• 제목/요약/키워드: Long term care service

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중고령 장애인의 장기요양서비스 이용의향 예측요인 연구: 중고령 장애인집단내 연령차이를 중심으로 (Factors Affecting Service Use Intention of Long-term Care among the Disabled: Focused on Age Differences of the Disabled)

  • 문용필
    • 한국사회정책
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    • 제25권1호
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    • pp.125-159
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    • 2018
  • 본 연구는 중고령 장애인의 장기요양서비스 이용의향 영향요인을 찾아내고, 각 연령집단의 특성과 영향요인을 규명하는데 목적이 있다. 중고령 장애인을 연령집단으로 구분하여 50-64세 장애인집단과 65세 이상 장애인집단 대상으로 확률효과 패널 로짓 종단분석을 실시하였다. 분석결과, 50-64세 장애인집단과 65세 이상 장애인집단별로 각각 영향요인에 차이가 있는 것으로 나타났다. 요인별로 살펴보면, 소인성 요인에서 연령, 거주지역, 교육수준, 배우자유무가 각 집단의 장기요양서비스 이용의향에 유의한 영향을 주는 것으로 나타났다. 자원요인에서 노인장기요양보험 제도인지여부, 저축유무, 근로소득유무, 주택소유여부가 각 집단의 장기요양서비스 이용의향에 유의한 영향을 주는 것으로 나타났다. 욕구요인에서 만성질환유무, 심리적 건강상태, IADL이 각 집단의 장기요양서비스 이용의향에 유의한 영향을 주는 것으로 나타났다. 이러한 연구결과를 바탕으로 중고령 장애인을 위한 장기요양서비스 제도개선에 대한 학술적, 정책적 함의를 제시하였다.

장기요양대상노인의 비공식적·공식적 자원연계 유형에 따른 서비스 만족도 연구 (A Study on Satisfaction of Service by the Models of Informal-formal Resources Linkages for Long-term Care Elder)

  • 김금열
    • 한국노년학
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    • 제30권4호
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    • pp.1027-1044
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    • 2010
  • 본 연구는 노인장기요양보험제도의 도입으로 공식적 보호가 확대되고 있지만 여전히 장기요양대상노인의 케어에는 비공식적 보호 욕구가 줄어들지 않고 있는 현상에 대해 효과적인 장기요양서비스 제공체계 고찰의 필요성에서 시작되었다. 따라서 본 연구의 목적은 장기요양대상노인의 비공식적·공식적 자원연계 유형을 도출하고 각 유형에 따른 서비스 만족도의 차이를 살펴봄으로서 효과적인 장기요양서비스 제공 모델을 발견하는 것이다. 이를 위해서 비공식적·공식적 자원연계 유형은 장기요양대상노인에게 15가지 케어관련과업을 제공하는 비공식적 보호제공자와 공식적 서비스제공자의 서비스 제공정도를 군집분석으로 구분하였고 각 유형에 따른 서비스 만족도의 차이는 다중회귀분석으로 분석하였다. 연구결과 비공식적·공식적 자원연계 유형은 가족수발 중심형, 상호 보완형, 과업 분리형, 공식적 수발 중심형으로 구분되었고 서비스 만족도가 가장 높게 나타난 유형은 상호 보완형 이었으며 이를 바탕으로 다음과 같은 점을 논의하였다. 첫째, 비공식적 보호와 공식적 서비스가 상호 보완적으로 제공되기 위해서는 공식적 서비스 제공체계에 비공식적 보호제공자의 역할을 결합시키는 노력이 필요하다. 둘째, 15가지 케어관련과업 중 개인적 및 일상생활지원 과업과 건강보호 과업은 서비스 제공자가 분리되어 있어 의료 및 장기요양서비스의 연계를 위한 통합적 케어 방안이 필요하다. 셋째, 공식적 서비스 제공자가 거의 모든 케어를 제공하는 공식적 수발 중심형은 상대적으로 서비스 만족도가 낮게 나타나 이에 대한 대책이 필요하다. 이상의 결과를 바탕으로 본 연구는 장기요양서비스의 효과성 향상을 위해서는 서비스의 양(量)과 질(質)적 차원에서 비공식적·공식적 자원연계 유형을 파악하고 서비스 제공 방안을 모색할 필요가 있다는 제언을 하였다.

