• Research in Community and Public Health Nursing
• /
• v.21 no.4
• /
• pp.386-397
• /
• 2010

Purpose: The purpose of this study was to compare functional status and the level of health care needs in elderly Koreans in health care institutions. Methods: Data were collected from 2,521 elderly patients admitted in 50 health care institutions (hospitals, oriental hospitals, geriatric hospitals, and health care facilities) selected through proportional stratified sampling in 2008. We used a long-term care (LTC) assessment tool developed by the government, which consists of 52 items with 5 subscales. Results: Statistically significant differences were detected in functional status and the level of health care needs among the subjects in different health care institutions. Of the sample population in geriatric hospitals, 48.9% were eligible for LTC Category 1, 20.9% for Category 2, and 17.2% for Category 3, and 13.1% of the subjects were not eligible for any of the categories. Of the sample population in health care facilities, 29.9% were eligible for LTC Category 1, 20.5% for Category 2, and 21.8% for Category 3, and 27.0% of the subjects were not eligible for any of the categories. Conclusion: The findings of this study indicate the necessity of the development of an evaluation system that helps determine whether a subject is eligible for LTC.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.14 no.3
• /
• pp.1335-1341
• /
• 2013

This study was conducted to identify the actual condition of exercise and the fact of influence to exercise in the disabled. The subject was consisted of 369 disabled. 84.5 percent of subject did exercise regularly. There was statistically significant in cause of disability(p<.001), type of disability(p<.001), grade of disability(p<.01), education(p<.01), economic state(p<.05), aim of rehabilitation exercise (p<.001). Chance to practice exercise in subject who intend to exercise was 16.18 times high than them who have no intention(95% CI =7.45~37.14). Regular exercise intervention is needed to disabled people in community.

• Journal of Convergence for Information Technology
• /
• v.10 no.5
• /
• pp.177-187
• /
• 2020

The purpose of this study was to classify the care needs of the older adults aged 65 and over and to identify characteristics of care need groups. This was a secondary analysis study using data from 2017 National Survey of Older Persons in Seoul. There were 50.4% in the general group without any support needs, 17.9% in the medical needs group, 14.2% in the welfare needs group with support needs of daily living or social activity, and 17.5% in the complex needs group with both medical and welfare needs. Significant differences were shown in most variables of the general characteristics, grading of long-term care or disability, financial burden and caregiving, health behaviors, health status, and life satisfactions among groups (p<.001). The complex care need group should be provided with integrated care service for medical and welfare through multidisciplinary team approach.

• 한국사회정책
• /
• v.25 no.1
• /
• pp.99-123
• /
• 2018

Purpose: This study empirically investigates the utilization and expenditure of health care and long-term care at the last year of life for long-term care beneficiaries in Korea. Methods: This study used National Health Insurance and Long-term Care Insurance claims data of 271,474 LTCI beneficiaries, who died from July 2008 to December 2012. Their cause of death, place of death, health care costs, and the provision of aggressive care were analyzed. Results: Cardio-vascular disease(29.8%) and cancer(15.3%) were reported as their major cause of death, and hospital(64.4%), home(22.0%), social care facility(9.2%) were analyzed as the place of death. 99.3% of subjects used both health care and long-term care during the last 1 year of life. The average survival period were 516.2 days after they were LTCI beneficiaries. The health care expenditure gradually increased near the death, and the last month were three times more rather than the first month. Furthermore, 31.8% experienced some aggressive cares(CPR, blood transfusion, hemo-dialysis, etc.) at the last month of life. Conclusion: The results of this study suggest that it is important to develop the end of life care policies(for example, hospice, advanced care directives) for the LTCI beneficiaries. They might contribute to the improvement of quality of life and the reduction of health care expenditure of the elderly at the end-of-life.

• 한국노년학
• /
• v.34 no.2
• /
• pp.369-386
• /
• 2014

The purpose of this study was to develop the classification of home-based long-term care activities and to test its validity. In this study, the taxonomy of long-term care activities was structured according to the service domain and process. Two expert groups participated in making a draft of the taxonomy that was composed of 7 service domains, 22 care needs, 22 service objectives, and 114 activities. Reliability and validity of the taxonomy was tested in a sample of 152 elderly subjects who used the home-based long-term care services. Based on the factor analysis of 114 activities, 21 factors were extracted from 114 activities. Internal consistency of the factors was high. Content validity was confirmed by the CVI. Long-term care insurance grade was used to assess the criterion validity. Among 21 care needs, 12 cares needs were significantly different from their grade. The classification of home-based long-term care activities demonstrated reliability and validity. In conclusion, the use of this classification is recommended while communicating with the elderly subjects, service providers, and the 3rd party payers.

