Health Policy and Management (보건행정학회지)

Korean Academy of Health Policy and Management (한국보건행정학회)
권호 표지
DOI QR코드

DOI QR Code

Factors Associated with the Non-Use of Beneficiaries of Long-Term Care Insurance Service: The Case of Jeollanam-do Province

노인장기요양보험 인정자의 미이용 관련요인 분석: 전남지역을 대상으로

  • Kuk, Kyung-Nam (Graduate School of Public Health, Graduate School, Yonsei University) ;
  • Kim, Roeul (Institute of Health Services Research, Yonsei University) ;
  • Lim, Seungji (Health Insurance Policy Research Institute, National Health Insurance Corporation) ;
  • Park, Chong-Yon (National Evidence-based Healthcare Collaborating) ;
  • Kim, Jaeyeun (Department of Public Health, Graduate School, Yonsei University) ;
  • Chung, Woojin (Graduate School of Public Health, Graduate School, Yonsei University)
  • 국경남 (연세대학교 보건대학원) ;
  • 김노을 (연세대학교 보건정책 및 관리연구소) ;
  • 임승지 (국민건강보험공단 건강보험정책연구원) ;
  • 박종연 (한국보건의료연구원) ;
  • 김재윤 (연세대학교 대학원 보건학과) ;
  • 정우진 (연세대학교 보건대학원)
  • Received : 2014.07.28
  • Accepted : 2014.12.20
  • Published : 2014.12.31
Download PDF
⟨ Previous Next ⟩

Abstract

Background: This study aimed to explore factors associated with the non-use of beneficiaries of long-term care insurance services for the elderly in Jeollanam-do Province by analyzing a dataset obtained from National Health Insurance Service. Methods: The study sample consists of 1,663 individuals who were evaluated as eligible for long-term care insurance services in Jeollanam-do Province during the period of July 1, 2008 through June 30, 2009. As a dependent variable, the non-use of the service was defined as one when a beneficiary had used it once or more times during one year after he or she was evaluated as eligible and as zero otherwise. A proportion analysis was conducted to describe characteristics of study sample. Chi-square tests were used to compare general characteristics between beneficiaries who had used the services and those who had not used them. Multiple logistic regressions were performed by three models including additional sets of explanatory variables such as socio-demographic characteristics, health conditions, and economic status. Results: Main results are summarized as follows. The proportion of beneficiaries who had not used the service was 14.5% of all beneficiaries. According to the results from the model using all explanatory variables, the factors associated with the non-use of the services were residence location, dwelling place, type of desired service, level of care needs, and instrumental activities of daily life limitations. Conclusion: In particular, regarding the type of desired service, the cash benefit showed a high likelihood of the non-use of the service; it had an odds ratio (OR) of 50.212 (95% confidence interval [CI], 24.00-105.04) compared with home service. In case of dwelling place, a hospital showed also a high likelihood of the non-use with an OR of 20.71 (95% CI, 10.12-42.44) compared with home.

