• 한국보건간호학회지
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• 제24권2호
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• pp.285-301
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• 2010

Purpose: The study was aimed at qualitatively enhancing and promoting a home visiting nursing program established in Korea on July 1, 2008, as part of the Long-Term Care Insurance for the Elderly program. Methods: Structural, procedural and consequential aspects of home visiting nursing care wereclassified on the horizontal axis by applying the standard notions for the evaluation of medical care (Donabedian, 1998). At the same time, the home visiting nursing care service support system and the service provision system weredivided on the vertical axis with reference to the accreditation standards for home visiting nursing care organizations suggested by the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO, 2008). The data were collected from June 4, 2008 to October 27, 2008, and were analyzed using SPSS ver. 15.0. Results: Twenty-two (proposed) standards, centered on the standard elements under the conceptual framework of the study, were developed, and comprised structural aspects (n=10), procedural aspects (n=6) and consequential aspects (n=6). Those criteria and indicators underwent two content validity surveys among groups of home visiting nursing care research and training experts. The research produced 22 proposed standards, 50 proposed criteria and 166 proposed indicators. Conclusion: The home visiting nursing care standards developed pursuant to the Long-Term Care Insurance for the Elderly Act and the applicability of these standards need to be verified by home visiting nurses. These proposed standards should prove useful in developing an assessment tool to encourage the qualitative enhancement of visiting nursing care in Korea.

• 보건행정학회지
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• 제16권1호
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• pp.95-116
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• 2006

According to rapid increase of the population of senior citizens, there has been growing concern of Long-Tenn Care(LTC) services recently. Long-Tenn Care services, however, haven't been established systematically in Korea and the supply of LTC services is not sufficient despite the increase in the current social demand. This study aims to estimate the 'Willingness to Pay(WTP)' for LTC insurance which the government plans to introduce by means of social insurance, using Contingent Valuation Method(CYM). In addition, this study analyzes the factors affecting WTP for LTC insurance. An interview survey was carried out to derive WTP for LTC from 450 people who lived in Seoul aged 20 and above during the period from 16th to 21st of June 2003. Double-Bounded Dichotomous Choice Method was applied among several CVMs available to estimate both use value and no-use value of goods. There was pilot survey carried out prior to the main survey. The results show that the average monthly. WTP for LTC provided in home and residential setting is 18,192Won and 19,293Won, respectively. In the case of home care, WTP goes higher depending on reliability of LTC insurance policy and need for LTC insurance, as well as marital status, education and average monthly income. On the contrary, WTP is conversely affected by higher age and higher bids. In the case of institutional care, the factors affecting WTP are similar to those of home care, except age. This study followed NOAA's suggestions generally and the value derived through survey could be reliable. However, there can be the least bias in the process of survey because the CVM should be used under the supposed circumstances. Despite those limitations, it can be concluded that the amount the citizens are willing to pay for LTC is high enough to meet the costs needed to provide LTC.

• 한국노년학
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• 제31권2호
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• pp.371-380
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• 2011

본 연구는 노인장기요양보험제도 도입 전후 의료기관 가정간호사업소 수 및 이용량 변화를 파악하고자 하였다. 건강보험심사평가원으로부터 노인장기요양보험제도 도입 직전 1년(2007.7.1~2008.6.30)과 제도도입 후 혼란기인 6개월 후 1년(2009.1.1-12.30)간 의료기관 가정간호 기본방문료(AN100)가 청구된 자료를 받아 분석하였다. 노인장기요양보험제도 도입 후, 약 40개 의료기관 가정간호사업소가 문을 닫았고, 사업소가 한 곳도 없는 시군구가 전체 시군구 중 53%에서 59%로 증가하였다. 또한, 노인의 의료기관 가정간호 이용은 물론(이용자수 13.4% 감소, 방문건수 20.9% 감소), 비노인의 이용도 감소하였다(이용자수 3.5% 감소, 방문건수 3.9% 감소). 비노인의 가정간호 이용감소는 가정방문 간호사업소의 감소로 가정간호에 대한 접근이 낮아져 나타난 결과로 유추할 수 있다. 가정간호사업소 당 총 수입액은 2009년 1년간 평균 121,850천원으로 최소 인력인 가정전문간호사 2인의 인건비를 감안하면 수익이 크지 않은 것으로 확인되었다. 이 연구결과를 통해 노인의 의료기관 가정 간호 이용감소는 노인장기요양보험 방문간호로 대체된다고 하더라도, 비노인의 가정간호 접근성을 높이기 위해서는 의료기관 가정간호사업소를 확대할 필요가 있다.

