• The Journal of the Korea Contents Association
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• v.22 no.6
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• pp.567-579
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• 2022

The purpose of this study is to find a way to improve the hospice system to increase comfortable home death, which people prefer, by understanding the factors affecting the difference in the rate of home death between South Korea and America within the hospice system. This study employs the Most Similar Systems Design, which is a case study approach. The result of this study is that both countries have public health insurance systems that are identical in terms of the appropriate time for the receipt of hospice services and the application procedure, which requires that two doctors confirm the patient's hospice eligibility. The main difference is that in South Korea, inpatient hospice is prevalent, whereas routine home care is predominant in the United States. Furthermore, in the United States, hospice assistants and housekeepers support at-home daily living care. Additionally, the United States provides inpatient respite care to allow care-giver, such as family to rest and there is no restriction on hospice-eligible diseases. To increase the accessibility of voluntary home death in South Korea, it is necessary to activate and expand the home type hospice service range and provide at-home daily living care, care-giver support services. Furthermore, there should be no restrictions on hospice-eligible diseases.

• 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.

• Journal of Hospice and Palliative Care
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• v.7 no.1
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• pp.17-28
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• 2004

Purpose: Even though there have been various efforts for the dying with dignity of terminal patients, no researches focused on the public attitudes. Methods: In February 2004, we sampled 1,055 persons over 20 years of age from the sixteen cities and local districts of Korea through the quota sampling method according to their gender, age, and location. We conducted a telephone survey with a structured questionnaire on the attitudes toward dying with dignity and hospice palliative care. Results: The most important conditions for the dying with dignity on the patients' views were 'removing burdens for other people' (27.8%). Over the half of the samples chose their home as a preference for place of death (54.8%). 82.3% of the respondents agreed to the idea of withdrawing the medically futile life-sustaining treatment. Fifty seven percents of the answered public said that they intended to use the hospice service in case of terminal illness. Eighty percents thought that health care insurance should cover hospice service, and 80.9% gave positive response to the necessity of advance directives. Respondents emphasized 'the financial support for the terminal patients' (29.8%), 'covering hospice service with health insurance' (16.5%), and 'the education and public relation for settlement of desirable dying culture and hospice service' (15.9%) as the roles and responsibilities of the government for the dying with dignity. Conclusion: This study shows that there is a possibility of significant consensus on hospice and palliative care system for the dying with dignity of patients and reduction of the suffering for their families among the general public.