• 보건의료산업학회지
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• 제5권2호
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• pp.105-117
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• 2011

The purpose of this study is to investigate evaluation and improvement of long-term care hospitals for changing long-term care hospitals fee system. Data were collected from 104 CEOs in nationwide long-term care hospitals using structured self-administered questionnaires during August 17 to 31, 2009. Major results of the empirical analysis are as follows; first, to change fixed sum medical fee per day caused to decline the level of geriatric service in 87% of CEOs. Second, 79% of CEOs were dissatisfied with changing fixed sum medical fee per day, and 47% of them were dissatisfied with graded fee for doctor and nurse management. Finally, they suggested that to specialize and to differentiate of long-term care hospitals will drive to improve long-term care hospitals function and to measure workforce based on rate of filled vacancies will increase efficiency and productivity of doctor and nurse management.

• 한국직업건강간호학회지
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• 제29권3호
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• pp.202-207
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• 2020

Purpose: COVID-19 infections have been erupting in places of worship, long-term care facilities, and call centers in Korea since January 2020. This study aims to diagnose and present an infection control system solution for long-term care facilities where at-risk elderly individuals are actively engaged in communal life. Methods: We conducted comparative analyses of infection control systems between long-term care facilities and medical institutions respective of relevant laws and this study's evaluation system. Results: To prepare for future infectious diseases, it is necessary to establish a long-term care facility infection control system and strengthen the standards thereof, to strengthen long-term care facility evaluation standards and to newly establish medical charges for infection control. Conclusion: Systematic procedure fortification and financial support provisions are necessary for infection control at long-term care facilities.

• 한국사회복지학
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• 제66권2호
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• pp.5-29
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• 2014

본 연구는 사회학적 신제도주의 관점에서 노인장기요양서비스를 제공하는 조직들이 평가제도를 어떻게 채택하고 집행하는지를 동형화와 분리현상으로 해석하였다. 이를 위해 장기요양서비스를 제공하고 있는 7개 기관을 대상으로 심층인터뷰를 한 자료를 질적 내용분석 하였다. 분석결과, 평가제도가 장기 요양기관의 공식적인 구조에 있어서는 동형화를 이끄는 것으로 나타났다. 그러나 장기요양기관 평가제도가 의도한 공급기관 간 경쟁을 통한 효율성을 촉진하는 방식으로 채택되기보다, 정부자원에 의존하기 위해 강압적으로 평가제도를 채택하는 것으로 나타났다. 이러한 결과는 평가제도가 정부규제에 의해 장기요양서비스를 표준화하는 양상으로 집행되고 있음을 확인시켜주었다. 또한, 동형화에 수반되는 조직의 공식구조와 실제 활동의 분리현상도 부분적으로 관찰되었다. 무엇보다 분리현상은 정부역할로서 조직의 이중구조에서 발생할 수 있는 비효율성의 문제를 개선할 수 있는 평가체계의 운용이 요구되며, 특히 돌봄 서비스의 고유성을 반영한 평가지표에 대한 개선이 시급함을 보여준다.

• 한국직업건강간호학회지
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• 제16권1호
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• pp.58-66
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• 2007

Purpose: A national long-term care system for elderly and the disabled has its unique evolution in each country. Japan, Germany and the United States may be the typical examples of respective social insurance system. This paper reviews the counterpart examples of Japan, Germany and the United States and looks at their accumulated long-term care system experiences and personal care system under workers' compensation. Methods: Literature review and website searching were conducted. Key words as 'workers' compensation insurance', 'personal care benefit' and 'long term care' were used in searching the related literatures. Results: Though the personal care benefit under current Workers'Compensation in Korea is very similar to Japan's, the long-term care system of Korea is not as well established. Germany and the United States have the provision of personal care benefit for injured workers within long term care system. Conclusions: We recommend some key issues to take into account for improving personal care benefit system in workers' compensation in Korea as follows: providing a comprehensive coverage through the linkage of long term care, introducing an assessment & evaluation system for the appropriate benefits, establishing insurer's role for quality management of personal care service, and developing a policy for family caregivers.

• 예술인문사회 융합 멀티미디어 논문지
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• 제9권11호
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• pp.1015-1026
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• 2019

본 연구에서는 노인장기요양시설 평가지표개발과 관련된 선행연구의 평가현장 적용성 및 실효성이 미흡하다는 문제의식하에, 노인장기요양기관(시설급여) 평가의 품질향상을 위한 평가지표를 개발하는 데 연구의 목적이 있었다. 이를 위해 2018년도 노인장기요양기관(시설급여) 평가지표에 대한 분석적 고찰, 일본의 노인특별요양홈 평가지표에 대한 분석, 한국의 노인장기요양시설 종사자와 일본의 노인특별요양홈 종사자를 대상으로 한 평가지표 및 평가체계에 관한 FGI를 실시하였다. 연구결과를 토대로 하여 이용자가 양질의 서비스를 제공 받을 수 있도록 지원하는 측면에서 평가지표를 개발하였다. 노인의 특성, 즉 유지 및 호전되기 어려운 노인성 질환의 특성과 기관운영의 방향 및 투명성, 그리고 종말기 케어의 필요성 등을 반영하였다. 기관운영, 환경 및 안전, 수급자 권리보장, 급여제공과정, 급여제공결과를 포괄하는 43개의 평가지표를 제시하였다. 또한, 중복되고, 불필요한 평가과정을 개선하여 평가의 과정 효율성을 증가시킬 수 있는 4단계 다층평가시스템을 제안하였다.

