• 제목/요약/키워드: Care service

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노인장기요양 등급 및 급여 특성이 의료이용에 미치는 영향 (The Effect of Long-Term Care Ratings and Benefit Utilization Characteristics on Healthcare Use)

  • 손강주;오성진;윤종민
    • 보건행정학회지
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    • 제33권3호
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    • pp.295-310
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    • 2023
  • Background: The long-term care (LTC) group has higher rates of chronic disease and disability registration compared to the general older people population. There is a need to provide integrated medical services and care for LTC group. Consequently, this study aimed to identify medical usage patterns based on the ratings of LTC and the characteristics of benefits usage in the LTC group. Methods: This study employed the National Health Insurance Service Database to analyze the effects of demographic and LTC-related characteristics on medical usage from 2015 to 2019 using a repeated measures analysis. A longitudinal logit model was applied to binary data, while a linear mixed model was utilized for continuous data. Results: In the case of LTC ratings, a positive correlation was observed with overall medical usage. In terms of LTC benefit usage characteristics, a higher overall level of medical usage was found in the group using home care benefits. Detailed analysis by medical institution classification revealed a maintained correlation between care ratings and the volume of medical usage. However, medical usage by classification varied based on the characteristics of LTC benefit usage. Conclusion: This study identified a complex interaction between LTC characteristics and medical usage. Predicting the requisite medical services based on the LTC rating presented a challenge. Consequently, it becomes essential for the LTC group to continuously monitor medical and care needs, even after admission into the LTC system. To facilitate this, it is crucial to devise an LTC rating system that accurately reflects medical needs and to broaden the implementation of integrated medical-care policies.

The Effects of Child Care Policy Change on Child Care Service Satisfaction - Focusing on the introduction of child care electronic voucher system -

  • Kim, Gaeun;Joo, Jeong-Joo;Park, Chimyen
    • 한국컴퓨터정보학회논문지
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    • 제20권10호
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    • pp.127-132
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    • 2015
  • This study is to test some expected performances coming from the introduction child care electronic voucher system, and suggest some policy implications. At first, this study established causal model on the expected performances of child care electronic voucher system, and then tested it through structural equation model on the base of survey. Survey was made through sampling employees of child care facilities in Gwangju Metropolitan City. This study showed that the expected effects of child care electronic voucher system are significant. This study suggested some implications basing on this analytical results.

요양병원형수가제 전환에 대한 요양병원의 평가 및 개선방안 연구 (A Study on Evaluation and Improvement of Long-term Care Hospitals for Changing Long-term Care Hospital Fee System)

  • 김영배
    • 보건의료산업학회지
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    • 제5권2호
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    • pp.105-117
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    • 2011
  • The purpose of this study is to investigate evaluation and improvement of long-term care hospitals for changing long-term care hospitals fee system. Data were collected from 104 CEOs in nationwide long-term care hospitals using structured self-administered questionnaires during August 17 to 31, 2009. Major results of the empirical analysis are as follows; first, to change fixed sum medical fee per day caused to decline the level of geriatric service in 87% of CEOs. Second, 79% of CEOs were dissatisfied with changing fixed sum medical fee per day, and 47% of them were dissatisfied with graded fee for doctor and nurse management. Finally, they suggested that to specialize and to differentiate of long-term care hospitals will drive to improve long-term care hospitals function and to measure workforce based on rate of filled vacancies will increase efficiency and productivity of doctor and nurse management.

병원 임상영양사의 업무별 소요시간 분석: 서울 및 경기 일부의 상급종합병원을 중심으로 (Time Measurement Study of Certified Clinical Dietitians from Tertiary Hospital in Seoul and Gyeonggi-do)

  • 엄미향;박유경;이송미;차진아;이은;류은순
    • 대한영양사협회학술지
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    • 제21권2호
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    • pp.123-139
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    • 2015
  • The objective of this study was to document how clinical dietitians working at tertiary hospitals spend their time based on several categories of activities using a time measurement study. The questionnaires were distributed to 14 tertiary hospitals, and dietitians answered by classifying their work activities into several categories such as general care, indirect care, direct care, outpatient care, and food service management. A total of 129 clinical dietitians replied and their answers were analyzed according to the categories of activities. The times spent on the categories are as follows: general care (76.7 mins/day, 14%), indirect care (228.4 mins/day, 35%), direct care (120.1 mins/day, 22%), outpatient care (61.5 mins/day, 11%), and food service management (99.0 mins/day, 18%). The total working hours for dietitians was 590.0 mins, which exceeds the standard working hours of 540.0 mins (9 hrs) a day. From this study, we found that clinical dietitians spent very limited time on direct care. Times spent on activities were different according to type of employment and food service. Internship dietitians spent their more time on general care (P<0.001) while irregular dietitians spent more time on outpatient care (P<0.05). In contracted managed food service hospitals, clinical dietitians spent significantly less time on food service management (P<0.001). Regardless of doctors' order and consultation fees, clinical dietitians performed more than 95 percent of free consultation to patients. Entry-level knowledge and skills of dietitians working at hospitals are very important for quality service, but it is equally important to create an administrative and social environment that encourages clinical dietitian to spend more time on direct patient care.

