• 제목/요약/키워드: system of long-term care insurance for the elderly

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장기요양서비스 전.후 가족의 수발 부담감에 영향을 미치는 요인 (Caregiver Burden in Caring for Elders Before and After Long-term Care Service in Korea)

  • 이홍자
    • 대한간호학회지
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    • 제42권2호
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    • pp.236-247
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    • 2012
  • Purpose: Purposes of this study were: evaluation of family burden of caring for elders who receive long term care services, and examination of differences in burden before and after the introduction of long term care service in Korea. Methods: Data were collected by questionnaires from 416 caregivers of elders who were registered with the Long Term Care Insurance Corporation in six cities. Data were collected in September, 2010 and analyzed using descriptive statistics, paired t-test, and ANOVA with the Scheffe test, and stepwise multiple regression. Results: Family burden decreased significantly after longterm care service was initiated. Subjective burden decreased from 2.93 to 2.69 (t=11.78, $p$<.001), and objective burden, from 3.40 to 3.10 (t=12.73, $p$<.001). Stepwise multiple regression analysis revealed that factors affecting subjective burden were family relations (F=13.60, $p$=.003), age (F=5.47, $p$=.019), job (F=6.98, $p$=.008), and education (F=4.59, $p$=.032), and that factors affecting objective burden were living together (F=17.66, $p$<.001), job (F=13.34, $p$=.003), monthly income (F=6.61, $p$=.010), and type of service (F=6.62, $p$=.010). Conclusion: The results of this first study to investigate caregiver burden after the Korean Long-term Care Insurance System was begun provide positive information for the development of strategies to decrease family burden in long term care.

노인장기 요양시설 종사원의 서비스 지향성 결정요인에 관한 연구 (Determinant Factors of Service Orientation for Human Resources of Long Term Care Facility)

  • 이성덕;황용철
    • 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.

Suggestions for the Work of Dental Hygienists and a Reflection of Health Insurance Charges according to Demographic Changes

  • Lee, Myung-Jin;Oh, Sang-Hwan
    • 치위생과학회지
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    • 제20권1호
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    • pp.1-8
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    • 2020
  • Given that the demand for dental care for elderly individuals is expected to increase according to demographic changes, long-term roadmaps for the current health insurance system should be actively planned. The study aimed to investigate the health insurance system in Korea, compared to that of Japan, and suggest directions for the work of dental hygienists to provide basic data on efficient improvements in the health insurance system. Based on the collected data, the website was used to collect additional related data from Korea and Japan. The most common cause of death in Korea was malignant neoplasms, and most patients were hospitalized for diseases and disorders of the musculoskeletal system and connective tissue. Dental care covered by Korean medical insurance for individuals aged 65 years or older was treatment oriented, such as dentures and implants, while in Japan, treatment-intensive items, such as visiting a dental hygienist for guidance and provision of home-care professional oral hygiene treatment, were covered. The percentages of remaining teeth in Korea and the percentage of remaining 20 teeth were 68.9% in those aged 65 to 74 years and 51.2% in those aged 75 to 84 years in Japan. A strategy for promoting oral health among elderly individuals should be established, and a multilateral intervention approach is required to prevent oral problems from leading to deterioration of whole-body health. The role of dental hygienists in providing comprehensive assessment to elderly individuals is important. In order to provide systemic oral care, it is necessary to introduce oral care systems according to the national policy.

재가노인의 장기요양예방과 자립지원에 관한 연구: 예방·자립지원 모형설계 방안제언 (A Study on a Prevention of Long-term Care self-reliance Support for the Elderly in Home: Proposal of an Prevention and Support for Self-reliance Support Model)