• 한국치위생학회지
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• 제16권3호
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• pp.373-381
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• 2016

Objectives: The purpose of the study is to investigate the awareness toward use and service contents of long term care for the elderly. Methods: A self-reported questionnaire was completed by 296 adults from August 13 to October 20, 2014. The questionnaire consisted of general characteristics of the subjects, awareness toward long term care insurance for the elderly, awareness toward long term oral health care services, use of long term care service and use intention for the long term care insurance. Data were analyzed by SPSS 18.0 program. Results: Those who were aware of the long term care insurance accounted for 55.4 percent. Approximately 50 percent of the respondents recognized long term care service items, home visit care, home visit bathing, and home visit nursing. Most of the respondents had information of long term care services by way of mass media and direct contact. Only 13.4 percent of the respondents were aware of the oral health service in the long term care insurance. The subjects were aware of denture cleaning, oral cleaning and oral health education out of oral health service in order; and oral health services that needed to be offered were denture cleaning, oral health education and professional toothbrushing. They reported that dental hygienists were the most important manpower that offered the efficient oral health care services. They answered that professional manpower and financial support are required for oral health services. The positive thinking to long term care insurance accounted for 89.2 percent and 91.3 percent had use intention for oral health services. Conclusions: Many elderly people have mastication or dysphagic problems due to systemic diseases. Therefore, it is necessary to announce the long term care insurance and long term care services for the elderly people.

• 간호행정학회지
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• 제12권2호
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• pp.225-232
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• 2006

Purpose: The purpose of this study was to analyze the services and cost of CVA patients in hospital-based home health care and compare the differences of home health care cost by hospital types. Methods: The subjects of this study were 5,756 home care patients with cerebrovascular disease. Data were collected by using home health care medical expense claims from 127 hospitals in 2004. Results: The home care service 'indewelling catheterization' was the highest(19.28%), and then 'nasogastric tube insertion and change(16.72%)', 'bladder irrigation(15.98)', 'wound management(simple dressing)(10.42%)' followed. Average home health care cost per visit was 39,943 won, and the highest 46,058 won in general hospitals and the lowest 33,922 won in tertiary hospitals, so there were statistically significant among the types of hospitals(F=1112.47, p<0.0001). Conclusions: The number of home health care patients has been rapidly growing with the increase of aged population and demand for home care services is rising. So, it could be urgent to develop a reasonable cost reimbursement system for home health services and to expend scopes of the roles of home care specialist nurses. Amid the demand of more detail understanding the present status of home care, our study can be contributed to provide fundamental information of home care in Korea.

• 한국보건간호학회지
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• 제29권3호
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• pp.403-411
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• 2015

Due to lack of an information system regarding the status of using home-visit nursing (HVN), it has barriers of providing improvement of the HVN for management of elderly health care in Korea. The twofold aims of the current review are to expose the existing agendas for HVN and to suggest the political implications for HVN of Korea based on the transition process and revised HVN system of Japan. This review suggests that an information evaluation system has to precede for HVN services in detail. And, the service provided per manpower should be assessed by separating the code of manpower (registered nurse, nurse aide, dental hygienist) as well as securing detailed and precise information on the HVN services. The other suggestion, development of a community-based home health care nursing model in order to provide necessary services for long-term health insurance beneficiaries. In addition, a master plan for health care for elderly should be established at the national level in order to establish an effective home health nursing delivery system.

• 가정∙방문간호학회지
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• 제21권2호
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• pp.127-138
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• 2014

Purpose: The objectives of this study were to analyze the state of hospital-based home care (HC) services annually and to provide basic information for research and policy regarding home care. Methods: This study is a secondary analysis of the yearly state of HC services from the Health Insurance Review & Assessment Services from 2007 to 2012. Results: The decreased by 34.6%, from 214 agencies in 2007 to 140 in 2012. The annual average number of active home care nurses was 440, which included 6.7% of the licensed home care nurses until 2012. The annual average number of HC patients were 32,000, and this number decreased by 21% in 2012, compared to that of 2008. Of the HC patients, about 70% were over 60 years of age. The chronic diseases among HC patients have been decreasing steadily since 2007. Seventy to eighty percent of the home visits were made in general hospitals or higher level hospitals. The total medical cost for HC services was 21 billion won in 2007, which consisted of 0.06% of the national medical costs, and it was 22 billion won and 0.03% in 2012. Conclusion: Based on the results of this study, further research on HC services is necessary to frame policies for the expansion of HC agencies.