일 도단위 농촌지역 재가노인복지사업 운영 실태조사 (A Study of Present Conditions of Domiciliary Elder Care Utilizing Public Health Care Institutions in Rural Area)

  • 김귀숙;한혜경;강경숙
    • 한국농촌간호학회지
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    • 제3권1호
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    • pp.34-43
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    • 2008
  • Purpose: The purpose of this study was to suggest new direction for domiciliary care for elders provided by public institutions in rural areas. Method: The participants in the study were elders using one of 11 public health care institutions, of which 8 operated day care services exclusively, and 3 operated both day care and short-term respite care services. A survey was conducted using a structured questionnaire that included items on general characteristics of the service users, conditions of the services, personnel, financial status, facilities, and perception of the tasks of the staff. Result: The service content of the day care centers included Western and Chinese medical service, physical services, activities of ADL, nursing care services, meal services and transportation services. Domiciliary care centers provided a wide variety of health and social welfare service for elders. Personnel consisted of 3 to 8 staff for day care centers and 7 to 10 for domiciliary care centers. Both types of centers rely on financial support from local government for operation. The perception of the staff was the need for operation of these centers by public health facilities such as public health centers and sub-centers. Conclusion: The result suggest a need to activate the function of public institutions to provide domiciliary care for elders. For this new change, the role as a social support system must be developed.

독거노인의 노인돌봄서비스 만족도에 영향을 미치는 요인 (Factors Affecting the Satisfaction of Elderly Care Service in the Elderly Living Alone)

  • 유용식
    • 한국엔터테인먼트산업학회논문지
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    • 제14권1호
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    • pp.179-186
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    • 2020
  • 본 연구의 목적은 독거노인의 노인돌봄서비스 만족도에 영향을 미치는 요인을 살펴보고, 노인돌봄서비스의 만족도 증진을 위한 기초 자료를 제공하고자 한다. 연구대상은 충북 J시의 노인돌봄기본서비스를 받고 있는 65세 이상 독거노인 301명을 대상으로 하였으며 영향요인을 살펴보기 위해 다중회귀분석을 실시하였다. 본 연구결과 독거노인의 노인돌봄서비스 만족도에 영향을 미치는 요인은 관리사 요인, 서비스 요인, 기관 요인, 소득수준이 유의미한 것으로 나타났다. 이는 생활관리사, 서비스 요인, 기관 요인이 높을수록, 소득수준이 낮은 독거노인 일수록 노인돌봄서비스 만족도가 높은 것으로 나타났다. 특히 생활관리사 요인이 노인돌봄서비스 만족도에 가장 큰 영향을 미치는 것으로 나타났으며, 다음은 기관요인, 서비스요인, 소득수준 순으로 나타났다. 이러한 연구결과를 근거로 정책제언을 하면 첫째, 생활관리사들의 전문성 증진과 처우개선, 둘째, 기관의 전문적이고 체계적인 서비스 지원과 사회안전망 강화, 셋째, 노인돌봄서비스의 품질향상을 위한 적절성·접근성·지속성 강화가 필요하다.

치매노인의 주간보호서비스 이용에 따른 주부양자의 피로, 우울, 생활 만족도 변화 (A Study on Changes of Primary Caregivers' Fatigue, Depression and Life Satisfaction by Using Dementia Day Care Service)

  • 이영휘;박경희;성연실
    • 성인간호학회지
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    • 제20권3호
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    • pp.443-451
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    • 2008
  • Purpose: This study is to examine how dementia day care service affects fatigue, depression and life satisfaction of caregiver. Methods: The study was conducted using a convenient sampling method from 6 Dementia Day Care Center in Incheon. Thirty nine primary caregivers answered the questionnaires. Pre-test was done before demented elders start using the dementia day care center and post-test was done five months after. Data were analyzed by using descriptive statistics and paired t-test. Results: There was a significant difference in caregivers' fatigue level after using dementia day care service(t=2.188, p=.035). Results of subcategories were as follows; There was a significant difference in caregivers' physical fatigue level(t=2.270, p=.029) and psychological fatigue level(t=2.277, p=.029) after using dementia day care service. However, there was not significant difference in caregivers' neurological fatigue level(t=1.312, p=.197). There was a significant difference in caregivers' depression level(t=3.066, p=.004) and life satisfaction(t=-2.131, p=.040) after using dementia day care service. Conclusion: The results indicated that dementia day care service is helpful for family with demented elders. Therefore it is necessary to expand dementia day care center in terms of its size and numbers in order to support increasing number of demented elders and their families.

