,100 elders. Data on material costs and management costs were collected from 5 visiting nursing agencies. The nursing costs were classified into 3 groups based on the nurse's visit time under the current reimbursement system of long-term care insurance. Results: The average nursing cost per minute was 246 won. The material costs were 3,214 won, management costs, 10,707 won, transportation costs, 7,605 won, and capital costs, 5,635 won per visit. As a result, the average cost of nursing services per visit by classification of nursing time were 41,036 won (care time <30 min), 46,005 won (care time 30-59 min), and 57,321 won (care time over 60 min). Conclusion: The results of the study indicate that the fees for nurse visits currently being charged for long-term care insurance should be increased. Also these results will contribute to baseline data for establishing appropriate nursing fees for long-term care services to maintain quality nursing and management in visiting nursing agencies.

• Journal of muscle and joint health
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• v.26 no.2
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• pp.90-101
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• 2019

Purpose: This study was aimed to describe older adults' experiences of living with urinary incontinence and using diapers for its management in long-term care facilities. Methods: Qualitative data were collected through in-depth interviews with 22 participants in long-term care facilities. Content analysis was used to analyze the data. Results: Three themes and six categories were emerged. Participants navigated through those three categories as stages, including the initial stage of confronting the unacceptable reality, transitional stage of physical and emotional suffering, and adaptive stage of accepting the diaper usage as a part of life and hoping improvement. Six categories were feeling terrible with unavoidable use of diapers, being frustrated by nursing staff shortage and unsatisfactory care for urinary incontinence, physical discomfort from of wearing diapers and remaining unchanged, emotional difficulties due to using diapers, accepting and adapting to diaper usage as a part of life, hope for gender-specific quality care for urinary incontinence. Conclusion: The findings suggest that using diapers should not be mandatory to manage older adults' urinary incontinence in long-term care facilities. It is also critical to establish policies to address issues of nursing shortage and financial support for qualitative care to manage urinary incontinence in long-term care settings.

• Journal of Home Health Care Nursing
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• v.29 no.2
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• pp.204-215
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• 2022

Purpose: This study aimed to identify factors affecting the carbapenem-resistant enterobacteriaceae (CRE) infection control performance of nursing staff, who closely contact patients with CRE in long-term care hospitals. Methods: A cross-sectional study design was used. A total of 135 nursing staffs working in seven long-term care hospitals in the southern and northern areas of the K province in Korea were included. We measured the CRE infection control general characteristics, knowledge, perception, and performance. Results: The main factors affecting the CRE infection control performance were education, knowledge, and perception. The model explained the 60.8% total variance in CRE infection control. Conclusion: Appropriate infection control strategies should be prepared to provide high quality nursing care and prevent the spread of CRE infection in long-term care hospitals. Establishing an efficient infection control system in long-term care hospitals is necessary.

• Journal of Home Health Care Nursing
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• v.28 no.2
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• pp.164-177
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• 2021

Purpose: The purpose of this study was to develop effective management indicators for improving efficiencies of visiting nursing centers. Method: This was a methodological research study to develop the key performance indicators based on balanced score cards for long-term care visiting nursing centers. The main methods used in this study were literature review, focus group interview, and content validity index. The data analysis was used frequency, percentage, mean, and standard deviation. Results: The common vision of the long-term care visiting nursing centers was identified as "The healthy visiting nursing center to serve high quality cares." Eight action strategies and 15 key performance indicators to achieve this vision were developed. Conclusion: Based on the results of this study, we suggest that the developed balanced score cards will be used as an effective managerial guideline to improve performances of long-term care visiting nursing centers.

• Korean Journal of Occupational Health Nursing
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• v.21 no.3
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• pp.308-316
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• 2012

Purpose: The purpose of this study was to describe the perception and practice of hospital infection control of nursing staff in long-term care hospitals by the level of supplementation of nurses. Methods: The participants were 212 nurses and nurse assistants in 13 long-term care hospitals in a metropolitan city and the data were gathered by self-reported questionnaires during August 2011 and analyzed by SPSS/WIN program. Results: The beds per a nurse were 15, and the proportion of nurses among nursing staff in long-term care hospitals was about 33%. In general, the level of infection control in practice was lower than that of perception. The highest perception and practice domain was 'Management of disinfection/contamination', and the lower level domains were 'Personal hygiene' and 'Hand washing' There were statistically significant differences in the hospital infection control of perception and practice depending on age, education, career in long-term care hospital, job position, the quantity of beds, nurse, and nurse assistant, beds per a nurse and proportion of nurses in hospitals. Conclusion: According to these results, the systematic and continual education on hospital infection control of the nursing staff in long-term hospitals should be carried out. In addition, the policy to add more nurses into long-term care hospitals must be implemented.

