• 한국보건간호학회지
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• 제19권1호
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• pp.148-160
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• 2005

Presented here are policy alternatives for understanding home health care for the long-term health care insurance system which is being developed for elderly people starting 2007. The summary of issues concerning home health nursing care under the long-term care insurance system include; 1) absence of comprehensive and systematic policy in home health care deliverly systems; 2) absence of community based home health agencies that are considered as the community residents in general. In order to overcome these problems and Issues, policy alternatives of home health care should 1) establish a comprehensive home health care policy for homebound persons; 2) establish the foundations for home health care nurses and community based home health care systems; 3) establish home health care facilities and infrastructure; and 4) promote research and development concerning home health care. Conclusively, a home health care system should be built on a comprehensive policy vision based on health policy, especially long-term care insurance system in the near future. Every homebound residents service has to be constructed systematically under suitable facilities considering the consumer characteristics and health conditions. By doing this, the consumer based comprehensive community home health care delivery system can be constructed in view of the long-term health care insurance system for elderly people.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제29권4호
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• pp.7-20
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• 2023

Purpose: The main purpose of this paper is to assess a body of research evidence that articulates the impact of physical and environmental factors on behavioral·psychological health and quality of life for the elderly people with dementia who reside in long-term care facilities. This follow-up study of the previous literature review aims to further identify physical and environmental factors, that improve health and quality of life for the elderly people with dementia, published in recent five years and to expand the understanding of clinical outcomes as mechanism that mediate the effect of physical environmental factors on improving behavioral·psychological health and quality of life for the elderly people with dementia. Methods: Comprehensive literature review has been conducted to identify empirical studies that link the design of dementia care facilities to health- and quality of care(QOL)-related outcomes and this follow-up review scrutinized peer-reviewed articles published in recent five years (from January 2018 to December 2022), filling the gap between the previous literature review and the current state of research. Results: The review identified a growing body of literature that articulates environment-related factors that improve behavioral·psychological health and quality of life for the elderly people with dementia living long-term care facilities. Implications: The findings of the review can be translated to design implications and design decisions to promote psychological and behavioral health and quality of life of people with dementia in long-term care facilities.

• 대한간호학회지
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• 제30권2호
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• pp.437-451
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• 2000

The purpose of this study was to estimate the forecast of bed demand for institutional long-term care for the elderly persons in Taegu Metropolitan City. The study subject was the total 1,877 elderly persons over age 65 living in Taegu. Among them 1,441 elderly persons were sampled from community and 436 were from the elderly admitted 5 general hospitals. Data collection was carried out by interview from 25 August to 25 December 1997. The measuring instrument of this study was the modified tool of CARE, MAI, PCTC, and ADL which were examined for validity and reliability. In order to forecast bed demand of Nursing Home, this study revised prediction techniques suggested by Robin. The results were as follows : 1. OLDi of Taegu City were 122,202 by the year 1998 and number of Low-Income Elderly Persons were 3,210. 2. The Level I : Senior Citizen Home $ADEMi=\frac{AQi * ASTAYi}{365 * AOCUi}$. AQi = OLDi * LADLi * NASi * ALONi * LIADLi * AUTILi. Predicted number of bed demand for Home Based. Elderly Persons were 4,210 and Low-Income Elderly Persons were 1,081 and Total Elderly Persons were 5,291 by the year 1998, 6,343 by the year 2000 and 8,351 by the 2005. 3. The Level II : Nursing Home $BDEMi=\frac{(BQ1i+BQ2i) * BSTAYi}{365 * BOCUi}$. BQ1i = OLDi * HADLi * ALONi * HIADLi BQ2i = OLDi * HADLi * FAMi * OBEDi Predicted number of demand for Total Elderly Persons were 668 by the year 1998, 802 by the year 2000 and 1,055 by the 2005. 4. The Level III : Nursing Home $CDEMi=\frac{COLDi * HDISi * CUTILi * CSTAYi}{365 * COCUi}+OQi/10$ Predicted number of demand for Total Elderly Persons were 1,899 by the year 1998, 2,311 by the year 2000 and 3,003 by the 2005. 5. Predicted number of bed demand of long-term care facilities in the year 1998 according to Levels were 4.3% among elderly persons in Taegu by Level I, 0.5% by Level II and 1.5% by Level III. Number of elderly persons in current long-term care facilities were 458 in LevelI I,284 in Level II. 6. Deficit number of bed demand of long-term care facilities were 4,833 in Level I, 384 in Level II, 1,899 in Level III for the elderly persons in Taegu Metropolitan City.