  • 김현실;황성자
    • 한국노년학
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    • 제30권4호
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    • pp.1359-1375
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    • 2010
  • 본 연구는 고령사회에 따른 장기요양재가노인 인구의 증가 현상을 예견하면서, 요양급여 의존 증을 최소화하고, 예방·자립지원의 유효성을 높이기 위하여 예방·자립지원 모형의 기초를 제시함으로 예방·자립지원의 실천적 함의를 얻고자 함이다. 연구방법으로는 첫째, 이론적 문헌연구를 통하여 장기요양노인에게 예방·자립지원에 대한 개념을 명확히 하며, 둘째, 표준장기요양이용계획서와 연구대상자가 소속된 노인복지센터의 장기요양급여 관련문서 분석을 통하여 예방·자립지원에 저해하는 요소를 분석하고, 셋째, 요양급여 이용자들의 요양급여이용실제에서 예방·자립지원을 저해하는 요소와 실제 욕구를 조사하여 이 세 가지의 질적 연구결과를 바탕으로 예방·자립지원 모형의 방향을 제시함으로써 예방·자립지원의 유효성을 높이기 위한 실천적 함의를 얻고자 하였다. 따라서 D시에 있는 주간보호센터와 노인복지센터의 사업자와 전문사회복지사의 협력과 승낙을 얻어 문서자료 수집과 연구 참여자에게 심층면접을 실시하였다. 연구 결과 문헌연구에서는 장기요양 예방·자립지원은 장기요양급여노인에게도 자신이 삶의 주체가 되어 살아가도록 이용자의 권리를 지원하는 '이용자 중심의 지원체계의 강화'로 전개되어야하는 것으로 분석되었다. 문서분석에서는 보건의료와 관련한 급여제공이 부재한 것으로 나타났고, 예방·자립지원을 위한 사회적지지체계의 미비 등이 나타났으며, 심층면접조사결과에서 장기요양급여이용노인의 예방·자립과 관련된 서비스의 강화가 요구되었으며 예방·자립을 위한 요양급여이용노인의 절실한 욕구는 ①고독감, 외로움, 불안, 공포 ② 자녀와 사람에 대한 그리움과 걱정, ③이동, 외출, ④ 보건·의료서비스·재활프로그램, ⑤ 주간보호이용욕구, ⑥주택구조의 불편, ⑦식사메뉴의 욕구, ⑧폐용증후군(disuse syndrome)의 발생 등이 도출되었다. 따라서 예방·자립지원모형은 ①이용자 중심의 지원체계의 강화, ②보건의료연계지원체계의 강화, ③사회적지지 체계강화의 3가지 축을 중심으로 예방·자립지원모형설계의 기초를 제시하고자 했다.

가정간호: 위기와 전망 (Home care services: crisis and prospects)

  • 송종례
    • Perspectives in Nursing Science
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    • 제6권1호
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    • pp.55-65
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    • 2009
  • The Korean government introduced Home Care Services System to cut medical cost and make efficient use of limited medical resources because of increasing chronic diseases and the growing population of the elderly. The Korean government established measures to control the use of insurance services by restricting the number of nurse's visits to patient's home and by asking the patients to shoulder the transportation fee of nurses during the visit. Factors such as oversupply of hospital facilities, low price of home care services, high insurance coverage for hospital services and increased nuclear family set up resulted in the limited use of home care nursing services. The introduction of long-term care insurance in 2007 brought the decrease in the number of home care agencies and these agencies are facing a crisis today. The increase in chronic diseases and growing population of the elderly recently resulted in the need to control the high medical cost. Home care services for early discharge patients and chronic-severe disease patients will contribute in the reduction of medical cost at the same time improves the quality of patient's life. To catch up with the demands of the nation, accessibility to home care services should be improved and policies such as the expansion of home care services insurance coverage and promotion of establishing home care agencies should be considered.

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고령자 관점에서 본 일본 사회보장제도의 역사적 전개에 관한 연구 - 1945년 사회보장 개념성립부터 2000년 개호보험의 시행까지 - (The Study on the Historical Development of Japanese Social Security System in view of the Elderly - From the Concept-Formation Period for Social Secuiry of 1946 to the Implementation of Nursing Care Insurance of 2000 -)

  • 이정남;윤철재
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제16권3호
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    • pp.7-18
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    • 2010
  • The purpose of this study is to derive periodical characteristics of the policy for the elderly in Japan by investigating the changes of social security system. The target period of 1946~2000 in Japan was divided into 3 periods for the understanding of periodical characteristics in the focuses of medical, welfare and pension system for the elderly; establishment of concept for the social security and welfare of Japan(1946,1950), appearance of social security system and the elderly problem(to late 1960's), infra construction for aging society(to late 1980's), development and reappraisal of practical policy for the elderly(to late 1990's). It is expected that this paper could provide basic data for the elderly-related policy making in our country.

노인장기요양보험제도의 시행이 장애노인의 삶의 질 궤적에 미치는 영향 (The effects of the implementation of long-term care insurance on the quality of life trajectory among older adults with disabilities)

  • 전해숙
    • 보건교육건강증진학회지
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    • 제32권3호
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    • pp.97-107
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    • 2015
  • Objectives: The current study aims to examine whether the influence of National Long-term Care Insurance(NLCI) on the quality of life(QoL) trajectory of older adults with disabilities is more positive than its influence on those without disabilities. Methods: Sample consisted of 5,362 elderly aged 65 and over who participated in the Korean Welfare Panel Study from Wave1 to Wave7. Data were analyzed using latent growth curve modeling. Results: Major findings are as follows. (1) Before the NLCI, the trajectories of QoL between older adults with disabilities and those without were same. (2) After the NLCI, elders with disabilities showed lower levels of QoL at the beginning, but the gaps gradually decreased with time. These results indicate that the implementation of NLCI more positively affected elders with disabilities than those without disabilities. Conclusions: These results suggest that the NLCI functions properly as one of social security nets to cope with the needs of older adults with disabilities. In conclusion, it is critical to develop a sustainable NLCI system to enhance the QoL of older adults with disabilities.

