• 응용통계연구
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• 제22권6호
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• pp.1229-1237
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• 2009

노인장기요양보험에서 가장 중요한 이슈는 급여대상자의 희망, 건강 및 기능상태에 따라 어떤 급여를 제공할 것인가 이다. 이를 해결하고자 노인장기요양보험의 보험자인 국민건강보험 공단은 급여대상자에게 '표준장기요양이용계획서'를 제공하고 있다. 본 연구에서는 표준장기요양이용계획 작성의 효율화 방안을 마련하고자 노인장기요양보험 3차 시범사업 표준이용계획 자료를 활용하여 노인장기요양급여 권고모형을 개발하였다. 모형개발에는 데이터마이닝의 의사결정나무모형, 로지스틱회귀모형, 앙상블 모형의 배깅과 부스팅 기법을 사용하였고, 이 중 실무자가 이해하기 쉬운 의사결정나무를 채택하여 권고모형을 설명 하였다. 본 연구는 노인장기요양보험 제도의 이용계획 수립의 객관성 및 과학성을 확보하고 이용계획 업무를 효율화하는 데에 기여할 것으로 기대된다.

• 보건행정학회지
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• 제23권1호
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• pp.90-100
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• 2013

Background: This study examined the relationships of dementia, stroke, and combined multimorbidity with long-term care utilizations among older people in South Korea. Methods: A nationally representative sample of 10,130 older adults who used long-term care services in 2010 were analyzed. We used the 5% sample of aged 65 years or older linked with National Health Insurance Corporation registry data of long-term care insurance system. The sample was categorized into three groups: dementia only (47.6%), stroke only (36.3%), and both dementia and stroke (16.1%). We estimated the use of institutional care, home care, and total expenditure of long-term care services, adjusting for the severity of each function (such as daily life, behavior or cognitive change, nursing care needs, and rehabilitation care needs) and sociodemographic characteristics. Results: Having dementia symptoms was positively associated with the use of institutional care services, on the other hand, having stroke symptoms was positively related with the use of home care. The total long-term care cost was higher in the group of having both dementia and stroke. Conclusion: Older persons with dementia symptoms and stroke symptoms have different patterns of long-term care utilization, and the multimorbidity increased the overall expenditure of long-term care utilization. These findings imply a need for differentiated management strategy targeting physically and cognitively impaired older persons, and special concerning for persons with multimorbidity conditions for long-term care insurance program in Korea.

• 한국주거학회논문집
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• 제25권2호
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• pp.99-107
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• 2014

This study attempts to provide implications for developing more efficient and effective community-based support system with AIP perspective for the elderly in Korea. The main purpose of this study is to analyze Japan's community-based integrated care system that respond to the concept of aging in place (AIP) and its cases. In Japan, they have offered Community-Based Service since 2005, and the advanced system which include integrated support categories and consolidated community/local resources will started in 2015 by The revision of Long-term Care Insurance policy, 2012. The result of policy analysis and case studies are as follows: 1) The suggestion for ideal support system model promoted a relationship of multiple agents include private sectors even resident and senior and specified responsibility sharing, 2) the system proposed Not only health and medical care support, living care and residence are also addressed as a comprehensive support. and 3) the amount of available community resource is different by each local government, but the effort to get the understanding of community residents and to connect with a potential community resource is also essential aspect to set effective community-based support system.

• 응용통계연구
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• 제31권6호
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• pp.693-706
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• 2018

노인의 신체기능에 부합하는 복지용구를 제공하는 것은 노인이 가능한 한 오랫동안 자신의 집과 지역사회에서 자립하여 생활할 수 있도록 돕기 위해 매우 중요하다. 본 연구는 수급자의 신체 및 인지 기능 상태를 고려하여 개개인에게 적합한 복지용구 품목을 권고할 수 있는 과학적인 복지용구 표준급여모형 알고리즘을 개발하고자 수행되었다. 모형개발에는 데이터마이닝기법인 의사결정나무를 활용하였다. 수급자 8,084명의 장기요양인정조사자료와 파워어세서가 작성한 표준급여계획, 수급자 특성 자료를 이용하여 데이터를 구축하였고, 15개 복지용구 품목별로 표준급여모형을 개발하였다. 본 연구는 노인장기요양보험의 복지용구 급여계획의 객관성 및 과학성을 확보하고 수급자의 자립생활과 안전을 향상시키는 데에 기여할 것으로 기대된다.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제16권3호
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• pp.57-68
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• 2010