• 한국화재소방학회논문지
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• 제30권6호
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• pp.124-129
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• 2016

본 연구의 목적은 노인요양시설 화재 소방안전 관련법의 중복 및 충돌 사례를 분석하고, 향후 시사점을 노인복지적 관점에서 제시하는 것이다. 노인요양시설은 소방관련된 시설에 대하여 건축법 및 소방시설법의 적용을 받는다. 여기에서 건축법 등 관련 법령과 소방시설법령 간 법 적용의 공백은 물론 중복 적용으로 인한 충돌 문제가 나타났다. 점차 관련 규정을 개선하고 있으나 아직 개선사항이 산재해 있고, 기존 시설에 대한 적용문제도 남아있다. 구체적인 사례 검토 결과를 살펴보며 이러한 문제점들과 향후 노인복지적 관점에서 시사점을 제시해보고자 한다.

• 보건행정학회지
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• 제30권4호
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• pp.522-530
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• 2020

Background: In 2008, Korea implemented a new type of social insurance known as "long-term care insurance". We examined the association between ownership of long-term care facilities and the incidence of pressure ulcers after the implementation of "long-term care insurance". This study is a population-based retrospective cohort study from 2006 to 2013. Methods: We used medical claims data from the Korean National Health Insurance Corporate Elderly Cohort Database from 2006 to 2013. These data comprise a nationally representative sample. To avoid confounders, only patients admitted to one long-term care facility and who stayed for >70% of the follow-up time were included; as a result, 3,107 individuals were enrolled. The main independent variable was the operating entity of the long-term care facility (local government, corporate bodies, and private for-profit owners), and the dependent variable was the 1-year incidence of pressure-ulcers. Survival analysis (Cox proportional hazard model) was used as an analysis method. Results: Compared to patients admitted to local government long-term care facilities, patients admitted to private long-term care facilities had a significantly higher 1-year risk of pressure ulcers (hazard ratio [HR], 1.94; 95% confidence interval [CI], 1.29-2.91); the risk was especially high among patients who were cognitively dependent (HR, 2.34; 95% CI, 1.25-4.37). Conclusion: Patients admitted to private for-profit long-term care facilities were more likely to have pressure ulcers compared to those in local government and corporate body long-term care facilities. Appropriate assessment tools and publicly available information, as well as more restricted legal requirements, are needed to improve the care quality and outcomes of patients in long-term care facilities.

• 사물인터넷융복합논문지
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• 제8권2호
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• pp.13-24
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• 2022

본 연구는 우리나라에서 매년 증가하고 있는 노인장기요양기관의 부당청구 맥락과 부당청구 예방을 위한 대책들이 어떠한지를 탐색하기 위해서 언론기사를 활용한 텍스트 마이닝 분석을 실시하였다. 기사는 뉴스 빅테이터 분석 시스템인 빅카인즈에서 수집하였고, 수집기간은 노인장기요양보험이 시행된 2008년 7월부터 2022년 2월 28일까지로 약 15년간이다. 이 기간 동안 '노인요양+부당청구', '장기요양+부당청구', 등의 키워드로 총 2,627개의 기사가 수집되었고, 이중 중복된 기사를 제외한 총 946개가 선정되었다. 본 연구의 텍스트마이닝 분석결과로 첫째, 모든 구간(2008.7.1-2022.2.28)에서 가장 높은 빈도로 언급된 상위 10위 키워드는 노인장기요양기관, 부당청구, 국민건강보험공단, 노인장기요양보험, 장기요양급여(비용), 노인요양시설, 보건복지부, 노인, 신고, 포상금(지급)의 순으로 나타났다. 둘째, N-gram 분석결과 장기요양급여(비용)과 부당청구, 부당청구와 노인장기요양기관, 허위와 부당청구, 신고와 포상금(지급), 노인장기요양기관과 신고 등의 순으로 나타났다. 셋째, TF-IDF 분석은 빈도분석의 결과와 유사하게 나타났지만, 신고, 포상금(지급), 증가 등은 순위가 상승하였다. 상기 분석결과를 바탕으로 노인장기요양기관 부당청구 예방을 위한 방향성을 제시하였다.

