• The Journal of Korean Physical Therapy
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• 제20권2호
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• pp.43-48
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• 2008

Purpose: The purpose of this study is to investigate the importance of grade decision and role of physical therapist which follows enforcement of elderly long-term residential care insurance system. Methods: One of the data from grade decision meeting in Bukgu, Busan on 2007 which was 88 case of attached finding of doctor was compared with findings of visited investigator. Result: Eighty-four investigation subjects had 186 diseases that included stroke and arthritis, requiring the need for physical therapeutic approaches. In addition, the results of the door-to-door research project in the northern district of Busan showed that there was no match out of 88 subjects who submitted the viewpoint of the doctor. Such a result was produced as the doctors did not diagnose the patient directly, but rather the diagnoses were obtained from guardians and a door-to-door researcher who had a poor understanding of geriatric motion and function. Conclusion: To enforce long-term care successfully, a re-investigation should be performed for the welfare of the aged.

• 한국노년학
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• 제29권2호
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• pp.645-656
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• 2009

본 연구는 의료기관 가정간호사업 현황을 총체적으로 파악하여, 의료기관 가정간호사업 활성화와 노인장기요양보험제도 도입 이후 세 가지 유형의 가정방문 간호사업을 효율적으로 기능역할 정립하는데 필요한 기초자료를 생성하기 위함이다. 건강보험심사평가원의 2006년 의료기관 가정간호 급여청구자료를 2차 분석하고, 전국 75개 의료기관 가정간호사업소의 사업현황을 횡단적 조사 분석하였다. 2006년 전체 의료기관 가정간호 이용자 중 65세 이상 노인은 20,343명(전체 대상자의 64.0%), 급여 청구는 98,822건(전체 청구의 70.1%), 방문은 333,889건(전체 방문의 76.8%)이었다. 이용자의 진단명은 뇌졸중 23.6%, 뇌졸중을 제외한 심장 등 순환기질환이 17.7%로 전체 청구 중 41.3%가 뇌졸중을 비롯한 순환기질환에 의한 것이었다. 다음은 당뇨 등 내분비계질환 10.4%, 신생물 9.7% 순이었다. 2006년 일 년간 노인대상 의료기관 가정간호 총 진료비는 13,247,992,290원(전체의 70.5%), 가정간호비용은 6,544,430,760원(전체의 72.2%)이었다. 2006년 일 년간 의료기관 가정간호 서비스 이용 노인 일인당 평균 총 진료비는 646,262원, 가정간호비용은 319,476원, 총 방문건수는 15.3건이었다. 의료기관 가정간호사업은 보건소 방문보건사업과 중재 종류는 유사하나, 보건소 방문보건사업에서는 수행되지 않는 헤마토크릿(16.8%), 혈색소(15.6%), 적혈구 침강속도(5.6%), 경피적산소분압(0.1%) 등 임상검사와 흡입배농 및 배액(0.7%), 약물저류 관장(0.1%) 및 가스관장(0.01%)등 특수처치가 수행되었다. 건강보험 급여한도 월 8회를 초과하여 전액본인부담금으로 의료기관 가정간호를 이용한 노인은 질환별로 욕창 7.0%, 암 5.4%, 당뇨 2.5%, 고혈압 1.1%, 뇌졸중 0.9%였다. 따라서, 이러한 서비스 차이를 반영하여 세 가지 유형의 가정방문 간호사업간 기능역할을 설정하고, 서비스 이용을 활성화하기 위해서 보험급여를 확대할 필요가 있다.

• 한국치위생학회지
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• 제22권1호
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• pp.63-72
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• 2022

Objectives: This study was conducted to prepare basic data to propose the necessity and utilization of oral welfare products in the welfare services of the long-term care insurance system, focusing on facility workers working in elderly facilities. Methods: The analysis was conducted on 144 workers working at some local elderly facilities. The questionnaire was constructed by classifying the use of oral welfare tools into 6 questions and the necessity and demand for oral welfare devices into 13 questions. Frequency analysis and technical analysis were performed for data analysis, and one-way ANOVA was performed for differences in the necessity and demand for oral welfare equipment. The statistical significance level was p<0.05. Results: As a result of examining the awareness of the necessity and demand for oral welfare equipment among workers in elderly facilities, the awareness of the necessity of including oral welfare equipment in the items of welfare equipment in the current long-term care insurance system was high at 4.15 points. As a result of analyzing the correlation between awareness of care products and the need and demand for oral welfare equipment, it was confirmed that there was a statistically significant positive correlation (p<0.01). Conclusions: In the long-term care insurance system for the elderly, oral welfare products need to be considered for welfare equipment services. The provision of oral welfare products within the long-term care insurance system for the elderly can provide opportunities and services to select various self-care tools. In addition, it is expected that it will be possible to promote changes in the long-term care insurance system for the elderly and to improve the system in a variety of positive ways.