장기요양노인을 돌보는 가족의 부양부담과 생활만족도의 관계에서 사회적 지지 자원의 조절효과 -장기요양재가서비스 이용자를 돌보는 가족부양자를 중심으로- (The Moderating Effect of Social Support Resources on Caregiving Burden and Life Satisfaction of Family Caregivers Performing Long-Term Care of the Elderly: A Focus on Using Home Care Services Under the Long-Term Care Insurance System)

  • 박주희
    • 가족자원경영과 정책
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    • 제21권3호
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    • pp.121-139
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    • 2017
  • This study aimed to explore the moderating effect of social support resources on the life satisfaction and caregiving burden of family caregivers taking care of the elderly in long-term care services. The study participants were selected from among the family caregivers utilizing 30 home care centers in Seoul, Korea. Of the candidates who agreed to participate in the study, 250 caregivers who had supported the elderly at home for at least 6 months were selected. The data collected were analyzed using SPSS ver. 21.0. The study findings were as follows. First, the whole family caregivers' caregiving burden of family caregivers was found to be slightly higher than the median value. More specifically, the physical burden was the heaviest, followed by the family relationship burden, the social activity burden, the emotional burden, and the financial burden. Social support resources and life satisfaction were found to be a little bit higher than the median value. Second, the variables that statistically significantly increased life satisfaction, starting with the strongest effect, were a lower psycho emotional burden, greater informational support resources, a lower economical burden, greater emotional support, a younger caregiver age, a higher monthly income, and a shorter care period. Third, informational support resources were found to have a moderating effect on the relationship between the support burden and life satisfaction. The more the participants used the informational support resource subcategory of the social support resources, the narrower the life satisfaction decrease, even though the caregivers felt a support burden. Informational support resources appear to have a statistically significant buffering effect.

노인장기요양시설의 현황 및 Web GIS 분석에 의한 농촌지역 요양시설과 보건소·병원간의 접근성 (The Present Condition of Nursing Home & Accessibility to Health Center and Hospital from Nursing Home in Rural Area by Web GIS Analysis)

  • 남윤철;박경옥
    • 한국농촌건축학회논문집
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    • 제12권4호
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    • pp.29-36
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    • 2010
  • The purpose of this study is to have detailed data of the distribution, locations, and the amount of people in the waiting line of the nursing home. Also, we studied the accessibility to the facilities by using Web GIS to analyze the transit time it takes from the nursing home to health center and hospitals. We can provide the basic data that could contribute when future plans for the nursing homes' locations, health and medical policy are made. The results are as follows. 1. The nursing homes are stiffly concentrated in regions of Seoul and Gyeongi-do where large number of the elderly covered by long-term care insurance and the waiting line was very long for the elderlies to enter the nursing homes. In these cities of Ulsan and Jeju where number of the elderly covered by long-term care insurance is relatively small, there were less facilities. 2. The nursing homes located in urban areas had higher occupancy rate and higher number of people in the waiting line. 3. The average time taken by driving from the nursing homes and health center was 10 minutes and there was not a noticeable difference between the cities. Driving from the nursing homes to hospitals in rural areas took 22 minutes which is 2.5 times of the time taken for urban areas. Daegu-si and Incheon-si had relatively short distance from the nursing homes and the hospitals while Jeju-do had the furthest. For rural areas, it is needed for health center to be equipped with a wider medical coverage, have closely connected with hospitals to minimize the differences they have from ones in rural areas. It is also needed to have ambulances equipped for tele-medical examination and treatment system.

노인 장기요양보험의 등급판정을 위한 의사결정나무 연구 (A Study on the Judgement Rating for Level of Need for Long-term Care Insurance Using a Decision Tree)

  • 한상태;강현철;최보승;이성건
    • Communications for Statistical Applications and Methods
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    • 제18권1호
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    • pp.137-146
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    • 2011
  • 노인장기요양보험은 고령이나 노인성질병 등으로 인하여 혼자서 일상 생활을 수행하기 어려운 노인 등에게 신체활동 또는 가사지원 등의 장기요양급여를 사회적 연대원리에 의해 제공하는 사회보험 제도로써, 우리나라에서는 2008년 7월부터 시행하고 있다. 신뢰성있는 등급판정을 위하여, 안정적인 수급자의 요양인정점수를 산출하는 것은 노인장기요양보험제도의 시행에 있어 매우 중요한 요소라고 할 수 있다. 본 연구에서는 요양인정점수 산출과 등급판정에 의사결정나무 모형을 사용하였고 안정적인 모형을 위해 원자료의 변환 및 절사, 다양한 분리기준(splitting criterion), 정지규칙(stopping rule)을 적용하였다. 본 연구에서 생성한 모형이 기존의 모형보다 안정적임을 확인하였다.