Research in Community and Public Health Nursing (지역사회간호학회지)

Korean Academy of Community Health Nursing (한국지역사회간호학회)
권호 표지
DOI QR코드

DOI QR Code

The Effects of Visiting Nursing Services in Long-term Care Insurance: A Difference-in-Difference Analysis

이중차이분석을 활용한 노인장기요양보험제도의 방문간호서비스 효과

  • Kim, Jieun (College of Nursing, Seoul National University) ;
  • Lee, Insook (College of Nursing, Seoul National University)
  • Received : 2015.02.06
  • Accepted : 2015.06.05
  • Published : 2015.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: The purpose of this study was to demonstrate the effects of visiting nursing services in long-term care (LTC) insurance on changes in health status and physical functions among the elderly. Methods: We analyzed survey data on the living status and welfare needs of the elderly from 2008 and 2011 using the difference-in-difference method with propensity score matching. Results: The subjects were 76 elders including 38 visiting nursing service users(intervention group) and 38 home-based LTC service users (control group). Results from DID analysis confirmed that the subjective health status level of the intervention group was 2.2 points higher (p=.044) and the depression level was 0.3 point lower (p=.039) than the control group. In addition, the intervention group's ADL score was 1.9 (p=.027) and IADL 3.9 (p=.030), showing that their health was deteriorated less. Conclusion: Visiting nursing service in LTC insurance was associated with delayed deterioration of subjective health status, depression, ADL and IADL. These findings suggest the need of rebuilding visiting nursing service programs focusing on prevention services, which will be more contributive to elderly health care and the reduction of social costs.

Keywords

References

  1. Statistics Korea. 2013 elderly statistics [Internet]. Seoul: Statistics Korea. 2013 [cited 2014 December 22]. Available from: http://kostat.go.kr/wnsearch/search.jsp
  2. Sun WD, Kim CW, Im HY, Kim SO, Seo DM, Yang YA, et al. Latest elderly long-term care insurance. Seoul: Elderly Information Center of Korea; 2012. 290 p.
  3. Park MH, Ha JC, Sihn IH, Kim HG, Lee SY, Cho JH, et al. 2008 the living status and welfare needs survey based analysis report. Analysis Report. Seoul: Ministry for Health Welfare and Family Affairs; 2009 February. Report No.: 11-1351000-000316-12.
  4. Long-term Care Insurance Corporation. Introduction of policy [Internet]. Seoul: National Health Insurance Corporation. 2013 [cited 2014 December 22]. Available from: http://longtermcare.or.kr/portal/site/nydev/MENUITEM_LTCARE/
  5. Boyd CM, Reider L, Frey K, Scharfstein D, Leff B, Wolff J, et al. The effects of guided care on the perceived quality of health care for multi-morbid older persons: 18-month outcomes from a cluster-randomized controlled trial. Journal of General Internal Medicine. 2010;25(3):235-242. http://dx.doi.org/10.1007/s11606-009-1192-5
  6. Lee YK. Evaluation of the elderly long-term care insurance: User's perspective. Health and Welfare Policy Forum. 2010; 168:25-33.
  7. Hyun KR, Kwon JH, Han EJ. A study on factors and improvement related to physical function change of LTC applicants. Analysis Report. Seoul: National Health Insurance Corporation; 2010 December 17. Report No.: 2010-20.
  8. Hyun KR, Lee SM. Effects on the functional status changes of LTC (long-term care) services. Journal of the Korean Gerontological Society. 2012;32(2):593-609.
  9. Kwon HJ, Cho YW, Ko JY. The effects of long-term care insurance on the life satisfaction and satisfaction in family relationships- The DD method combined with propensity score matching. Korean Journal of Social Welfare. 2011;63(4):301-326. https://doi.org/10.20970/kasw.2011.63.4.013
  10. Park CJ. Cost-effectiveness analysis of long term care services: Care in institutions vs in-home care. Journal of Welfare for the Aged. 2010;50(0):145-171.
  11. Lee KE. Health outcomes for older adults with stroke in nursing home and home care [master's thesis]. [Seoul]: Yonsei University; 2013. 54 p.
  12. Lee JS, Han EJ, Kang IO. The characteristics and service utilization of home nursing care beneficiaries under the Korean long term care insurance. Journal of Korean Academy of Community Health Nursing. 2011;22(1):33-44. https://doi.org/10.12799/jkachn.2011.22.1.33
  13. Lee AJ, Park YH, Hong MS, Lee PS, Choi KS, Kim CS. Performed the first anniversary of long-term care insurance visiting nursing service policy debate for the activation. Trend Analysis Report. Seoul: National Health Insurance Corporation; 2009 September 17. Report No.: 1000028627.
  14. Jung YS. A study on home visiting nursing care and medical care utilization in the elderly patients with long-term care [dissertation]. [Gimhae]: Inje University; 2012. 103 p.
  15. Kang SB, Kim HS. The relationship between home-visit nursing services and health care utilization among nursing service recommended beneficiaries of the public long-term care insurance. Health Policy and Management. 2014;24(3):283-290. http://dx.doi.org/10.4332/kjhpa.2014.24.3.283.
  16. Kim MH. Development of home visiting nursing standards based on a long-term care insurance for the elderly program. Journal of Korean Public Health Nursing. 2010;24(2):285-301.
  17. Moon KJ. Current status and problems of home visit nursing service within long term care insurance [master's thesis]. [Seoul]: Sungshin Women's University; 2011. 71 p.
  18. Sumg MS, Jang HJ, Kim CG, Kang KH, Nam KA, Park JD. Comparative study of home nursing care services under the long-term care insurance system in four nations. Journal of Korean Public Health Nursing. 2010;24(2):211-225.
  19. Kim MH. Roles of visiting nurses defined based on long-term care insurance regulation for the elderly. Journal of Korean Public Health Nursing .2009;23(2):232-250.
  20. Kim KH. Health needs of visiting health subjects evaluated by using RAI-MDS-HC 2.0. Journal of Korean Society of Living Environmental System. 2008;15(1):102-111.
  21. Andersen RM. Revisiting the behavioral model and access to medical care: Does it matter? Journal of health and social behavior. 1995;36(1):1-10. http://dx.doi.org/10.2307/2137284
  22. Elkan R, Kendrick D. What is the effectiveness of home visiting or home-based support for older people? Copenhagen, Denmark: World Health Organization Regional Office for Europe's Health Evidence Network (HEN); 2004 June. 19 p.
  23. Patorno E, Grotta A, Bellocco R, Schneeweiss S. Propensity score methodology for confounding control in health care utilization databases. Epidemiology Biostatistics and Public Health. 2013;10(3):8941-8916. http://dx.doi.org/10.2427/8940
  24. Lee TH, Ko YK, Kim BN, Kim HC, Kee IS, Jung SH, et al. Performance evaluation about operation the LTC insurance system: 3rd. clinical effects of LTC insurance and development of clinical indicator. Seoul: Ministry for Health Welfare and Family Affairs; 2011. 181 p.
  25. Lee MJ. A study on measurement issues of the quality of longterm care services for older adults. Social Welfare Policy. 2011;38(1):141-165. https://doi.org/10.15855/swp.2011.38.1.141
  26. Huber M, Hennessy P. Long-term care for older people. Paris: OECD Publishing; 2005. 138 p.
  27. Lee JS, Han EJ, Kwon JH, Kang IO. Correlation analysis between standard LTC utilization plan and expenditures for long term care. Seoul: National Health Insurance Corporation; 2008. 188 p.
  28. Park JY, Lee YH, Kwon JH, Lee EM, Lee HY, Kim YH. Development of Integrated care model for LTC and medical service. Development Report. Seoul: National Health Insurance Corporation; 2010 October. Report No.: 2010-18.