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일부 대전시민의 영양상태와 지역사회 영양관리서비스 요구도에 관한 단면조사연구 (Nutritional status of Daejeon citizens and needs of community nutrition care services: a cross-sectional study )

  • 이다혜;전민선
    • 대한지역사회영양학회지
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    • 제28권1호
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    • pp.11-23
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    • 2023
  • Objectives: This study aimed to determine the nutritional status of residents, to examine the perception and needs of community nutrition care service, and to compare and analyze the results of females and males living in Daejeon, Korea. Methods: The subjects were 592 adults and elderly (278 men and 314 women) residents of Daejeon. The dietary quality was assessed using the nutrition quotient (NQ), and data of the perception and needs for community nutrition care service were obtained by a questionnaire survey. Descriptive analysis was applied to analyze the demographic characteristics, perception and needs of the respondents, and independent t-test and chi-square test were performed to analyze and compare the differences between female and male participants. Results: A nutritional status that required monitoring was established in 78.9% of the respondents in this study. The balance factor (29.1 points) was much lower than the national average. In the diversity factor, the NQ score of the female group was 47.6 points, which was 8 points lower than that of males; the NQ grade was 43.9%, showing a significant difference between females and males (P < 0.001). The respondents answered that those who needed community nutrition care services were residents experiencing health care difficulties. Additionally, dietitians (35.6%) were pointed out as the most suitable service providers. The most important factor of community nutrition care service operation was securing the budget (47.0%). Conclusions: The results of the present study show that Daejeon residents need overall nutrition support, and a demand for community nutrition care services exists. Our findings provide basic data and can serve as a foundation for the development and establishment of a community nutrition care service model.

Searching for Ways to Improve Visiting Oral Health Care Services in Korea through Comparison with Japanese System in Long-Term Care Insurance

  • Sang-Hwan Oh;Rumi Nishimura;Soo-Jeong Hwang
    • 치위생과학회지
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    • 제23권2호
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    • pp.154-168
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    • 2023
  • Background: Legal regulations and fees have been established in Korea to provide visiting oral health care services to individuals with long-term care insurance (LTCI). However, beneficiaries of this service are very limited. Therefore, to improve the Korean system we propose a comparative analysis with the Japanese system. Methods: This study is a descriptive analysis based on secondary data, such as statistics, laws, and service record forms from Korea and Japan. The most recent institutional documents were obtained through a Google search. The variables investigated were financial resources of LTCI, co-payment structure, monthly limit of LTCI benefits, care levels of LTCI, service providers, service costs, contents of service, and the number of cases of service. Results: In both Korea and Japan, LTCI is financed through a combination of taxes and insurance premiums. However, the monthly limit for receiving LTCI services in Japan is about 2.4 times higher than in Korea. Visiting medical and dental treatment is also possible in Japan. Furthermore, nursing staff can provide daily oral health care services according to dental hygienists' instruction unlike Korea. Oral health care services in Korea are focused on oral hygiene and prevention of oral diseases, while Japan additionally provides oral function screening, patient education for oral health management, and training for nursing staff to enhance oral function, eating, and swallowing of the patients. Conclusion: We concluded that the possibility of visiting dental treatment, differences in monthly limit of LTCI benefits, oral function assessment and guidance, as well as collaboration with other healthcare professionals contributed to the difference in the frequency of utilization of visiting oral health care services between Korea and Japan.

Continuing Care Retirement Communities 거주 노인들의 급식서비스에 대한 인식

  • 이경은
    • 대한지역사회영양학회:학술대회논문집
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    • 대한지역사회영양학회 2004년도 춘계학술대회
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    • pp.395-395
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    • 2004
  • Continuing care retirement communities (CCRC)는 노인들을 위해 주거, 급식, 의료 및 기타 서비스를 제공하는 long-term care service의 한 종류이다. CCRC는 한 시설 내에서 independent living, assisted living, skilled nursing 서비스를 모두 제공한다는 점에서 다른 long-term care service와 구별된다. 본 연구의 목적은 CCRC에서 제공되는 급식서비스의 품질(service quality)과 가치(perceived value)에 대한 노인 고객들의 인식, 고객만족도(customer satisfaction), 급식관련 행동의사 간의 관계를 파악하는 것이었다.(중략)

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