• Title/Summary/Keyword: Health care need

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The Effects of Visiting Nursing Services in Long-term Care Insurance: A Difference-in-Difference Analysis (이중차이분석을 활용한 노인장기요양보험제도의 방문간호서비스 효과)

  • Kim, Jieun;Lee, Insook
    • Research in Community and Public Health Nursing
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    • v.26 no.2
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    • pp.89-99
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    • 2015
  • Purpose: The purpose of this study was to demonstrate the effects of visiting nursing services in long-term care (LTC) insurance on changes in health status and physical functions among the elderly. Methods: We analyzed survey data on the living status and welfare needs of the elderly from 2008 and 2011 using the difference-in-difference method with propensity score matching. Results: The subjects were 76 elders including 38 visiting nursing service users(intervention group) and 38 home-based LTC service users (control group). Results from DID analysis confirmed that the subjective health status level of the intervention group was 2.2 points higher (p=.044) and the depression level was 0.3 point lower (p=.039) than the control group. In addition, the intervention group's ADL score was 1.9 (p=.027) and IADL 3.9 (p=.030), showing that their health was deteriorated less. Conclusion: Visiting nursing service in LTC insurance was associated with delayed deterioration of subjective health status, depression, ADL and IADL. These findings suggest the need of rebuilding visiting nursing service programs focusing on prevention services, which will be more contributive to elderly health care and the reduction of social costs.

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

  • Kang Ju Son;Seung-Jin Oh;Jong-Min Yoon
    • Health Policy and Management
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    • v.33 no.3
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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.

Survey on the Occupational Disabled Status using Functional Assessment Tools (간병요양중인 산재환자의 실태 - 산재환자 기능판정도구를 중심으로 -)

  • Choi, Jeong-Myung;Oh, Jin-Joo;Kim, Chun-Mi
    • Korean Journal of Occupational Health Nursing
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    • v.19 no.2
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    • pp.180-189
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    • 2010
  • Purpose: The purpose of this study was to investigate the actual condition of the disabled due to Occupational accidents based on the functional evaluation tool. Method: The data were collected from 2 Workers Accident Medical Corporation, 311 subjects between February and August, 2007. The tool comprised of six components including physical function, cognitive function, communication, emotional and disturbing behavior, nursing skills and rehabilitation needs. Results: Among the disabled, the average point of physical function of 5 was found in 61.92% and to express and understand were evaluated as normal in 36.69% and 33.44%, respectively. Also, hearing and vision were evaluated as normal in 53.50% and 37.98%, respectively. 19.01% of the disabled had emotional problems and 13.78% had disturbing behavior. Most disabled were in need of nursing skills with 97.73% ROM and activities. The 78.18% and 76.90% of disabled were in need of rehabilitation because of right and left leg in full movement disorders, respectively. Conclusion: The evaluation score for the disabled caused by Occupational accidents was diverse showing 10 to 19 points and 140 to 150 points. The result means the care cost should be determined depending on the care needs of the disabled because there is such a diverse range of care needs for them.

Perceptions of Residents Visiting Local Health Centers on the Collaborating Care of Korean Traditional Medicine and Western Medicines (양.한방협진에 대한 지역주민의 인식 - 일부 보건소 이용자를 중심으로 -)

  • Yoon, Tae-Hyung;Park, Hae-Mo
    • Journal of Society of Preventive Korean Medicine
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    • v.14 no.1
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    • pp.37-48
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    • 2010
  • Objective : The purpose of this research was to provide basic data for developing the collaborating care of Korean traditional medicine and western medicines by analyzing the perceptions of residents visiting local health centers on the collaborating care. Method : To this end, a self-administrated questionnaire was surveyed to 417 participants from March 10 to March 19, 2005. The questionnaires were regarding medical preferences, effectiveness, co-operative treatment types, and the demographic characteristics of the study population. The main statistical methods employed for analysis were frequency chi-square test analysis, using SPSS system 12.0 software for Windows. Result : First, the perceptions of collaborating care, such as preference and effectiveness, were better for residents who had experienced Korean traditional medicine(p < 0.05). Second, the most favorable collaborating care type was the neuromuscular disease and rehabilitation, and in particular, the preference of the patient who had experienced Korean traditional medicine was much higher than those who had not experienced it(p < 0.05). Third, as for recognizing the future of collaborating care, respondents insisted that collaboration care has to be conducted under evidence-based research. The reasons why collaborating care has not been active were reported as "difference in solving disease problems between oriental medicine and western medicine." The most important role of the Korean traditional medicines in the public sector was to provide specialized service for the elderly and low income households. Conclusion : Most respondents expected the positive effects of the collaborating care and wanted it to develop, particularly for neuromuscular diseases. As for the health promotion program in health centers, it was more popular than the home visiting program for the elderly and preventive rehabilitation for stroke. Now we must plan to balance between the need of the community and the medical provider on collaborating care.