• 한국노년학
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• 제31권1호
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• pp.97-109
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• 2011

이 연구는 노인장기요양보호 인력의 소진 예측 요인을 살펴보고, 노인장기요양서비스 인력의 소진 예방을 위한 대안을 제시하고 있다. 노인장기요양보호는 고령이나 노인성 질병으로 인하여 일상생활을 혼자 수행하기 어려운 노인 등에게 신체활동 또는 가사지원 등의 서비스를 제공하는 것이다. 연구 대상은 전남지역 노인장기 요양시설에 근무하는 직원 216명이고, 자료수집은 자기기입식 방법의 설문지를 이용하였으며, 분석방법은 SPSS 12.0을 이용하여 회귀분석을 실시하였다. 노인장기요양서비스 인력의 소진 척도는 22개 항목의 3가지 하위척도, 즉 정서적 고갈, 탈인격화, 자아성취감의 감소로 구성된 MBI를 사용하였다. 분석 결과에 의하면 직무요인인 클라이언트 요인, 업무과중, 역할갈등, 수급자 가족과 갈등이 소진에 유의미한 영향을 끼쳤고, 동료의 정서적 지지가 소진을 감소시키는 효과가 있는 것으로 나타났다. 연구 결과를 통해 노인장기요양보호 인력의 전문적 지위와 평판을 강화하기 위한 제도 보완과 소진을 예방하는데 동료의 정서적 지지 체계가 중요한 요인임을 확인하였다. 결론으로 이 연구결과를 바탕으로 노인장기요양서비스 인력의 소진 예방을 위한 제도적 실천적 함의를 제언하였다.

• 한국콘텐츠학회논문지
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• 제19권1호
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• pp.587-597
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• 2019

우리나라 인구의 빠른 고령화와 일상생활이 어려운 노인들이 증가하여 사회적 연대를 위한 노인장기요양 제도가 실시되었다. 제도 도입 후 나타난 장기요양제도의 구조적 문제 해결을 요구하고 있으며 기관 및 급여유형별로 통합된 요양서비스 제공체계, 노인의료-요양의 연속성 부족에 따른 요양병원-시설 간 기능정립 문제 등도 제기되고 있다. 이 연구에서는 문제점을 개선하기 위하여 입소정원, 종사인력, 제공서비스와 관련한 연구문제를 설정하였으며 FGI를 실시하였다. 연구결과 지역 내 노인 인구와 인정자 수, 노인성 질환자수 등 장기요양 수요를 반영, 지역별 적정 기관 및 인력 수급 정책 방향 제시하고, 지자체별 목표와 수급계획을 수립하여, 장기요양기관 지정요건 절차 강화 및 지정 갱신제 등 인증제도 도입이 검토되어야 하며, 남성요양보호사 육성 및 수가 인상 등을 통한 종사자 처우개선을 통하여 원활한 인력수급이 필요하다고 보았다. 급식비의 보험적용과 유관기관과의 연계를 통한 프로그램 확대제공, 원활한 입소관리를 위한 의료외 사고 중재기구가 필요하다고 나타났다.

• 한국치위생학회지
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• 제10권4호
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• pp.727-734
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• 2010

Objectives : The aim of this study was to assess the oral health care of the elderly in long-term care facility on caregivers' behaviors. Methods : Cross-sectional study in a cluster sample of 171 caregivers recruited from 17 facilities located in the Province of Gangwon. The Questionnaire was consisted of 16 items contained oral hygiene care, denture care, oral health education and general characteristics(Chronba's ${\alpha}$=0.87). Using SPSS WIN 12.0, descriptive statistics and chi-square test were conducted to examine the subjects general characteristics, the status of oral health education and denture care. Results : 1. The mean age of care givers was 42 years and 88.9% education experience rate was found. 2. Above 70% of them was found in daily oral hygiene care after every meal. They used toothbrush and toothpaste, they keep the toothbrush properly. 3. The denture care was conducted by most of care givers, containing proper storage. But three of ten care givers was cleaned denture by toothpaste or used water only. It was severe at the care givers didn't received oral health education(p<0.05). Conclusions : The contents of oral health education for care givers should contain the denture care(time and the reason shouldn't use toothpaste). Further large-scale longitudinal studies are needed to determine professional oral health care and to develop evidence of the dental hygiene practice for the elderly in long-term care facilities.

• 한국치위생학회지
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• 제17권5호
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• pp.705-719
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• 2017

Objectives: The purpose of this study is to look into the health insurance systems and application in Korea and Japan in order to improve elderly people's quality of life. Their quality of life can be improved by upgrading the long term care systems; and extending treatment and prevention. Methods: This study is to examine long term care systems articles through content analysis in the National Health Insurance Service. Data were collected from the printed Internet and analyzed. Results: A part-time dentist system in elderly care facilities has trouble in taking care of old people's oral health due to both lack of time and operational difficulties. It is urgent to arrange dental experts who can permanently stay in care facilities and to build systems which can be managed periodically and continually. Conclusions: As having staff training for the efficiency and using the manpower in care facilities (care workers), it is necessary to solve the unequal medical service in oral health care for the elderly in Korea.