Cited by

  1. Regional Comparison of Home Visiting Care Service Satisfaction among Elder Beneficiaries of the Long Term Care Insurance vol.27, pp.2, 2016, https://doi.org/10.12799/jkachn.2016.27.2.114
  2. Demand and willing to pay for oral hygiene service in long-term care insurance of elderly vol.42, pp.4, 2018, https://doi.org/10.11149/jkaoh.2018.42.4.204
  3. 시간동인 활동기준원가계산 기반 재가 방문간호센터 원가관리프로그램 개발 및 적용 vol.49, pp.5, 2019, https://doi.org/10.4040/jkan.2019.49.5.586
  4. 재가장기요양기관 방문간호사의 간호 경험 vol.19, pp.11, 2015, https://doi.org/10.5392/jkca.2019.19.11.603
  5. 노인장기요양보험 방문간호사의 재직의도에 영향을 미치는 요인 : 전문직업성, 직무만족도, 회복탄력성을 중심으로 vol.20, pp.12, 2019, https://doi.org/10.5762/kais.2019.20.12.322
  6. 노인장기요양인력 확보 방안: 간호사와 간호조무사 중심으로 vol.27, pp.1, 2020, https://doi.org/10.22705/jkashcn.2020.27.1.64
  7. 노인장기요양보험 재가방문간호 서비스 개발과 확대 방안 vol.27, pp.3, 2015, https://doi.org/10.22705/jkashcn.2020.27.3.241
  8. Examination of the Educational Needs of Home Visit Nurses: A Cross-Sectional Descriptive Study vol.18, pp.5, 2015, https://doi.org/10.3390/ijerph18052319
  9. 방문간호센터 경영효율성 개선 사례 분석: 경영 컨설팅 적용을 중심으로 vol.28, pp.2, 2021, https://doi.org/10.22705/jkashcn.2021.28.2.111