• 디지털융복합연구
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• 제18권4호
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• pp.479-487
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• 2020

본 연구의 목적은 노인주간보호시설에 대한 잠재이용자들이 지각하는 이용욕구와 운영 현황을 파악하여 문제점과 발전방향을 제안하는 것이다. 자료수집은 J도에 거주하는 일반인 320명을 대상으로 기관 인식과 이용욕구를 설문지로 조사하였으며, 6개 시설의 기관장 및 종사자에 대한 심층인터뷰, 기관의 운영 현황을 파악하고자 하였다. 분석결과 잠재이용자들은 주간보호시설의 기능 및 구체적인 역할에 대해 많이 인지하고 있지 않았으며, 시설비용 부담은 국가에서 부담하며, 시설을 이용 시 중요한 요인은 시설 및 환경인 것으로 나타났다. 심층인터뷰에서는 지금의 정책이나 제도는 현실과 괴리가 커 종사자들의 지위나 역할 그리고 기관의 운영 상태와 맞지 않는 것으로 나타나, 현장형 시스템의 재정립이 요구되고 있다. 연구결과를 바탕으로 주간보호시설의 발전방향은 국가차원에서 시민들에게 주간보호시설의 인식 개선 및 제고를 위한 적극적인 홍보와 가족지원강화가 필요하다. 둘째, 이용자의 욕구를 반영한 시설과 환경의 개선을 통한 요양서비스의 질을 높여야 한다. 셋째, 종사자의 열악한 고용 여건과 처우를 현실에 맞게 개선해 요양서비스의 질을 높여 나가야 한다.

• 한국콘텐츠학회논문지
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• 제15권12호
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• pp.560-571
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• 2015

본 연구는 국민의료비의 재원별 공급 분석뿐만 아니라 수요를 결정하는 주요 요인인 연령별과 소득계층별을 동시에 고려한 모형을 설정하고 GARCH 모형을 활용하여 실증분석을 수행하였다. 실증분석 결과에 의하면 포괄적인 형태의 의료보험제도는 보장성이 양호하게 구축되어 있지만, 연령별 및 소득계층별 지원정책을 보다 구체화해야 하는 것으로 나타났다. 그리고 잠재적 취약계층을 지원하기 위해서는 민간재원을, 취약계층을 지원하기 위해서는 공공재원의 확충이 필요한 것으로 분석되었다. 즉, 이와 같은 재원별 확충의 우선순위를 통해 국민의료비 지출의 효율성을 제고할 수 있는 것으로 나타났다. 인구 고령화와 관련해서 살펴보면 보건정책이 적절하게 대응하고 있는 것으로 분석되어, 노인보건의료 관련법이나 노인장기요양보험 등이 양호하게 운용되고 있는 것으로 분석되었다.

• 지역사회간호학회지
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• 제19권4호
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• pp.660-672
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• 2008

Purpose: To analyze the home care services provided to the elderly aged 65 and older by a hospital-based home care agencies and to investigate the effects of long-term care insurance for the elderly. Method: The subjects were the home care service recipients aged 65 and older in 172 hospital-based, home care agencies registered in Health Insurance Review & Assessment Service in January, 2007. The data were collected using a questionnaire from March 16 to April 15, 2007. The questionnaire return rate was 43.8%. Result: The hospital-based home care agencies were able to visit 66.5% of the national administrative districts. Of the home care service recipients, over 50% were 65 years old and older. About 43% of the agencies reported that over 50% of their patients would be subject to the long-term care insurance. They expressed concern that home care services would be withdrawn once the insurance system is initiated. Conclusion: This study suggests that hospital-based home care agencies need to manage home care services with long-term care insurance. It also recommends developing guidelines for the use of services and referrals.

• 보건행정학회지
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• 제20권3호
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• pp.104-122
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• 2010

Long-term care insurance has been introduced in Korea a year ago, and we are in a stage requiring to set principles regarding the generosity of coverage and how to gradually extend the coverage. This study empirically analyzes how the long-term care insurance in Korea is operated. Special attention is given to who is the main beneficiary of the long-term care insurance introduction, and what is the factors influencing the elderly's decision to apply for or use long-term care services. Use of a detailed information of individuals' public health insurance and long-term care insurance from administration data made it possible to control for health status, socioeconomic status including family type, housing tenure, income level. Logit models were employed to analyze the effects of various socioeconomic factors on the likelihood of applying and using long-term care services. Also, this study employed a survey questioning whether to ever willing to take other option as a alternative to residential care or home-care and the level of cash benefit for which they are willing to replace the formal care with informal care. The result indicated that although the poorest elderly population groups are in the greatest need for the long-term care service, they are in difficulty using the service due to economic burden. This implies the copayment amount needs to be adjusted in order for the poor elderly group to be able to get the benefit of the long-term care service.

