National Health Insurance Corporation initiated Home and Community Long-term care Agency Quality Assessment(HCLA-QA) program in 2010. This study aims to explore long-term care agencies' perceptions and attitudes toward HCLA-QA program, focused on the home-visit care agencies. Total 473 agencies completed the questionnaires(response rate 13.6%), using the e-mail and fax survey methods with high-capacity web-fax server of NHIC. On the results of this study, we found the agencies' different perceptions and attitudes on HCLA-QA program according to their quality ratings as QA results. Compared to the agencies with low quality ratings, the agencies with high quality ratings tend to have more time for preparation, better understandings about HCLA-QA program, more positive perceptions that quality indicators generally are valid, and more affirmative attitudes that the notifications of QA results are helpful for agencies. Our findings can be very useful for establishing strategies for improving the HCLA-QA program. The policy makers, the insurer, and the agencies need to consider the opinions of the agencies with high quality ratings as well as the ones with low quality ratings.
Elderly people want to live in the community even if they are in poor health. However, there is no integrated care support system suitable for the health and functional status of the elderly. So the elderly are choosing living facilities. The purpose of this study is to explore exploring whether the elderly are applying for a long-term care certification. First, mild geriatric patients were mainly using home care services such as visitation care. However, some of the milder elderly were enrolled in nursing homes. And the service that does not fit the functional status of the elderly is used. Second, it is concentrated on the use of visiting care services. Third, elderly people outside the class did not receive sufficient help for daily life, and the use of community welfare services such as the elderly welfare center was low. As a result, long-term care admitters are not able to continue to live in the community even though their health and functioning status is mild, and elderly people out of grade are unable to properly use the necessary community care services. The condition is likely to deteriorate.
Asia-pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology
/
v.7
no.3
/
pp.597-604
/
2017
The purpose of this study is to examine the moderating effect of choice realization between service quality and user satisfaction to elderly home care services. For this purpose, we analyzed 258 respondents who received elderly home care service in Jeollabuk-do. Considering the assumption that the moderating effect of choice realization would be different by rural and urban areas because of the disparity of the elderly welfare infrastructure, the urban and rural areas were analyzed separately. The analyses showed that choice realization had a moderating effect on the relationship between service quality and user's service satisfaction for the service clients resided in urban areas. However, there was no significant moderating effect of choice realization for the service clients in rural areas. This result implies that the moderating effect of selection realization is different in rural and urban areas because of the poor elderly home care facilities in rural areas. In order for aged people to actively express the effect of service user choice, it is necessary to solve welfare imbalance between regions through expansion of welfare infrastructure and policy support to rural area.
Journal of agricultural medicine and community health
/
v.44
no.1
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pp.28-38
/
2019
Objectives: We searched and reviewed the literature including the laws or acts, statistics, guidelines, papers and conference proceedings related to home visit nursing care in South Korea. Method: We searched and reviewed the literature including the laws or acts, statistics, guidelines, papers and conference proceedings related to home visit nursing care in Korea. Results: There are three types of home care nursing in Korea. Public health center provides home visit nursing to vulnerable population by registered nurses for free, based on community health act in public health center. As of 2017, 1,261,208 people were enrolled in the visiting health program of public health center. Health behavior and disease management has been improved and showed having cost-benefit effect among the enrolled people in visiting health program. Visiting nursing care in long-term care services is provided by registered nurses or nurse aid, based on long-term care act. The cost is paid as the unit price according to service time. 1,095,764 older people used long-term care services in 2017, only 0.2% of total cost used for home visiting nursing. Even though the number of user of home visiting nursing, it was reported that users spent less medical cost and hospitalized shorter. Hospital-based home care nursing is provided to patients and their families under the prescription of a doctor by family nurse specialists who are employed by medical institute based on medical law. Four hundred sixty family nurse specialists worked for hospital-based home care nursing and hospital-based home care services accounted for 0.038% of total medical expenses in 2017. Conclusion: Even though home visit nursing care services are different in aspect of legal basis, personnel, running institutes, and cost basis, home visit nursing care showed cost-benefit effect and good health outcomes. In order to advance home visit nursing care, the integrated home visiting care, improvement of working condition, and revision of legal basis should be considered.
As the demand for elderly care service has been on rise due to the increasing of the aging population, the role of visiting caregivers becomes increasingly important. In this context, this study aims to examine whether there are moderating effects of social support and self-efficacy on the relationship between resilience of visiting caregivers and their burnouts. The hierarchical regression analysis was used for statistical analysis. The findings from the study are as follow. First, resilience has a negative effect on burnout. As the resilience increases, the burnout decreases. Second, social support has moderating effects on the relationship between a resilience sub-variable(positivity) and burnout. Third, self-efficacy has a moderating effect on the relationship between a resilience sub-variable(self-regulation) and burnout. The findings of the study suggest that nursing facilities pay attention to psychological characteristics of visiting caregivers as well as their job characteristics in designing burnout prevention programs for them.
