Browse > Article

On the Feasibility of a RUG-III based Payment System for Long-Term Care Facilities in Korea  

김은경 (을지의과대학교 간호대학)
박하영 (가톨릭대학교 의료경쟁대학원)
김창엽 (서울대학교 보건대학원)
Publication Information
Journal of Korean Academy of Nursing / v.34, no.2, 2004 , pp. 278-289 More about this Journal
Abstract
Purpose: The purpose of this study was to classify the elderly in long-term care facilities using the Resource Utilization Group(RUG-III) and to examine the feasibility of a payment method based on the RUG-III classification system in Korea. Method: This study measured resident characteristics using a Resident Assessment Instrument-Minimum Data Set(RAI-MDS) and staff time. Data was collected from 530 elderly residents over sixty, residing in long-term care facilities. Resource use for individual patients was measured by a wage-weighted sum of staff time and the total time spent with the patient by nurses, aides, and physiotherapists. Result: The subjects were classified into 4 groups out of 7 major groups. The group of Clinically Complex was the largest (46.3%), and then Reduced Physical Function(27.2%), Behavior Problems (17.0%), and Impaired Cognition (9.4%) followed. Homogeneity of the RUG-III groups was examined by total coefficient of variation of resource use. The results showed homogeneity of resource use within RUG-III groups. Also, the difference in resource use among RUG major groups was statistically significant (p<0.001), and it also showed a hierarchy pattern as resource use increases in the same RUG group with an increase of severity levels(ADL). Conclusion: The results of this study showed that the RUG-Ill classification system differentiates resources provided to elderly in long-term care facilities in Korea.
Keywords
Long-term care; Elderly; prospective payment system;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Bjorkgren, M. A., Hakkinen, U., Finn-Soveri, U. H., & Fries, B. E. (1999). Validity and reliability of Resource Utilization Groups(RUG-III) in Finnish long-term care facilities. Scand J public Health, 27(3), 228-34
2 Fries, B. E. (2002). The New Technology of Assessing Elderly and Disabled Persons: The interRAI Consortium -International Conference on Long-Term Care Policy and Practice for New Era. 2nd Activity center of National Taiwan University, March, 22-25
3 Jung, K. H., Oh, Y. H., Byun, J. K., Byun, Y. C., Cho, A. 1., & Moon, H. S. (1998). A survey study on life style and welfare need of elderly on 1998 years. Korea Institute for Health and Social Affairs
4 Kim, H. J. (2000). The validity of RAI-MDS 2.0. Seoul National University of Korea, Seoul
5 Kim, H. J., Jun, K. J., Kim, H. G., So, A. A., Lee, K. M., Kim, E. Y., & Park, E. O. (2000). Development of Services Delivery Modelfor the Elderly in the Community. Korea Health Industry Development Institute & Graduate School of Public Health, Seoul National University, Korea, Seoul
6 Ministry of Health & Welfare(MOHW). (2001). Introduction of the elderly health and welfare on 2001 year
7 Sgadari, A., Morris, J. N., Fries, B. E., Ljunggren, G., Jonsson, P. V., DuPaquier, J. N., & Schroll, M. (1997). Efforts to establish the reliability of the Resident Assessment Instrument(RAI). Age Aging, 26(2), 27-31
8 Zbylot, S., Job, C., Evelyn, M., & Boulter C. (1995). A Case-Mix Classification System for Long-Term Care Facilities. Nurs Manage, 26(4), 49-54
9 Carpenter, G. I., Ikegami, N., Ljunggren, G., Carrillo, E., & Fries, B. E. (1997). RUG-III and resource allocation: comparing the relationship of direct care time with patient characteristics in five countries. Age Ageing, 26(2), 61-65
10 Gruber-Baldini, A., Zimmerman, S., Mortimore, E., & Magaziner, J. (2000). The validity of the minimum data set in measuring the cognitive impairment of persons admitted to nursing homes. J Am Geriatr Soc, 48, 1601-1606
11 Carpenter, G. I., Main, A., & Turner, G. F. (1995). Casemix for the elderly inpatient: Resource Utilization Groups(RUG) validation project. Case mix for the elderly inpatient working group. Age Ageing, 24(5), 5-13
12 Morris, J. N., Fries, B. E., Steel, K., Ikegami, N., Bernalbei, R., Carpenter, G. I., Gilgen, R., Hirdes, J. P., & Topinkova, E. (1997). Comprehensive clinical assessment in community setting : Applicability of the MDS-HC, J Am Geriatr Soc, 45, 1017-1024
13 Frijters, D., & van d Kooij, C. H. (1994). Classification of nursing home residents in resource utilization groups. Tijdschr Gerontal Geriatr
14 Baker, J. J. (1998). Prospective Payment for Long-Term Care. An Annual Guide. Aspen: Maryland
15 Centers for Medicare & Medicaid Services(CMS). (2002). http://cms.hhs.gov/medicaid/reports, http://cms.hhs.gov.
16 Fries, B. E., Schneider, D. P., Foley, W. J., Gavazzi, M., Burke, R., & Cornelius, E. (1994). Refining a casemix measure for nursing homes: Resource Utilization Groups(RUG-III). Medi Care, 32, 668
17 Korea National Statistical Office(KNSO). (2002). Sensus of population in Korea on 2000 years. Korea National Statistical Office
18 Schroll, M. (1995). Reliability estimates for the minimum data set for nursing home resident assessment; Comparison between USA and Denmark. Copenhagen Univ. Denmark
19 Kim, S. M., Kim, E. K., Kim, S. R., Lee, Y. T., & Kang, D, O. (2001). On development of Long-term Care Payment System for establishing of delivery system. Korea Health Industry Development Institute
20 Cameron, J. M. (1985). Case-mix and resource use in long-term care. Medi Care, 23(4), 296-309
21 HCFA (Health Care Financing Administration). (1995). Resident Assessment Instrument(RAI). Minimum Data Set(MDS) v2 user's manual. 73-105
22 Lee, J. J. (1999). Application of RUG-III for long-term care elderly patients. Unpublished doctoral dissertation, Yonsei University of Korea, Seoul
23 Winn, S. (1975). Assessment of cost-related characteristics and conditions of long-term care patients. Inquiry, 12, 344
24 Topinkova, E., Neuwirth, J., Mellanova, A., Stankova, M., & Hass, T. (2000). Case-mix classification in post-acute and long-term care. Validation of Resource Utilization Group III(RUG-III) in the Czech Republic. Cas Lek Cesk, 139(2), 42-48
25 Fries, B. E., Schneider, D. P., & Foley, W. J. (1989). Mary Dowling. Case-Mix classification of Medicare residents in Skilled Nursing Facilities: Resource Utilization Groups. Medi Care, 27(9), 843-858
26 Chang, H. S., Kim, E. K., Oh, J. H., & Chang, H. J. (1996). A study on development of Management of the Long-Term Care Hospital. Korea Health Management Institute
27 Organization for Economic Cooperation and Development (OECD). Health data. 2000
28 Schneider, D. P., Fries, B. E., Foley, W. J., Desmond, M., & Gormeley. (1988). Case mix for nursing home payment: Resource utilization groups, version II. Health Care Financing Annual Supplement, 39-52
29 Ikegami, N., Fries, B. E., Takagi, Y., Ikeda, S., & Ibe, T. (1994). Applying RUG-III in Japanese long-term care facilities. Gerontologist, 34(3), 628-639
30 Kim, E. K. (2003). On the Feasibility of RUG-III based Payment System for Long-Term Care Facilities. Unpublished doctoral dissertation, Catholic University, Korea, Seoul