• 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.

• Perspectives in Nursing Science
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• 제15권2호
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• pp.81-91
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• 2018

Purpose: This study aimed to suggest strategies for advancing local-government-based accreditation systems and surveyor training in long-term care facilities in Korea. Methods: A comprehensive review of the literature including research papers and official reports issued by governments from the United States, Australia, and Japan was conducted to explore domestic and international policies related to long-term care facility certification and accreditation systems. Results: The USA has two types of care quality assurance systems including mandatory certification (5-star rating system) by the Centers for Medicare and Medicaid Services and voluntary accreditation by the Joint Commission on Accreditation of Healthcare Organizations. Australia operates a government-based mandatory accreditation system for all long-term care facilities through the Australian Aged Care Quality Agency. Japan, particularly the Tokyo district, operates a third-party evaluation system that involves the voluntary participation of long-term care facilities. Conclusion: This study provides several strategies to enhance accreditation processes and surveyors'expertise. For instance, motivating facilities to voluntarily participate in accreditation is necessary by 1) providing sufficient and continuous consultations and feedback about how to improve care quality, 2) differentiating accreditation domains and indicators from the national health insurance certification system, and 3) actively utilizing accreditation results and providing incentives.

• 한국사회복지학
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• 제64권4호
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• pp.31-56
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• 2012

본 연구의 목적은 일본 개호정책 전개과정에서의 '가족개호(가족에 의한 개호제공)'에 대한 금전적 평가에 초점을 맞추어, 특히 개호보험제도의 도입이 '가족개호의 비용화'에 미친 영향을 살펴봄으로써 '가족개호'의 제도화 현상을 포착하는 것이다. 이를 위해 본 연구에서는 '개호의 사회화' 이념을 '가족개호의 비용화'라는 분석개념으로 조작적으로 정의하고, 이 '가족개호의 비용화' 상황과 그에 대한 국가의 개입방식을 개호서비스 제공에서의 가족의 역할과 가족개호에 대한 사회적 평가의 수준, 그리고 가족개호자(여성)의 가정 내 환경 및 노동시장에서의 지위 등과의 관련 속에서 분석한다. 이러한 분석을 통하여, 본 연구에서는 일본 개호정책의 전개과정에 나타난 '가족개호의 비용화구조'를 밝힘으로써 개호보험제도 실시와 더불어 현금급여가 극히 잔여적으로 도입될 수밖에 없었던 정책적 맥락을 이해하고자 한다.

• 한국사회복지학
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• 제66권1호
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• pp.221-249
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• 2014

이 논문은 장기요양서비스의 질 향상을 위하여 서비스 목표라 할 수 있는 '좋은 돌봄'의 개념을 정립하고 그 구성요소를 찾아내며, 좋은 돌봄을 산출할 수 있는 조건에 대해 탐색했다. 또한 서비스 질을 어떻게 측정하는 것이 바람직한가에 대해서도 모색하였다. 이를 위하여 정부가 채택하고 있는 질 확보전략을 비판적으로 평가하고, 돌봄의 근원적 속성을 탐구한 선행 문헌들을 검토하고 지난 5년간 서비스 제공 경험에서 축적된 서비스 현장의 지혜를 질적연구방법을 통해 담아내고자 하였다. 연구 결과, '좋은 돌봄'은 개개인의 총체적 삶의 질(total quality life)이 가능한 최대로 보장될 수 있도록 단순히 신체적 기능적 욕구 충족만이 아니라 진정한 관심이 결합되어야 한다. 좋은 돌봄을 위한 가장 중요한 조건은 '좋은 돌봄관계'를 형성하는 것이다. 돌봄제공자와 돌봄수급자 간 관계가 시장규범에 훼손되지 않고, 상호신뢰 및 존중과 진정한 소통으로 돌봄수급자 욕구를 중심에 둔 개별화된 서비스를 제공하여야 한다. 평가체계는 전면적인 상대평가보다는 시설서비스의 핵심적 질에 대하여는 기관규모별 절대기준 인증체계를 마련하고, 인증기준 이상 부분은 기관마다 자율적으로 특성화하는 것이 바람직하다. 방문 재가서비스 평가는 이용자 만족도, 돌봄종사자 만족도, 재가서비스기관의 사례관리체계 등이 평가내용으로 구성되는 것이 적절하다.

• 가정간호학회지
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• 제29권3호
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• pp.329-338
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• 2022

Purpose: This study aimed to develop an infection control e-learning training program for long-term care facility care workers to prevent emerging infectious diseases and evaluate its effectiveness. Method: The program was developed using the analysis design development implementation evaluation (ADDIE) model. The effectiveness of the program was evaluated for 30 care workers. The knowledge and performance of the care workers before and after the program were analyzed by a t-test. Results: In the analysis stages, a literature review on infection control, knowledge and performance of infection control, and education needs was performed, and focus group interviews with ten care workers were conducted. In the design stage, education topics, educational content, and educational methods were selected for the program. A video was produced centered on eight themes. In the development stage, a system for education was developed, and each topic was uploaded. In the implementation stage, the program was applied to 30 care workers, and a questionnaire was administered. In the program's final evaluation, there was a significant difference in infection control knowledge (t=3.06, p=.005), and there was no significant difference in infection control performance. Conclusion: In this study, the necessary topics were finally selected by quantitatively and qualitatively analyzing the educational needs of care workers taking care of the elderly in long-term care facilities. It is necessary to understand the long-term effect and the degree of performance of the observation method in the future.