• Journal of The Korea Institute of Healthcare Architecture
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• v.22 no.4
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• pp.7-17
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• 2016

Purpose: As our population ages and becomes an elderly society the number of elderly care hospitals is rapidly increasing. Because physical functions and spatial perception in the elderly decrease with age, these hospitals require more systematic and intelligent space designs. The design of these spaces are even more complex because they must accommodate medical programs to treat various different diseases and ailments and also because there are many first time patients and irregular short term patients that seek out outpatient treatment services. Also by analyzing the spatial configuration systems and systematic relationships between each of the functional spaces of the outpatient treatment service departments for hospitals specialized in care for the elderly by focusing on the hallway and corridor systems of these hospitals, the according characteristics and trends were examined. Methods: Based on preceding research, the types of hallway and corridor systems of these hospitals were categorized into five types, including gallery corridors, middle corridors, hall-type, mixed type and cyclic type corridors, and into six types according to function including by medical diagnosis, patient registration, examination, administration and convenience and shared common space to derive any interconnecting relationships between the corridor systems. Also by comprehensively examining the types and combined utilization of the corridor types and the integration and the intelligibility of the space syntax, any trends within the corridor system were derived. The elderly care hospitals examined in this research study were twelve hospitals that opened after the year 2000 in Korea with more that 150 sick beds with areas larger than $1000m^2$ and with all outpatient medical service related rooms located entirely on a single floor of the hospital. Results: The following results could be confirmed based on this research study. 1) The spaces where medical diagnosis and examination occurred were adjacent, and the movement lines for first time patients and re-visiting patients were taken into consideration by separating the treatment space. 2) This research study confirmed that the larger the size of the hospital was, there were more detailed categorizations of treatment services and that there was a tendency for treatment areas to be separated and independent from examination areas. 3) There was a tendency for integration and intelligibility to decrease the more complex and diverse the combination of hall types designed into the corridor systems of these hospitals was. cyclic type corridors dramatically decreased the intelligibility of the corridor systems of these hospitals. 4) The priority rank of these spaces were confirmed to be highest in the order of registration, diagnosis, examination, treatment, administration and shared common spaces. However it was confirmed for the local integration that the diagnosis scope had the highest priority rank. Implications: There were exceptional cases confirmed where the number of unit spaces did not have an absolute effect on integration and intelligibility. These results can be interpreted to mean that this can be overcome through efficient architectural planning.

• Journal of agricultural medicine and community health
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• v.35 no.1
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• pp.13-20
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• 2010

Objectives: This study was conducted to be identify the effects oral hygiene improvement of the elderly by caregiver in a rural. Methods: It recruited Fifty three elderly patients were recruited who admitted at a long-term hospital located in Mokchon city, Chungchungnam-do province. as the intervention group. Fifty two elderly patients group were selected another one long-term care hospital in Daegu city as control group. study was conducted for seven months. long-term care hospital. for seven months from Dec. 2007 to June 2008. For three months, the caregivers provide tooth brushing and cleaning artificial teeth once a day, to intervention group. once a day for three months. Results: Before the program there was no significant difference between the control and the intervention groups in general characteristics, prevalence rates of diseases, oral sanitary condition. Dental plague score was decreased significantly(p<0.001) before and after intervention in the intervention group. Using analysis of covariance for evaluation of the effect of the intervention, a significant difference was observed between the intervention group and the control group(p<0.01). Conclusions: These results were thought to be used as important basic data to develop oral health management program for elderly patients who needed long-term care.

• Korea Journal of Hospital Management
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• v.6 no.3
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• pp.130-147
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• 2001

