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http://dx.doi.org/10.12799/jkachn.2016.27.3.272

Effects of Visiting Nursing Services in Long-term Care Insurance on Utilization of Health Care  

Lee, Sangjin (Ministry of Health and Welfare)
Kwak, Chanyeong (Division of Nursing, Hallym University)
Publication Information
Research in Community and Public Health Nursing / v.27, no.3, 2016 , pp. 272-283 More about this Journal
Abstract
Purpose: This is a comparative study using secondary data from the Korean national long term care (LTC) insurance. Methods: Visiting nursing (VN) service users (n=666) and non-users (n=4,375) were extracted and compared in terms of medical expenditures, length of hospitalization, and annual number of ambulatory care visits to investigate effects of VN services in LTC. Results: Total health care expenditures were compared between the two groups and it was found that VN service users spent about $ 1700 than non-users for their medical costs between 2009 and 2011. The average length of in-hospital stay for VN service users was 19.4 days shorter than that of non-users. However, using VN services did not significantly influence the annual number of ambulatory care visits. Conclusion: The study has found that VN services are effective ways of providing community-based LTC services. We recommend LTC policy makers to further utilize VN services to deliver cost effective health care services.
Keywords
Long term care insurance; Nursing service; Medical care cost; Inpatient; Outpatient;
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Times Cited By KSCI : 6  (Citation Analysis)
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1 Teng YH, Teng JJ, Lee MY, Hsieh MH, Chen YJ, Lin JY, et al. Determinants of emergency medical utilization among the elderly population in Taiwan: A national longitudinal cohort study. Archives of Gerontology and Geriatrics. 2013;56(2):364-369. http://dx.doi.org/10.1016/j.archger.2012.10.012   DOI
2 Park JH, Choi ID, Kwon JH, Kang IO, Lee EM. Home services activation plan through the use of long-term care benefit behavior analysis. Seoul: National Health Insurance Corporation;2009 December. Report No.: 2009-30.
3 Ikegami N. Impact of public long-term care insurance in Japan. Geriatrics and Gerontology International. 2004;4(s1):S146-S148. http://dx.doi.org/10.1111/j.1447-0594.2004.00182.x.   DOI
4 Neufeld E, Hirdes JP, Perlman CM, Rabinowitz T. Risk and protective factors associated with intentional self-harm among older community-residing home care clients in Ontario, Canada. International Journal of Geriatric Psychiatry. 2015;30(10):1032-1040. http://dx.doi.org/10.1002/gps.4259   DOI
5 Kim JS, Shin HR. The Coordination between the long-term care service and health service. Journal of Welfare for the Aged. 2015;67:83-105.
6 Kim MH, Kwon SM, Kim HS. The effect of long-term care utilization on health Care utilization of the elderly. The Korean Journal of Health Economics and Policy. 2013;19(3):1-22.
7 Long-term Care Insurance Corporation. Introduction of policy [Internet]. Seoul: National Health Insurance Corporation. 2013 [cited 2016 May 2]. Available from: http://longtermcare.or.kr/portal/site/nydev/MENUITEM_LTCARE/
8 Jung WS, Yim ES. The effect on health care utilization of the non-use of beneficiaries of long-term care insurance servicearound of geriatric hospital's medical cost-. Journal of the Korea Academia-Industrial Cooperation Society. 2015;16(11):7463-7473. http://dx.doi.org/10.5762/KAIS.2015.16.11.7463   DOI
9 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   DOI
10 Kown JH, Han EJ, Lee JS. Long-term care services payroll management improvement. Research Report. Seoul: National Health Insurance Corporation; 2009 December. Report No.:2009-33.
11 Jung WS. Effect of long-term care utilization on health care utilization of the medicaid elderly. Journal of the Korea Academia-Industrial Cooperation Society. 2014;15(11):6746-6755. http://dx.doi.org/10.5762/KAIS.2014.15.11.6746   DOI
12 Kuk KN, Kim RE, Lim SJ, Park CY, Kim JY, Chung WJ. Factors associated with the non-use of beneficiaries of long-term care insurance service: The case of Jeollanam-do province. Health Policy and Management. 2014;24(4):349-356. http://dx.doi.org/10.4332/KJHPA.2014.24.4.349   DOI
13 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 Community Health Nursing. 2011;22(1):33-44.   DOI
14 Tanuseputro P, Chalifoux M, Bennett C, Gruneir A, Bronskill SE, Walker P, et al. Hospitalization and mortality rates in long-term care facilities: Does for-profit status matter?. Journal of the American Medical Directors Association. 2015;16(10):874-883. http://dx.doi.org/10.1016/j.jamda.2015.06.004.   DOI
15 Byeon DH, Hyun HJ. Importance and performance of visiting nurse services provided under the long term care insurance system for the elderly. Journal of Korean Academy Community Health Nursing. 2013;24(3):332-345. http://dx.doi.org/10.12799/jkachn.2013.24.3.332   DOI
16 Chin YR, Hong WL. Changes on hospital-based home care services utilization after long-term care insurance launch. Journal of the Korean Gerontological Society. 2011;31(2):371-380.
17 Lee HY, Moon YP. The effect of long-term care utilization on health care utilization of the elderly. The Korean Journal of Health Economics and Policy. 2015;21(3):81-102.
18 Jeon JG. Changes in medical fee and utilization of services before and after the introduction of the long-term health insurance for the elderly: Focused on demographic, sociologic and physical characteristics [master's thesis]. [Seoul]: Yonsei University;2010. 76 p.
19 Lichtenberg FR. Is home health care a substitute for hospital care?. Home Health Care Services Quarterly. 2012;31(1):84-109. http://dx.doi.org/ 10.1080/01621424.2011.644497   DOI
20 Tomita N, Yoshimura K, Ikegami N. Impact of home and community based services on hospitalization and institutionalization among individuals eligible for long-term care insurance in Japan. BMC Health Services Research. 2010;10:1-13. http://dx.doi.org/10.1186/1472-6963-10-345   DOI
21 Kim JS, Sun WD, Lee GJ, Choi ID, Lee HY, Kim KA. Study establish the role of hospitals and nursing care facilities-Focusing on the linkage scheme-. Research Report. Seoul: Korea Institute for Health and Social Affairs; 2013 December. Report No.: 2013-31-18.
22 Sun WD. Installation analysis and policy implications of the elderly long-term care facilities [Internet]. Sejong: Korea Institute for Health and Social Affairs. 2015 [cited 2016 May 10]. Available from:http://www.kihasa.re.kr/web/publication/periodical/issue /list.do
23 Elkan R, Kendrick D, Dewey M, Hewitt M, Robinson J, Blair M, et al. Effectiveness of home based support for older people:Systematic review and meta-analysis. BMJ. 2001;323(7315):719-725.   DOI
24 Oyama Y, Tamiya N, Kashiwagi M, Sato M, Ohwaki K, Yano E. Factors that allow elderly individuals to stay at home with their families using the Japanese long-term care insurance system. Geriatrics & Gerontology International. 2013;13(3):764-773. http://dx.doi.org/10.1111/ggi.12002   DOI
25 Fortinsky RH, Madigan EA, Sheehan TJ, Tullai-McGuinness S, Fenster JR. Risk factors for hospitalization among Medicare home care patients. Western Journal of Nursing Research. 2006;28(8):902-917. http://dx.doi.org/10.1177/ 0193945906286810   DOI
26 Hastings SN, Heflin MT. A systematic review of interventions to improve outcomes for elders discharged from the emergency department. Academic Emergency Medicine. 2005;12(10):978-986.   DOI
27 Chung 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.
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.