The purpose of this study is to investigate the current characteristics of healthcare and welfare policies in Japan focused on the related policies in 2000's. In Japan, with the perspectives of entering the super-aged society by 2005 and the movement of all of the baby boom generation into the elderly generation by 2015, more rapid progress to the aging society is expected. From this situation, Japanese government has developed diverse elderly-oriented strategies such as "structural reform of social security", "nursing care system" and "gold plan 21" in 2000's. However, most of the related researches targeted the period to early 2000's, excluding the papers about the individual policies. Recently in our country, many related policies have been developed such as the enforcement of "long term care insurance system for the elderly" by 5 year period reevaluations and the preparation for 2nd step of "Plan for Ageing Society and Population"(2011~2015). At this moment, the investigation on the related policies of Japan could give appropriate references to us, a late starter of aging society.

• 한국실내디자인학회논문집
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• 제19권3호
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• pp.242-250
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• 2010

Recently, the long-term care insurance for the elderly was carried out according to the elderly is increased rapidly and the formation of sympathy that a nation and society try commonly to share health and welfare promotion of the elderly. The purpose of this study is to analyze the present status of nursing home after that the long-term care insurance is enforced in chungcheongbuk-do and to utilize as basic data. The study limited its survey to those facilities that refer to the Ministry of Health and Welfare data, that had the capacity of more than 50 people. The result are as followings. Firstly, most of the nursing home were located on the outskirts of the city. But it must be constructed in the city center if the recent deinstitutionalization trend is reflected. Secondly, notwithstanding the provisions of the Elderly Welfare Law, if the Livability and amenity are considered, the plan of a single or a twin room is needed. The ondol(溫突) system bedroom for the safety of the elderly had to be planned and for the color planning of a bedroom, a heating, the furniture, the form of a door, corridors, etc. should be partly improved. The fastener in which it is appropriate for the main exit, a stair, an elevator, the lighting device, and etc. is needed and the installation of a wandering path for the dementia patient and etc. is required. Thirdly, most of the dining room arranged on the first floor but it is not nearly used and it used for employee or the other use. Therefore, we have to consider the system in which it can deliver the meal to a bedroom. If the smell of the elderly and etc. is considered, the sufficient height of the floor should be reflected for the ventilation equipment. Lastly, The improvement of the existing law are required.

• 지역사회간호학회지
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• 제10권1호
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• pp.106-120
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• 1999

Japan has been prepared for aging society from 1970. In 1970, the percentage of distribution of population of 65 years old and over was 7.1%. It is similar to present percentile of the elderly in Korea. Therefore, it will be needed to study about home care and home visiting nursing in Japan at present. This study was aimed to prepare the fundamental documents for home care nursing in Korea and to know the background of new health care system of Long-term Care Insurance in Japan, by studying home care and home visiting nursing in Japan. With the continuing aging of the population, especially the increase in the number of latter stage elderly, it is predicted that there will be an increase in the number of the elderly who are bedridden and suffering senile dementia. To ensure that these people will be able to continue living in the communities and homes they are accustomed to, surrounded by their families and neighbors, Japan substantially improve and expand in-home services. There were also long-term effort to reach the level of services outlined in the Gold Plan and the New Gold Plan within the decade between FY 1991 and FY 1999 in the field of health care and welfare. Under this plan, the most noticeable change was occurred in home care, home was permitted as the field of care and visiting nursing was established in law. Through this 10- Year Strategy for Promotion of Health and Welfare Services for the Aged, many problems have been improved and solved, but some problems remained such as inadequate service supply and consumption of medical insurance for the elderly. Japan will be a society composed 25% of elderly people of total population in 2020, and it will be soon faced with a shortage of welfare and medical facilities and manpower. As for equalizing the benefits and cost burdens, and other future arrangements for health care and welfare, Long-term Care insurance system was established in 1994. This system will be enforced from April 2000 and use present facilities and services. To know home care and home visiting nursing in Japan, we need to consider present conditions well and to take notice of changes and measures to cope with an aging society continuously.