• Journal of Korean Academy of Nursing Administration
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• v.4 no.2
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• pp.351-361
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• 1998

The purpose of this study was to explore whether there is a point within the range of physical impairment after which the cost of home care exceeds the cost of nursing home care among the elderly who require long-term care. The provision of long-term care for the elderly is a major health policy issue, in part due to the aging of the American population and dramatic increase in health care costs. The framework for this study was guided by Pollak's(1973)model of costs of alternative care settings for the elderly. This study used a retrospective, descriptive correlational design. Physical impairment was measured by the modified Index of Activities of Daily Living(Katz et al. 1963). Cost of care was measured by the average cost per patient per day. The sample for this study included 67 patients receiving long-term care at home from the Long-term Home Health Care Programs (LTHHCPs) and 67 patients receiving long-term care in nursing homes. Data were collected on patient characteristics. including activities of daily living and cognitive impairment. and on the number of physician visits. emergency room visits. and hospitalization from the patient records. For each patient. Medicaid cost data for home care services/or nursing home services were collected from the financial department of each home care agency or nursing home. The living costs and informal care costs were estimated for home care patients. The results indicated that the home care sample and the nursing home sample were similar in terms of gender. ethnic background. and marital status. The elderly patients in the home care sample were: however. younger and less physically impaired than those in the nursing home sample. The hypotheses of this study were supported: For elderly persons with physical impairment scores below 12(possible range of 0 to 14), cost of care was lower in home care than in the nursing home care setting. However, for elderly persons with physical impairment scores above 12. the cost of care was higher in home care than in the nursing home care setting. Thus. in this sample for elderly patients with extreme physical impairment, the cost of home care exceeded the cost of nursing home care.

• Health Policy and Management
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• v.34 no.3
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• pp.249-260
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• 2024

Background: The Republic of Korea's aging population escalates medical and long-term care costs. While prior research has suggested that long-term care might reduce these costs, these studies had limitations in their subjects and duration, making it difficult to generalize the results. This study aims to evaluate cost changes between the long-term care group and the general older adults group after addressing these limitations. Methods: A cohort was derived from the 2015 national population using stratified sampling. Subsequently, 15,114 individuals (7,557 in each group) were identified through 1:1 propensity score matching. The study employed a difference-in-differences analysis to explore variances in medical costs and long-term care benefits post-utilization of long-term care services. Results: Compared to the general older adults group, the long-term care group experienced a reduction in monthly per capita total medical costs by 56,459 Korean won (KRW). Although costs at tertiary and general hospitals increased, those related to long-term care hospitals decreased by 90,687 KRW. Including long-term care benefits, overall expenditures increased by 948,038 KRW. Conclusion: The analysis reveals that the long-term care group faces higher medical costs in acute care than the general older adults group, emphasizing a greater need for medical services within this group. To meet the increasing medical demands of the long-term care group, a collaborative strategy linking community resources, healthcare, and long-term care facilities is imperative. Additionally, developing and implementing preventive health habit management strategies for middle-aged and older adults is essential to diminish the future requirement for long-term care.

• Korean Journal of Adult Nursing
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• v.28 no.5
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• pp.572-584
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• 2016

Purpose: The purpose of this study was to explore the subjective experience of job stress among nurses working in long-term care hospitals. Methods: A phenomenological approach was used for the study. Data were collected from May to June, 2016 using open-ended questions during in-depth interviews. Participants were nurses working in long-term care hospitals and had reported experiences of stress. Six nurses participated in this study. Results: Six themes emerged from the analysis using Colaizzi's method: (a) Heavy workload and responsibility due to nurse shortage, (b) Getting exhausted by caring for cognitively impaired patients, (c) Feeling pressure due to conflict with patients' family, (d) compassion for patients who are getting worse, (e) Low value in being a long-term hospital nurse, and (f) Efforts to overcome stress. Conclusion: Sufficient labor supply, environmental improvements, program for improving interpersonal skills, education and counseling on end-of-life care, and recognition improvement about long term hospital are suggested to reduce the job stress of long-term hospital nurses.

• Journal of Korean Public Health Nursing
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• v.37 no.2
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• pp.275-289
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• 2023

Purpose: This study developed a structural model for explaining and predicting terminal care performance in long-term care hospital nurses. The model was based on the stress integration model of Ivancevich and Matteson(1980) and the results of previous studies. Method: Data was obtained from August to September 2022 from 267 nurses in 13 long-term care hospitals in G-do. Results: Results of model verification for this study, revealed that factors directly affecting the terminal care performance of long-term care hospital nurses were nursing work environment(β=0.43, p<0.001), death anxiety(β=-0.29, p<0.001), and terminal care stress(β=0.22, p=0.003). However, the attitude toward nursing care of dying(β=0.07, p=0.287) had no effect on the terminal care performance. Conclusion: The results of this study, confirmed the necessity of improving an individual's perceived nursing work environment, continuous education related to terminal care to reduce death anxiety, and an interventional approach for enhancing terminal care performance.

• The Korean Journal of Health Service Management
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• v.10 no.3
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• pp.159-171
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• 2016

Objectives : This study was performed to investigate the characteristics and ADL(Activities of Daily Living) associated factors of elderly inpatients in long-term care hospitals. Methods : Data were collected from the nationwide data of 'Survey of Patients (2013-2014)' administerd by the Ministry of Health & Welfare. The data included in this study consisted of 27,606 cases of elderly inpatients in long-term care hospitals. Results : The survey scores for the elderly inpatients were as follows: 57.6% 'Needed much and total help' with ADL, followed by 26.6% who 'Needed much help', and 15.8% who 'needed minimal supervision' in long-term care hospitals. The ADL score was high in the following categories: women, old age, referred visit, health insurance type, not-recovered & death, transferred, corporate hospitals, small hospital size, low number of physicians per 100 beds, and high number of nursing staff per 100 beds. The inpatients with 'diseases of the nervous system', 'diseases of the circulatory system' and 'diseases of the genitourinary system' were more likely to have high ADL scores. Conclusions : The results of this study suggest that long-term care hospitals should provide active and proper care for patients with high ADL scores and improve medical personnel training as well provide more medical care.