Keywords

References

  1. Organization for Economic Cooperation and Development. OECD health statistics 2014 [Internet]. Paris: Organization for Economic Cooperation and Development; 2014 [cited 2013 Oct 10]. Available from: http://www.oecd.org/els/health-systems/health-data.htm.
  2. Ministry of Health and Welfare. Ministry of health and welfare statistical yearbook of 2013. Seoul: Ministry of Health and Welfare; 2013.
  3. Han EJ, Kwon JH, Lee JM, Lee JS, Choi JK, Park JD. A improvement of service support counselling system for in-home care service user in the national long-term care insurance. Seoul: National Health Insurance Service; 2013.
  4. Curry LA, Robison J, Shugrue N, Keenan P, Kapp MB. Individual decision making in the non-purchase of long-term care insurance. Gerontologist 2009;49(4):560-569. DOI: http://dx.doi.org/10.1093/geront/gnp041
  5. Lee D. Determinants of long-term care services utilization for the elderly [dissertation]. Seoul: Yonsei University; 2006.
  6. Lim JG. A study on factors of elderly residential care service utilization for using decision tree regression. Korean J Soc Welf 2008;60(3):129-150. https://doi.org/10.20970/kasw.2008.60.3.006
  7. Lee Y. Current situation and policy implication for the elderly long-term care insurance. Health Welf Policy Forum 2009;156:23-31.
  8. Chung WK. Determinants of demand for long-term care service. KDI J Econ Policy 2009;31(1):139-167. https://doi.org/10.23895/kdijep.2009.31.1.139
  9. Kim BN. Determinants of long-term care service utilization [dissertation]. Seoul: University of Seoul; 2009.
  10. Bass DM, Noelker LS. The influence of family caregivers on elder's use of in-home services: an expanded conceptual framework. J Health Soc Behav 1987;28(2):184-196. DOI: http://dx.doi.org/10.2307/2137131
  11. Friedman HR. Determinants of caregiver's decisions about respite service use [dissertation]. Chicago (IL): Northwestern University; 1996.
  12. Calsyn RJ, Winter JP. Predicting different types of service use by the elderly: the strength of the behavioral model and the value of interaction terms. J Appl Gerontol 2000;19(3):284-303. https://doi.org/10.1177/073346480001900303
  13. Borrayo EA, Salmon JR, Polivka L, Dunlop BD. Utilization across the continuum of long-term care services. Gerontologist 2002;42(5):603-612. DOI: http://dx.doi.org/10.1093/geront/42.5.603
  14. Finlayson M. Changes predicting long-term care use among the oldest-old. Gerontologist 2002;42(4):443-453. DOI: http://dx.doi.org/10.1093/geront/42.4.443
  15. Cha HB. A study of family caregiver's preference and its determinants for the long-term care service use for the impaired elderly. Seoul: Chung-Ang University; 1998.
  16. Lee IJ. The determinants of community service utilization among family caregivers of the impaired older persons. Korean J Soc Welf 2004;56(3): 183-205.
  17. Kang IO, Park JY, Kwan JH, Kim KH. Policy alternatives of healthcare systems for the elderly in Korea. Seoul: National Health Insurance Service; 2007.
  18. Kim EY, Nam ES, Chae YR, Lee HK. Factors affecting the elderly's preference for utilization of long-term care services based on Andersen's Behavioral Model. J Korean Gerontol Soc 2008;28(3):385-602.
  19. Kim JY. A study on factors influencing selection and determination of long-term care [dissertation]. Seoul: Ewha Womans University; 2008.
  20. Lee HS. Health status and utilization of long-term care facility in the urban and rural aged. J Korean Acad Community Health Nurs 2008;19(2): 260-269.
  21. Song DY. Factors affecting family caregivers' preference for utilization of community eldercare services. Korean J Soc Welf 2003;53:105-128.
  22. Yoo SH, Kim CS. An exploratory study on the effects of caregivers' family relationship to the elderly with dementia: focusing on problems, burden and institutionalization. J Welf Aged 2004;26:191-214.
  23. Chang SI. Effect factors of long-term care services utilization of elderly stroke patients in Taiwan [dissertation]. Cleveland (OH): Case Western Reserve University; 1993.
  24. Andersen R, Newman JF. Societal and individual determinants of medical care utilization in the United States. Milbank Mem Fund Q Health Soc 1973;51(1):95-124. DOI: http://dx.doi.org/10.2307/3349613
  25. National Health Insurance Service. Assessment for long-term care insurance [Internet]. Seoul: National Health Insurance Service [cited 2013 Oct 25]. Available from: http://www.longtermcare.or.kr/portal/site/nydev/MENUITEM_GRADEPROC/.
  26. Lee Y. Determinants of long-term care service use by elderly. J Korean Gerontol Soc 2009;29(3):917-933.
  27. Miner S. Racial differences in family support and formal service utilization among older persons: a nonrecursive model. J Gerontol B Psychol Sci Soc Sci 1995;50(3):S143-S153. DOI: http://dx.doi.org/10.1093/geronb/50b.3.s143
  28. Park JY, Lee YH, Kwon JH, Lee EM, Lee HY, Kim YH. The development of an integrated care model for the long-term care and medical service. Seoul: National Health Insurance Service; 2010.
  29. Sun WD, Choi JS, Yoo GC, Jang SR, Kim SJ, Improvement in evaluation and management system of long-term care quality in Korea. Seoul: Korea Institute for Health and Social Affairs; 2013.

Cited by

  1. The Effect on Health Care Utilization of the Non-Use of Beneficiaries of Long-Term Care Insurance Service - around of Geriatric Hospital's Medical Cost - vol.16, pp.11, 2015, https://doi.org/10.5762/KAIS.2015.16.11.7463