• 한국사회복지학
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• 제60권3호
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• pp.129-150
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• 2008

본 연구는 노인장기요양보험제도 2차 시범사업 결과를 바탕으로 우리나라 노인의 요양시설 서비스 이용에 영향을 미치는 요인을 탐색해 보고자 하였다. 이론적 모형으로는 앤더선과 뉴만(Andersen and Newman)의 행동주의 모델을 토대로 하여 영향요인을 구분하였으며, 연구방법은 의사결정분석을 이용하였다. 분석결과 서비스 이용에 가장 큰 영향을 미치는 것은 대상 노인의 서비스 이용의향이었으며, 이러한 선행요인 다음 중요한 요인으로 자원 요인(수발자 있음 및 동거가족 여부)으로 나타났다. 욕구요인으로는 인지장애가 있는 경우, 치매로 인한 문제행동이 있는 경우, 기본적 일상생활수행능력에 있어 완전도움을 받아야 하는 경우로 나타났다. 이러한 분석결과는 앤더슨과 뉴만의 행동주의 이론의 과정을 그대로 보여주고 있음을 알 수 있는데, 즉 선행요인과 자원요인에 의해 서비스 이용형태가 달라지며, 이러한 선행요인과 자원요인은 욕구요인과 결합하여 실제 서비스 이용에 영향을 주는 것으로 나타났다. 이를 통해 본 연구는 시설 서비스 이용 대상자의 욕구요인을 정확히 파악하여 이에 적절한 서비스 내용을 구축하고 지역사회 내 시설서비스 이용노인을 선별하는데 기초 자료를 제공하는데 기여하고자 한다.

• 지역사회간호학회지
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• 제29권4호
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• pp.530-538
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• 2018

Purpose: This study tried to identify changes in family burden after the introduction of the long-term care insurance and to examine the factors influencing subjective and objective caring burden and depression of family caregivers of elders receiving home-based long-term care. Methods: Data were collected from 203 family caregivers of elders from August 1 to 31, 2015 using questionnaires. They were analyzed in descriptive statistics, t test, ANOVA test, and multiple regression analysis. Results: The mean score of depression was 7.24, which suggested mild depression level. The subjective family burden was 2.71 and the objective burden 3.04. The factors affecting depression included subjective burden (t=5.08, p<.001), objective burden (t=2.80, p=.006), time of elderly care per day (t=-3.61, p< .001), caregiving duration (t=3.33, p=.001), age (t=3.13, p=.002), family relationship (t=2.48, p=.014), and economic status (t=1.99, p=.047). Conclusion: The family burden was most important influencing factor on caregiver's depression. Therefore, services and supports to alleviate caregivers' burden in the home-based care should be added to long-term care.

• 한국임상약학회지
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• 제26권1호
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• pp.13-23
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• 2016

Background: South Korea is rapidly being an aging-society and the demand of long-term care insurance services for elderly patients is rising. In addition, because the elderly taking multiple medicines, the adherence is lowered and the adverse events are easily occurred. Therefore, many are interested in introducing the geriatric pharmacy specialist to manage this situation. Purpose: By applying a similar program such as the geriatric pharmacy specialist working in nursing home, we conducted this study to evaluate the potential contribution to both the health insurance services and financial savings for the elderly patients. Methods: We conducted a trial in an elderly nursing home to collaborate between doctor and pharmacist making a checklist for improving medication adherence and establish a consultation system. Also we applied a smart phone application in the pharmaceutical care processes. Results: Thereby completing the drug therapy related checklist apply to nursing facilities in South Korea. And we got a performance that improves medication adherence when used in the clinical practice settings. Conclusion: By introducing a training program of pharmacy care managers and geriatric professionals such as the United States and Japan, we revealed the elderly nursing home residents and vulnerable elderly people living alone were improved the medication adherence and it will contributed to the health and quality of life of the patients.