This study was to investigate the effects of interpersonal relationships on job satisfaction of home-visiting care helpers and the category of interpersonal relationships was subdivided into elderly clients, guardians, colleagues and directors considering the person-to-person nature of home-visiting care helper's job characteristics. A group of 336 care helpers who engaged in home-visiting care service providing facilities in Daejeon City was selected as a research subject, and the data were analyzed with SPSS 22.0 program using reliability, frequency, correlation and hierarchical multiple regression. The results for the final analysis revealed that the effect of socio-demographic features was not significant while, among characteristics of job performances, work priority, turnover experience, and career choice reasons turned out to have significant impacts on job satisfaction. In particular, interpersonal relationships except the one with guardians were found to be the most influential variables and the effects of those relationships on job satisfaction were significant. The influencing power was stronger in relationships with director, elderly clients, and colleagues in order, and the job satisfaction level was higher as they were in better relationships with director, elderly clients, and colleagues. The results of this research shows that it is necessary to set an atmosphere where harmonious interpersonal relationships can be formed inside and outside of facilities in order to improve job satisfaction of home-visiting care helpers.
This study identified the use types of a home help service and the level of service quality and reviewed the extent of their effects on consumer satisfaction. As a result of measuring the service quality in terms of support, assurance, reliability, empathy and responsiveness, a high overall reliability was demonstrated in the service. The consumer satisfaction with the home help service was discovered as being high, in general. Meanwhile, with the female research participants, the lower the service fee was perceived to be, the higher the consumer satisfaction. The quality assessment items concerning support and reliability were found to be important variables which were influential on consumer satisfaction. Therefore, it has been shown to be imperative to prepare political alternatives regarding the development of the service standard in order to protect user's rights, offer relevant information, and ensure reliability in the home help service.
The purpose of this research is to analyze the overall problems at the moment of October 2008, and then to find the improvements of home-help services of the Long-Term Care Insurance(LTCI), which has been revealed many problems since it was released in July 2008. The research uses the literature survey which analyzes 2nd-hand materials studied by other people already, and survey research was executed from active social workers in the area of LTCI. Based on the policy analysis framework of Gilbert and Specht, all the data are analyzed in the scopes of client·benefit(service)·finance·transferring system. This research has found the problems in each scope of home-help services of the LTCI. Firstly, the client system has some problems in mismatching between registered and service clients, estimating client number, and judging service levels. Secondly, the service system reveals deficiency in professionality of social workers, service quality lowering by loose qualification criteria on workers, non-reasonable limitation of service time available, and the same fare system applied to visiting-help service in spite of different levels. Thirdly, in financing system, clients need to pay additional money to get extra services such as meal, hair cutting, bathing etc., due to government financial support stopped, some organizations have to reduce services and replace full-time workers to part-time ones, which makes the service quality worse. Lastly, in the transferring system, the management system for service quality is not well prepared. There are too much competion because of allowing too many home-help service organizations and care worker academies. The suggestions that this research has found to improve the policy are as follows. ① It is desirable to make the registered clients the service ones as many as possible in the long term perspective. ② The LTCI organization requires more workers and higher professionality. ③ Many elderly people who are not eligible now require connection system to be more served. ④ Management system and service manual for care worker are to be developed. ⑤ Laws related to the service contents and process should be modified, the proportion of client charge needs to adjust. ⑥ Home-help service organization licensed by the LTCI needs to be financially supported publicly. ⑦ Monitoring system to home-help service organization needs to be strengthened. ⑧ Evaluation tools to home-help service organization and workers is required. ⑨ Specification to open the home-help service organization needs to be more strict.
This study aims to investigate the awareness and needs of patients as consumers and therapists as providers on the introduction of home physical therapy in the long-term care insurance. The survey participants were 96 patients and 132 physical therapists to a questionnaires, we analyzed for frequency of each questionnaire about awareness and necessity. As a result of the test, they considered that physical activity support services provided by nurse and nurses aid ware not specialized enough(pt 60,4%, PT 75,4%) and quality therapy should be available through a home physical therapy(pt 47.9%, PT 59.2%). Also, patients responded that the priorities to improve long-term care insurance were given to lowering expenses(35,4%) and expanding coverage of subjects(32.3%) while the physical therapists responded that professionals should be expanded(73.8%) and diverse rehabilitation services(20.2%) and a rehabilitation team should be introduced. They responded that the reasons of home physical therapy were needed that it was hard for patients to visit medical centers(PT 30.0%) themselves and it would be improvable for them to get physical function in elderly(pt 47.1%) through the service. In conclusion, as most patients as well as physical therapists responded that home visit therapy services should be introduced and their awareness of it was very high, it is suggested that the service should be quickly introduced as soon as possible.
The study was performed to identify the functional status change of beneficiaries of Long-Term Care Insurance and its related factors. We conducted the logistic regression with 17,652 beneficiaries during August and September in 2008. As a result, activities of daily living(ADL), behavioral changes, rehab, instrumental activities of daily living(IADL) and cognitive function, followed by nursing care area were improved in a greater degree. For the institutional service, level-1 beneficiaries was significantly improved in rehab area and level-2 beneficiaries was improved in ADL. For the home-visit care service of in-home services, level-1 beneficiaries was improved in ADL, level-2 beneficiaries was improved in ADL and rehab area, level-3 beneficiaries was improved in ADL, cognitive function and behavioral changes. For the day-and-night care service, level-1 beneficiaries was improved in ADL, IADL, behavioral changes and rehab area, level-2 beneficiaries was improved in behavioral changes, level-3 beneficiaries was improved in cognitive function and behavioral changes. For the short-stay service, level-3 beneficiaries was improved in behavioral changes. By the above results, there was a difference in a functional improvement by level and used services. Therefore, government need to provide the personalized service system based on the objective and comprehensive understanding for health and functional status of beneficiaries.
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