• Health Policy and Management
• /
• v.25 no.1
• /
• pp.40-52
• /
• 2015

Background: The purpose of this study was to analyze the increase in Grade of Nursing Management Fee of medical institutions and establish a reasonable government policy by examining which factors affect the increase of nurse staffing. Methods: Analyzing data collected from the Health Insurance Review & Assessment Service resource management department with targets of 1,104 medical institutions. The study period was 5 years from June 30, 2008 to June 30, 2013. SAS ver. 9.2 (SAS Institute Inc., Cary, NC, USA) was used for statistical analysis. The data was analyzed by a chi-square test and also conducted muiltivariate logistic regression analyses for variables of basic characteristics, human resource characteristics, and material resources. Results: Adjusted odds ratio (AOR) of the rise in Grade of Nursing Management Fee among other hospitals compared to hospitals owned by government or universities was 0.264. The AOR in hospitals established after November 2006 compared to those before June 1995 was 2.383. The AOR in Gangwon, Chungcheng South, and Jeolla South Provinces compared to Seoul was 0.084, 0.036, and 0.194, respectively. The AOR in hospitals with more than 6.75 specialists per 100 beds compared to those with less than 6.75 specialists per 100 beds was 7.514. The AOR in hospitals with more than 17.48 nurse per 100 beds compared to those with less than 17.48 nurse per 100 beds was 3.300. The AOR in hospitals with 50% to 75% bed utilization, 75% to 90% bed utilization and more than 90% bed utilization compared to those with less than 50% bed utilization was 5.428, 9.884, and 10.699, respectively. The AOR in hospitals with one magnetic resonance imaging (MRI) and more than two MRI compared to those with no MRI was 2.018 and 2.942, respectively. Conclusion: This result has showed policies to induce the rise in Grade of Nursing Management Fee among old hospitals and the incentive system for local medical institutions are needed. Also we need to develop a governmental policy for medium-small hospitals with low operation rate of beds and insufficient medical personnel and number of equipment in hospitals.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.15 no.11
• /
• pp.6746-6755
• /
• 2014

This study examined the effect of long-term care utilization on the health care utilization of Medicaid elderly. The subjects were 5,834 long-term care insurance with the level 1 Medicaid elders, who received either service or non-service. This study examined the impact of long-term care service on the probability of health care utilization and the costs of health care utilization. The total medical cost and inpatient day between 2009-2007 were significant factors affecting long-term care utilization (${\beta}=.29$, p< .001, ${\beta}=.33$, p< .001 ) and this variable explained 22.6% of the total medical cost and 22.4% of the inpatient day. The results showed that non-service in long-term care was associated with an increase in health care utilization. The current long-term care insurance system should place higher priority and more resource allocation on long-term care utilization to increase the efficiency of the insurance system.

• Health Policy and Management
• /
• v.21 no.2
• /
• pp.195-212
• /
• 2011

Objectives: This study investigates the relationship between nurse staffing levels and differences in patient outcomes in terms of average length of stay, in-hospital mortality rate and 30-day death rate in order to evaluate the effectiveness of a policy that differentiates fees for inpatients on the basis of nurse-to-bed ratios. Methods: We obtained information on inpatients from health insurance claims data published by the Health Insurance Review and Assessment Service(HIRA) in 2008, organizational factors(type of hospital, ownership) from the records of the hospital report system in 2008, and nurse staffing levels, which were graded on a scale of 1 to 7, from data compiled between December 15, 2007, and September 20, 2008. The data were segregated according to type of hospital and quarter and finally 3,517 records of 1,182 hospitals were analyzed using multi-level analysis. Results: The average length of stay in grade 1~6 hospitals was lower than that in grade 7 ones, but the difference was much below one day. No significant difference was found among different grades in tertiary hospitals. Further, variations in staffing levels did not result in any significant difference in the in-hospital mortality rate and 30-day death rate. Conclusions: High nurse staffing levels did not result in better patient outcomes compared with low staffing levels. We therefore recommend modifying the above nurse staffing policy so as to make it more effective in improving patient outcomes.

• Journal of Digital Convergence
• /
• v.18 no.1
• /
• pp.187-198
• /
• 2020

The purpose of the study is to investigate infection management status of long term care hospitals and infection prevention knowledge of caregivers. This is descriptive study to investigate the factors affecting caregivers' infection control performance in long term care hospitals. The data collection period was from August, 2018, and a total of 197 caregivers from 8 long term care hospitals. The data analysis were done Win SPSS 20.0 with t-test, ANOVA, pearson's correlation coefficient, and hierarchical multiple regression analysis. Infection prevention knowledge was positively correlated with infection control performance (p=<.001). The factors influencing performance in a long term care hospital caregivers were over seventy years old (t=2.50, p=.013), eight-hour working time (t=-2.62, p=.010), nursing staffing First grades (t=2.48, p=.014), and infection prevention knowledge (t=2.96 p=.003), which explained 12.9% (F=6.70 p<.001). In summary, we recommend to develop infection education interventions to improve caregivers' infection control performance in long term care hospitals and to improve of the function in long term care hospitals.

• Journal of Industrial Convergence
• /
• v.21 no.10
• /
• pp.167-180
• /
• 2023

The aim of this study is to explore the factors that influence the health care utilization of disabled workers who returned to their original workplace after an occupational accident. The study sample consisted of 457 workers who suffered from occupational accidents and were rated as disabled based on the data from the PSWCI in 2021. Data analysis was performed using a hierarchical multiple regression analysis with SPSS WIN 26.0. The study findings revealed that the number of outpatient visits was affected by factors such as daily wage payment, economic status, physical activity limitations, subjective health status, and chronic diseases. Moreover, health care expenditures were determined by factors such as having a caregiver for daily living, burn injuries, and physical activity limitations. Therefore, to increase the accessibility of health care utilization for disabled workers, the role of nurses in the workplace should be expanded, employers should include a health care utilization plan when developing a return-to-work plan, and research on the introduction of a paid sick leave system that allows workers to rest when they are sick is needed. It is also necessary to alleviate the economic burden by increasing the coverage of benefits for burn and rehabilitation treatments.