• Communications for Statistical Applications and Methods
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• v.18 no.1
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• pp.137-146
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• 2011

Long-term care insurance is a social insurance system that provides benefits to the elderly who have difficulty taking care of themselves for a period of at least 6 months. This system was started in July, 2008 and it is very important to set proper judgement ratings for the approval process. We try to develop and improve the judgement rating system using decision tree models. Our tree model is found to be more stable and efficient than the previous one.

• 한국사회정책
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• v.24 no.1
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• pp.67-95
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• 2017

This study compared policies of elderly abuse of long-term care facilities on WHO, Main countries for improvement of Korean policy. So, This study reviewed policies of elderly abuse of long-term care facilities on WHO, Main countries. So, This study reviewed risk factors that may increase the potential for abuse of an older person can be identified at individual level, care-woker levels, socio-cultural levels and facilities levels. The results of the study were as follows: First, The openness of long-term care facilities are emphasized on many countries. There are a need for a policy considerations such as policies of Ombudsman, Adult guardianship for visiting facilities, external monitoring. Second, There was a difference of facilities infrastructure and workers of treatment condition long-term care facilities each other countries. So It is important to improve facilities infrastructure and workers of treatment condition. Third, It is necessary to consider traits of elderly in long-term care facilities. Especially, it is required to manage dementia elderly and elderly on night time in long-term care facilities. Finally, implications and future directions of policies of elderly abuse of long-term care facilities were discussed based on the finding of the study.

• 한국사회정책
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• v.25 no.3
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• pp.103-130
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• 2018

The study aims to analyse Korean Long-Term Care Insurance system in terms of caring justice on the premise that elder care should be included in discussions and policies of care. Caring justice means an ideal of equal sharing duties and rights of care by all citizens. Four dimensions of caring justice(decommodification, defamilialization, degenderization and elderly participation and power) were established for the analysis. The results of the analysis were presented that Korean Long-Term Care Insurance system was maintained by commodificated and gendered care services attempting defamilialization with the exclusion of elderly beneficiaries, which represented typical caring injustice. Policy suggestions were made to realize caring justice: improving the status of caring labour by achieving proper service price and public employment, reorganization of life cycle based caring system integrating children, disabled adults and elders, and developing user-centered long-term care system to guarantee participation and choice of people in caring relationships.

• 한국노년학
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• v.30 no.3
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• pp.855-869
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• 2010

The purpose of this study is to identify how to efficiently integrate long-term care facilities into geriatric hospitals. We conducted a survey on the current operations of facilities and medical services of 2009 of 192 long-term facilities and 168 geriatric hospitals in Korea between October and November. Technical statistics and chi-square test were conducted on the collected data using the SPSS 13.0/Win program. There was a difference between the two facility types in terms of the co-payment levels of the food services. Both types selected the budget deficit as their major management problem. Ease of access and the surrounding environment were critical factors used to select the location of both types of facilities. Facility users benefited from the discounted co-payments of both facility types. However, facility users wanted more frequent visits and support from their family members during their stay at the facilities. It was discovered that users in the long-term care facilities stayed longer, that is until they died, compared to their counterparts in geriatric hospitals. The two types of facilities provided their services totally separately to users. Users of the two types of facilities are poorly supported and cared for by their families. This study suggests that setting reasonable service fees, paying caretakers, introducing an integrated facility, strengthening facility assessment standards, introducing the family doctor system, and introducing the handling of long-term care insurance by geriatric hospitals would allow the integration between long- term care facilities and geriatric hospitals to be beneficial.

• Korean Journal of Social Welfare
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• v.63 no.4
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• pp.301-326
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• 2011

The major purpose of this study is to evaluate the impact of the long-term care insurance program. In order to estimate the impact of policy accurately, certain bias which might hamper the validity of this study has been removed by Propensity Score Matching(PSM) and Double Difference(DD) method from the semi-experimental design. To study the effects of long-term care insurance on the elderly and their family members as social outcome variable sand the quality of life of their family and satisfaction in family relationships, the third and fourth waves of Korea Welfare Panel are used to match experimental and comparative groups by the propensity score matching. Then, DD method, using the panel fixed effects model, is applied to estimate the differences of those groups'treatment effects before and after the policy implementation. As a result, it was found that the Quality of life on the elderly and their family members is statistically meaningless, while the satisfaction in family relationships has much increased after the policy implementation. The result has a limitation in that this evaluation is performed at the point when the long-term insurance program has not been ripened enough. However, there is an important implication on the significance of realizing the main goal of the long-term care insurance to improve the quality of life of the elderly and their family members and as for the potentiality of further system improvements.

• 한국사회정책
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• v.25 no.1
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• pp.99-123
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• 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.

• The Journal of the Korea Contents Association
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• v.18 no.1
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• pp.76-89
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• 2018

The purpose of this study is to analyze factors affecting a grade maintenance of long-term care service users. Using 2008-2014 long-term care raw data of National Health Insurance Service(NHIS), the predictors were examined through the logistic regression by long-term care beneficiaries of grade. The results showed that there are differences by 3 factor groups and grade groups(1-3 grade). In socio-demographic factors, in the 1, 3 grade, Individuals 64 or younger presented a much higher probabilities of the grade maintenance than those 85 and over. In the 3 grade, people of living alone, resident of rural area presented a much higher probabilities of the grade maintenance than others. In disease factors, In the 1 grade, people with dementia presented a much higher probabilities of the grade maintenance than other 2, 3grades. In the 2 grade, people with stroke, fracture presented a much higher probabilities of the grade maintenance than others. In the 3 grade, people with cancer presented a much higher probabilities of the grade maintenance than others. In service factors, In the 2, 3grade, people having more renewal numbers presented a much higher probabilities of the grade maintenance than others. In the 1 grade, people who use facility benefits for more days presented a much higher probabilities of the grade maintenance than others. In the 2 grade, people who use in-home benefits for more days presented a much higher probabilities of the grade maintenance than others. Based on the finding of study, implications and future research directions were discussed for policy considerations.

• 한국사회복지학회:학술대회논문집
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• 2007.04a
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• pp.683-685
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• 2007

• 한국노년학
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• v.34 no.2
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• pp.369-386
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• 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.

• The Korean Journal of Applied Statistics
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• v.27 no.5
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• pp.667-679
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• 2014

National Health Insurance Service(NHIS) provide care-plans for beneficiaries in the long-term care insurance(LTCI) systems that help them use LTC services appropriately. The care-plan includes recommendations for the most adequate type of care (gold standard) for beneficiaries. This study develops a decision-support system to determine the appropriate type of care plan. To develop a model, we used a data set that well-trained assessors in the NHIS investigated as a gold standard for beneficiaries: nursing home care, home-visit care, home-visit bathing, home-visit nursing, or day and night care. The decision-support system was established through a decision-tree model, because it may be easy to explain the algorithm of a decision-support system to working groups and policy makers. Our results might be useful in evidence-based care planning in an LTCI system and contribute to the efficient use of LTC services.