• 가정∙방문간호학회지
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• 제26권1호
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• pp.36-50
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• 2019

Purpose: The purpose of this study is to analyze the status quo of hospital-based home care utilization in Korea from 2008 to 2017. Methods: Data from a total of 1,396 medical institutions, 350,390 patients, and 3,563 home care nurses were analyzed using claim data from the Health Insurance Review & Assessment Service. Results: The number of hospital-based home care agencies decreased from 177 in 2008 to 115 in 2014. This number started to increase in 2015 and reached 179 in 2017. The number of hospital-based home care patients declined from 35,056 in 2008 to a low of 26,848 in 2013. This number started to increase in 2014 and reached 67,863 in 2017. Essential hypertension was the most common disease among hospital-based home care patients from 2008 to 2015. The number of hospital-based home care visits declined from about 500,000 in 2008 to a low of 362,000 in 2013. This number started to increase in 2014 and reached 658,000 in 2017. Conclusion: It is necessary to vigilantly monitor hospital-based home care agencies, patients, and the utilization of services. This may help establish platforms for providing community and home-based nursing services for the super-aged society in Korea.

• 한국전문물리치료학회지
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• 제29권2호
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• pp.94-105
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• 2022

Background: As South Korea enters an aged society, the government has emphasized the need for a soft landing of the older adults into the community after the acute and recovery periods under a national policy of "community care." However, the institutionalization of community rehabilitation services to implement this is insufficient. Japan had already entered an aged society when the Long-Term Care Insurance System was introduced in 2000. Thus, the case of Japan's institutionalization of the system is expected to have implications for us in supplementing a suitable system for the aged society. Objects: This study compared the institutionalization process of the Long-Term Care Insurance System in South Korea and Japan and the services currently being implemented in each country. Methods: To examine the institutionalization process and services of the system, related legal rules and regulations, government reports, and articles were reviewed. To examine the operation status of the system, statistical data provided by each country's government were analyzed. Results: Japan recognized the importance of community rehabilitation even before the enactment of Long-Term Care Insurance. Thus, community rehabilitation services, such as home-visit rehabilitation and health facilities, were already stipulated in the law. Under such institutional legacy, Long-Term Care Insurance was able to establish a service system, which balanced welfare and health-related services, including various types of services with enhanced rehabilitation functions. In South Korea, rehabilitation policies were not much considered in the process of institutionalizing the system; thus, it was composed mainly of services focusing on care and recuperation. Conclusion: In order to realize community care, rehabilitation services need to be developed in Long-Term Care Insurance System in various forms such as home-visit services, daily services, short stay, and facility services.

• 한국노년학
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• 제32권2호
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• pp.467-485
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• 2012

노인장기요양보험 재가서비스의 질 향상을 목적으로 2010년도에 처음 도입된 재가장기요양기관평가제도는 재가서비스 질의 수준을 한 단계 끌어올렸다는 평가를 받고 있지만, 한편으로는 지속적인 제도개선의 필요성이 제기되었다. 재가장기요양기관평가제도의 발전을 위해서는 평가대상자인 재가장기요양기관들의 의견을 수렴하여 제도 개선에 반영함으로써 평가에 대한 피평가기관의 수용성을 높이는 것이 중요하다. 이에 본 연구는 '2010년 재가장기요양기관 평가'에 참여한 피평가기관 중 재가서비스 이용자의 86.7%를 차지하고 있는 방문요양기관의 평가책임자들을 대상으로 평가단계와 평가체계 전반에 대한 인식과 태도를 조사하였다. 조사는 국민건강보험공단 대용량 웹팩스 서버와 전자메일을 이용하여 진행되었으며, 3,487개 방문요양기관 중 473개소가 최종 설문을 완료하였다. 연구결과에 의하면, 평가등급에 따라 장기요양기관평가에 대한 인식과 태도에 차이가 있는 것으로 나타났다. 즉, 평가등급이 높은 기관일수록 평가준비기간이 길었고, 평가에 대한 이해도가 높았으며, 평가항목들이 장기요양서비스의 질을 적절히 평가한다고 생각하고 있었고, 평가결과 통보서의 내용이 기관의 질 개선 활동에 유용하다고 생각하고 있었다. 이러한 연구결과는 피평가기관의 재가장기요양기관평가 제도에 대한 인식과 의견을 제시함으로써 향후 재가장기요양기관평가제도에 대한 개선안을 마련하는데 유용하게 활용될 것으로 기대한다.