This study is about major symptoms of elderly and medical services for elderly in long-tenn care facilities. The subject of this study was 298 patients over 00 years old staying in two geriatric hospitals and two nursing homes. The symptoms and medical services were level of patient classification from RUG(Resource Utilization Group)-III which is applied for both Medicare and Medicaid for skilled nursing facilities reimbursement system in US and designed for measuring patient characteristics and medical staff time. This classification is explained by each patient resource(staff time) utilization level which is called CMI(Case-Mix Index). In this study, the symptoms and services were compared by facility type and they were categorized by level and compared by CMI. Major findings are as follows; 1. There were more elderly who have cognitive function problems in nursing homes than patients in geriatric hospitals. There were more patients with behavioral problems in geriatric hospitals than residents in nursing homes. These results were both statistically significant. 2. The patients in geriatric hospitals received significantly more nursing rehabilitation services, rehabilitation services and extensive services than residents in nursing homes. Other hands, special care services were provided significantly more to residents in nursing homes than elderly in geriatric hospitals. 3. ADL and depression variables had higher CMI when the symptoms were heavier condition. The CMI were not matched with levels of cognitive function problems and behavioral problems. 4. The CMI matched well significantly with levels of nursing rehabilitation services, special care services, and clinically complex services provided for the patient in geriatric hospitals and only nursing rehabilitation services in nursing homes. The CMI for rehabilitation services level and extensive services had regular trends. From the result of this study, the resource utilization level and services provided for elderly in each long-term care facilities were figured out. For the further study, it needs to have more concern about RUG-ill which classification variables were just analyzed.

• The Journal of the Korea Contents Association
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• v.20 no.10
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• pp.308-325
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• 2020

This study examines factual facilites safety of long-term care facilities for eldery, for improvement of Korean policy. So, This study reviewed policies of facilites safety of long-term care facilities on main OECD countries. We analyzed factual survey of facilites safety of long-term care facilities in Seoul metropolitan area. The results of the study were as follows: First, There were differences of law and rule of facilites safety of long-term care facilities in comparison with those of social welfare facilities, child day-care center, hospital. Second, it was the result of location condition analysis. Long-term care facilities in the Seoul metropolitan area were located on more than six floors of buildings. The location conditions of private facilities are weak compared to those of corporations and local governments. Third, there were the result of internal structure of facilities. Overall, the placement status was insufficient. For instance, there are smokeproof masks/fireproof blankets, smoke windows(fire safety windows), smoke smothering. In addition, there were places where legal essential installation structures were insufficient. Private facilities were generally insufficient in facility structures compared to those of local governments and welfare corporations. Fourth, there were the result of safety management. It was confirmed that private facilities were insufficient compared to local government facilities. For instance, there are safety management analysis, response manuals, fire preparedness training, etc. Finally, implications and future directions policies of facilites safety of long-term care facilities were discussed based on the finding of the study.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.4
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• pp.2674-2683
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• 2015

This study was performed to determine the levels of depression(CES-D) and its related factors among the elderly people affiliated with long-term care insurance services in urban areas. The interviews were performed, during the period from March 1st, to May 31th, 2012, to 388 elderlies. As a result, the levels of depression among all subjects were 21.6% of normal group, and 78.4% of depression group. The distribution of depression according to the grade of long-term care insurance were 83.6% in Grade I, 82.1% in Grade II and 67.0% in Grade III, and the level of distribution were significantly higher according to the higher grade of long-term care insurance. For the results of multiple logistic regression analysis, the odds ratio was increased in older age group, in the poor health status group, and in the group of seldom in activity of hobbies than their counterparts, but it was decreased in the higher monthly income group than lower group. Above results suggested that the depression was significantly related with the variables such as sociodemographic characteristics, economic status, health related factors and health status.

• Health Policy and Management
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• v.27 no.1
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• pp.56-62
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• 2017

Background: There have been deviations in the regional rate of certification in Korean long-term care insurance (LTCI). This study aimed to explore the determinants of the rate of certification in LTCI. Methods: The panel data of the year 2010-2014 of the 227 National Health Insurance Service (NHIS) regional office were used. Making use of 26 explanatory variables (socio-demographic factors, access to the long-term care services, etc.), we estimated the random effects model using STATA SE ver. 13.0 program (Stata Corp., College Station, TX, USA) and tried to find out the determinants of the regional rate of certification. Results: Estimation results showed that the most important determinants of the regional rate of certification in LTCI are the long-term care infrastructure such as capacity or number of the homecare service institution, sanatorium, or convalescent hospital. The number of the elderly who lives alone and the dimentia patients were positively related to the regional rate of certification in LTCI. Conclusion: The estimation results implied that the regional variation in the rate of certification in LTCI has nothing to do with the NHIS regional offices or their employees. To alleviate the deviation in the regional rate of certification in LTCI, we suggested the analysis of the deviation in the survey checklist. We also proposed to found the regional comprehensive support center to prevent the geriatric illness and to improve the residents' health, etc.