Community Care for Cancer Patients in Rural Areas: An Integrated Regional Cancer Center and Public Health Center Partnership Model

  • Kang, Jung Hun;Jung, Chang Yoon;Park, Ki-Soo;Huh, Jung Sik;Oh, Sung Yong;Kwon, Jung Hye
    • Journal of Hospice and Palliative Care
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    • v.24 no.4
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    • pp.226-234
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    • 2021
  • Purpose: The accessibility of medical facilities for cancer patients affects both their comfort and survival. Patients in rural areas have a higher socioeconomic burden and are more vulnerable to emergency situations than urban dwellers. This study examined the feasibility and effectiveness of a cancer care model integrating a regional cancer center (RCC) and public health center (PHC). Methods: This study analyzed the construction of a safety care network for cancer patients that integrated an RCC and PHC. Two public health institutions (an RCC in Gyeongnam and a PHC in Geochang County) collaborated on the development of the community care model. The study lasted 13 months beginning in February 2019 to February 2020. Results: The RCC developed the protocol for evaluating and measuring 27 cancer-related symptoms, conducted education for PHC nurses, and administered case counseling. The staff at the PHC registered, evaluated, and routinely monitored patients through home visits. A smartphone application and regular video conferences were incorporated to facilitate mutual communication. In total, 177 patients (mean age: 70.9 years; men: 59%) were enrolled from February 2019 to February 2020. Patients' greatest unmet need was the presence of a nearby cancer treatment hospital (83%). In total, 28 (33%) and 44 (52%) participants answered that the care model was very helpful or helpful, respectively. Conclusion: We confirmed that a combined RCC-PHC program for cancer patients in rural areas is feasible and can bring satisfaction to patients as a safety care network. This program could mitigate health inequalities caused by accessibility issues.

Needs of Home Care Nursing Services for Hospital Patients (재원환자의 질환군에 따른 가정간호 요구도)

  • Han, Sung-Suk;Kim, Soon-Lae;Lee, So-Young;Kwon, Eun-Ha
    • Research in Community and Public Health Nursing
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    • v.18 no.1
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    • pp.165-176
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    • 2007
  • Purpose: The purpose of this study was to investigate the needs of home care nursing services in relation to the patients in hospital. Method: Subjects were 129 patients who admitted hospital and were selected through convenience sampling. Data were collected using the Home Health Care Need Assessment Questionnaire constructed by the Korea Health Industry Development Institute. Data were analyzed using SAS 8.12 program by applying percentage. Results: 1. According to the diagnosis of the subjects, the majority had cancer (25.0%), followed by musculoskeletal disease (15,6%), neuro/cerebral vascular disease (14.1%), digestive (10.9%) and respiratory disease (10.9%). 2. With regard to fundamental nursing service, subjects wanted to receive home care services for the following reasons: Problem identification and diagnosis (77.5%), vital sign check (49.6%); and intake and output measure (20.9%). 3. With regard to clinical laboratory tests, 62.8% wanted to receive blood tests, and followed by urine tests 26.4%, and wound drainage 26.4%. 4. With regard to medication and treatment service, 40.3% of the subjects wanted to receive intravenous fluid therapy, 26.4% intravenous antibiotics, and 26.4% the monitoring of fluid therapy. 5. With regard to therapeutic nursing service, 33.3% wanted to receive wound care, 26.4% ROM exercise, and 27.9% foley catheter change and care. 6. With regard to educational needs, 42.6% wanted education on infection monitoring, 41.4% on medication, and 34.9% on diet. 7. With regard to counseling needs, 65.9% wanted to receive telephone counseling about patient condition, 52.7% counseling about re-admission and 51.9% direct counseling about patient condition. In the group of injury and toxicity, and cardiovascular/circulatory diseases, 100% wanted telephone and direct counseling about the patient condition. Conclusion: Therefore, in order to improve the quality of hospital based home health care services, various factors that affect to the need of home health care should be analyzed and specified nursing care should be looked into.

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Structural Equation Modeling of Self-Care Behaviors in Kidney Transplant Patients Based on Self-Determination Theory (자기결정성이론에 근거한 신장이식환자의 자가간호행위 구조모형)

  • Jeong, Hye Won;So, Hyang Sook
    • Journal of Korean Academy of Nursing
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    • v.48 no.6
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    • pp.731-742
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    • 2018
  • Purpose: The purpose of this study was to test a hypothesis explaining direct and indirect relationships among the factors affecting self-care behaviors of kidney transplant patients, based on self-determination theory. Methods: Data were collected from 222 outpatients with kidney transplantation. The endogenous and exogenous variables of the hypothetical model consisted of healthcare provider's autonomy support, duration after kidney transplantation, basic psychological need satisfaction, autonomous and controlled motivation, depression, and self-care behaviors. Collected data were analyzed using SPSS/WIN 24.0 and AMOS 24.0. Results: The hypothetical model demonstrated a good fit: RMSEA=.06, SRMR=.04, TLI=.94, CFI=.97. Statistically significant explanatory variables for the self-care behaviors of kidney transplant patients were duration after transplantation and basic psychological need satisfaction. Healthcare provider's autonomy support was indirectly significant, while autonomous motivation, controlled motivation and depression were not statistically significant for self-care behaviors. The variables accounted for 59.5% of the self-care behaviors of kidney transplant patients. Conclusion: It is necessary to develop an autonomy support program for healthcare providers to enhance the self-care behaviors of kidney transplant patients. Preventing the deterioration of self-care behaviors will be possible by conducting this program at one year and six years post-transplantation. In addition, the results suggest the need to developing personalized autonomy support programs for healthcare providers that can meet the basic psychological need satisfaction of kidney transplant patients.