• 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 Families and Better Life
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• v.26 no.5
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• pp.195-209
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• 2008

The purpose of this study was to provide basic information about design guidelines of activity areas in elderly nursing facilities. For the study, the activity areas of 44 facilities in Korea were investigated to categorize their spatial compositions and forms, and then a case study about 19 facilities was conducted to analyse their hierarchical characteristics. The results of the study were as follows: First, the major type of spatial composition among 44 research facilities was concentration, but compartment type was the main among unit-care facilities. By the year, all the types of spatial composition were evenly distributed during recent five years, while concentration type was about 40% before 2003. Second, the major form of activity areas was hall or corridor extension for large group. But there was more alcove or separation form among small group spaces. Third, in the case analysis about hierarchical characteristics, hall and corridor extension form met the requirements of accessibility and openness of public and semi-public areas. On the other hand, separation form had a problem in satisfying both requirements. The semi-private areas, which were around the elderly bedrooms and the elderly were able to watch activities in, were not sufficient in many facilities. Fourth, the division of public and semi-public area was mainly by furniture, and the individuality of semi-private area was defined by dead-end place and corner seats of the window or the corridor. The diversity of semi-private area was likely to be appeared in connection or distribution type. On the basis of the results, the basic design guidelines for activity areas in elderly nursing facilities could be suggested as follows: On the whole, connection or distribution type in spatial composition is more efficient for hierarchical flow than concentration or compartment type is, especially in Korean facilities having many elderly residents per floor. In detail, the design of public and semi-public area should be focused on their openness and accessibility. The recommended forms of activity areas were hall or corridor extension in public area, and living room, corridor extension, or large corridor in semi-public area to effectively function as large or small group spaces. In semi-private areas, the spatial diversity and individuality should be considered.

• Journal of Hospice and Palliative Care
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• v.5 no.1
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• pp.31-42
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• 2002

Purpose : The purpose of this study was to evaluate the present status of hospice palliative care programs in Korea as a basic database for standardization of hospice palliative care. Method : The data was collected from July to October, 2001. The instrument used for this study was the questionnaires which was consisted of the general characteristics of organization, recipient of service, manpower, contents of service, financial conditions and facilities. Sixty-four hospice palliative care programs answered the questionnaires, confirmed by telephone. Results : They were 40 hospital-based hospice palliative care programs and 24 nonmedical hospice palliative care programs. 11 Hospital-based hospice palliative programs have isolated unit or hospital affiliated free standing hospice. 6 Non-hospital hospice palliative programs have a free standing hospice. Major subjects of hospice palliative program were terminal cancer patients but patients with non-terminal illness were also included. Only 24 of 64 hospice palliative programs had all of the essential professionals : physicians, nurses, social workers, and clergies. Home hospice palliative care programs have a referral system in hospital based (89.7%) and nonmedical programs (73.7%). 24hr hospice are were provided in 26 hospital-based (65.0%) and 9nonmedical programs (37.5%). There were rooms for family in half of hospital-based programs. 73.9% of hospice palliative care programs have financial problems. 62.0% of Hospice palliative care programs need financial support from government. Conclusion : 64 Hospice palliative care programs provided hospice palliative services but had many problems in manpower, quality of care and facility. For improving the quality of terminal patients' life and promoting the cost effectiveness of health care resources, it is necessary to consider the standardization and institutionalization of hospice palliative care.