• Research in Community and Public Health Nursing
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• v.28 no.2
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• pp.196-205
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• 2017

Purpose: Art program has been found to enhance mood such as increasing motivation, self-expression and decreasing depression in older adults. This study was conducted to investigate the effects of clay art and drawing on depression and self-expression among elderly people at a long-term care center. Methods: The research was a pre-test and post-test non-equivalent design. Sixty older patients (clay art program=28. Drawing art program=32) over the age of 65 were recruited from 2 long-term care hospitals to participate in the 5 weeks program. Each group was scheduled with 10,120-minute evaluation sessions, twice per week. Test measures were completed before and after the 5 week intervention period for all participants. The data was collected from April 27 to May 29, 2015. It was analyzed with SPSS 22.0 using chi-square, t-test and paired t-test. Results: There were no significant difference in the levels of depression (t=0.21, p=.830) and total score of self-expression (t=-0.10, p=.919) between the two groups. However, the pre-post scores of self-expression in the clay art program (t=0.22, p=.826) were improved compared to the drawing art program (t=0.80, p=.430). Conclusion: Further studies are needed to evaluate the effectiveness of clay art program for extended senior care applications.

• Journal of Korean Academy of Nursing
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• v.49 no.2
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• pp.203-214
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• 2019

Purpose: The purpose of this study to develop a fringed fall prevention program based on King's goal attainment theory and education. This study is applied to the personal, interpersonal, and social systems of fall high-risk patients to test its effects. Methods: This study was a nonequivalent control group pre- and post-test design. There were 52 fall high-risk patients in the experimental group and 45 in the control group. The experimental group received six sessions, with the group sessions lasting 60 minutes and the individual sessions lasting 20~30 minutes. Data were analyzed using descriptive statistics, an ${\chi}^2-test$, a paired sample t-test, and a Wilcoxon signed-ranks test utilizing IBM SPSS software. Results: For the 3-month intervention period, the fall prevention program was found to be particularly effective for patients in the experimental group (from 3.38 to 1.69 per 1000 patient days; p=.044), as opposed to the control group (from 1.94 to 1.49 per 1000 patient days; p=.300). For the 6-month follow up period, the fall prevention program was again found to be effective for patients in the experimental group (from 3.26 to 0.76 per 1000 patient days; p=.049) compared to the control group (from 1.98 to 1.01 per 1000 patient days; p=.368). Conclusion: These results indicate that the fringed fall prevention program is very effective in reducing falls, not only during the intervention period, but also after the intervention period has ended. We can therefore recommend this program for use concerning fall high-risk patients in long-term care hospitals.

• Journal of the Korean Institute of Rural Architecture
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• v.12 no.4
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• pp.29-36
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• 2010

The purpose of this study is to have detailed data of the distribution, locations, and the amount of people in the waiting line of the nursing home. Also, we studied the accessibility to the facilities by using Web GIS to analyze the transit time it takes from the nursing home to health center and hospitals. We can provide the basic data that could contribute when future plans for the nursing homes' locations, health and medical policy are made. The results are as follows. 1. The nursing homes are stiffly concentrated in regions of Seoul and Gyeongi-do where large number of the elderly covered by long-term care insurance and the waiting line was very long for the elderlies to enter the nursing homes. In these cities of Ulsan and Jeju where number of the elderly covered by long-term care insurance is relatively small, there were less facilities. 2. The nursing homes located in urban areas had higher occupancy rate and higher number of people in the waiting line. 3. The average time taken by driving from the nursing homes and health center was 10 minutes and there was not a noticeable difference between the cities. Driving from the nursing homes to hospitals in rural areas took 22 minutes which is 2.5 times of the time taken for urban areas. Daegu-si and Incheon-si had relatively short distance from the nursing homes and the hospitals while Jeju-do had the furthest. For rural areas, it is needed for health center to be equipped with a wider medical coverage, have closely connected with hospitals to minimize the differences they have from ones in rural areas. It is also needed to have ambulances equipped for tele-medical examination and treatment system.

• 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.