• 대한지역사회작업치료학회지
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• 제1권2호
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• pp.45-59
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• 2011

목적 : 본 연구는 복지국가의 개념과 사회복지영역을 살펴보고, 우리나라 장애인복지정책의 발전을 비교 분석해 보기 위함이다. 연구방법 : 문헌고찰을 통하여 복지국가의 개념과 사회복지의 영역을 기술하였고, 우리나라의 사회복지정책과 장애인정책을 각 정부별로 비교 분석하였으며 마지막으로 노무현 정부의 장애인정책을 분석하였다. 결과 : 경제성장과 더불어 복지정책과 장애인복지정책은 '선택적 복지'에서 '보편적 복지'의 형태로 발전하였다. 사회복지정책의 영역에 있어서도 과거 이승만 정부시절의 '최소한의 보장'에서 노무현 정부의 '참여복지'에 이르기까지 영역의 확대가 이루어지고 있으며 이러한 현상은 장애인 복지정책에서도 나타나는 현상이다. 결론 : 지역사회 작업치료사는 오늘날 '보편적 사회복지'의 큰 틀에서 등록 장애인 뿐 만 아니라 지역사회의 드러나지 않는 장애를 지닌 일반인과 노인을 위한 방문재활서비스와 같은 미 충족 작업치료서비스를 발견하고 제공해야 할 것이다.

• 보건행정학회지
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• 제23권2호
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• pp.132-144
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• 2013

Background: The purpose of this study was to analyze the medical expense change and influencing factors after introducing longterm care insurance system. The study period was 2 years before and after introduction of the system. Methods: We analyzed data collected from two divided group lived in Incheon. Four hundred and eighty-five elderly who received long-term care wage for one year were selected for experimental group. For control group, 1,940 elderly were selected by gender and age stratified random sampling. Difference-In-difference analyses was used for evaluating policy effectiveness. Also multiple regression analyses were conducted to identify the factors associated with total medical expenditures. The control variables were demographic variables, economic status, diseases, and medical examination variables. Results: Difference-in-difference analyses showed that total average medical expenses among long-term patients has decreased by 61.85%. Of these, the hospitalization expenses have decreased by 91.63% and the drug expenses have increased by 31.85%. Multiple regression analyses results showed that total average medical expenses among long-term patients have significantly decreased by 46.5% after introducing the long-term care insurance. The hospitalization expenses have significantly decreased by 148.5%, whereas the drug expenses have increased by 53.6%. And outpatient expenses have increased by 10.4%, but the differences were not statistically significant. Conclusion: The results showed that total medical expenses and hospitalization expenses have decreased after introducing the long-term care insurance. These results could support the opinion that the health insurance spending among long-term patients will be reduced gradually by long-term care insurance through changing medical demand.

• 한국보건간호학회지
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• 제24권2호
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• pp.285-301
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• 2010

Purpose: The study was aimed at qualitatively enhancing and promoting a home visiting nursing program established in Korea on July 1, 2008, as part of the Long-Term Care Insurance for the Elderly program. Methods: Structural, procedural and consequential aspects of home visiting nursing care wereclassified on the horizontal axis by applying the standard notions for the evaluation of medical care (Donabedian, 1998). At the same time, the home visiting nursing care service support system and the service provision system weredivided on the vertical axis with reference to the accreditation standards for home visiting nursing care organizations suggested by the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO, 2008). The data were collected from June 4, 2008 to October 27, 2008, and were analyzed using SPSS ver. 15.0. Results: Twenty-two (proposed) standards, centered on the standard elements under the conceptual framework of the study, were developed, and comprised structural aspects (n=10), procedural aspects (n=6) and consequential aspects (n=6). Those criteria and indicators underwent two content validity surveys among groups of home visiting nursing care research and training experts. The research produced 22 proposed standards, 50 proposed criteria and 166 proposed indicators. Conclusion: The home visiting nursing care standards developed pursuant to the Long-Term Care Insurance for the Elderly Act and the applicability of these standards need to be verified by home visiting nurses. These proposed standards should prove useful in developing an assessment tool to encourage the qualitative enhancement of visiting nursing care in Korea.