장기요양 시설서비스 이용자의 소득수준별 본인부담금에 대한 인식 차이 (Differences in Family Caregivers' Opinions about Out-of-Pocket Payment for Long-Term Care Facilities by Income Levels)

  • 권진희;문용필;이정석;한은정
    • 보건행정학회지
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    • 제27권2호
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    • pp.139-148
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    • 2017
  • Background: The purpose of this study is to investigate family caregivers' opinions about out-of-pocket payment for long-term care (LTC) facilities, and find the differences in the opinions for family caregivers of all different levels of income. Methods: We used the data of the study on out-of-pocket payment in national long-term care insurance, including 1,552 family caregivers with the elderly in long-term care facilities. Results: The average out-of-pocket payment per month was 511,635 Korean won and distributed from 230,750 to 1,365,570 Korean won. The amount of out-of-pocket payment might be affected by not co-payment but the cost of non-covered service. There were differences in them for family caregivers of all different levels of income. Opinions were surveyed about 5 issues. By levels of income, there were differences in their opinions about 3 issues, the financial burden on LTC, the necessity of reducing out-of-pocket payments, and to be willing to pay more for a high quality service. But there were not different opinions about the interruption of LTC service and staying with LTC facilities. Conclusion: These findings suggest that the range of out-of-pocket payment for LTC facility is wide and it can be a burden to lower income group. It should be to prepare the policies to ease the financial burden and support the appropriate LTC use.

요양병원 환자분류체계 개발 (Development of Patient Classification System in Long-term Care Hospitals)

  • 이지윤;윤주영;김정회;송성희;주지수;김은경
    • 간호행정학회지
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    • 제14권3호
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    • pp.229-240
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    • 2008
  • Purpose: To develop the patient classification system based on the resource utilization for reimbursement of long-term care hospitals in Korea. Method: Health Insurance Review & Assessment Service (HIRA) conducted a survey in July 2006 that included 2,899 patients from 35 long-term care hospitals. To calculate resource utilization, we measured care time of direct care staff (physicians, nursing personnel, physical and occupational therapists, social workers). The survey of patient characteristics included ADL, cognitive and behavioral status, diseases and treatments. Major category criteria was developed by modified delphi method from 9 experts. Each category was divided into 2-3 groups by ADL using tree regression. Relative resource use was expressed as a case mix index (CMI) calculated as a proportion of mean resource use. Result: This patient classification system composed of 6 major categories (ultra high medical care, high medical care, medium medical care, behavioral problem, impaired cognition and reduced physical function) and 11 subgroups by ADL score. The differences of CMI between groups were statistically significant (p<.0001). Homogeneity of groups was examined by total coefficient of variation (CV) of CMI. The range of CV was 29.68-40.77%. Conclusions: This patient classification system is feasible for reimbursement of long-term care hospitals.

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노인장기요양보험 방문간호 권고군의 방문간호 이용과 의료 이용의 관계 (The Relationship between Home-Visit Nursing Services and Health Care Utilization among Nursing Service Recommended Beneficiaries of the Public Long-Term Care Insurance)

  • 강새봄;김홍수
    • 보건행정학회지
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    • 제24권3호
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    • pp.283-290
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    • 2014
  • Background: This study aimed to examine the relationship between home-visit nursing services and health care utilization under the public long-term care insurance program in Korea. Methods: We analyzed the long-term care need assessment database and the long-term care and the health insurance claim databases of National Health Insurance Service between July 2011 and June 2012. The sample includes a total of 20,065 home-visit nursing recommended-older beneficiaries who use home-visit nursing and/or home-visit care, based on a standard benefit model developed by the Health Insurance Policy Institute of National Health Insurance Service. The beneficiaries were categorized into home-visit nursing use and non-use groups, and the home-visit nursing use group was again divided into high-use and low-use groups home-visit nursing, based on their total annual home-visit nursing expenditure. Two-part models and negative-binomial regression models were used for the statistical analysis. Results: The home-visit nursing use was negatively associated with the number of outpatient visit and cost, while adjusting for all covariates. The home-visit nursing use was also negatively associated with the inpatient cost among the high home-visit nursing use group. Conclusion: The findings implies home-visit nursing use prevents health care utilization. Further studies and policy strategies that can promote and strengthen home-visit nursing services under the public long-term care insurance are necessary in Korea.

요양병원 노인 입원환자의 특성 및 ADL (일상생활수행능력) 관련 요인 : 환자조사 자료 (2013-2014)를 이용하여 (Characteristics and ADL (Activities of Daily Living) Associated Factors of Elderly Inpatients in Long-Term Care Hospitals : A Survey of Patients (2013-2014))

  • 박영희
    • 보건의료산업학회지
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    • 제10권3호
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    • pp.159-171
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    • 2016
  • Objectives : This study was performed to investigate the characteristics and ADL(Activities of Daily Living) associated factors of elderly inpatients in long-term care hospitals. Methods : Data were collected from the nationwide data of 'Survey of Patients (2013-2014)' administerd by the Ministry of Health & Welfare. The data included in this study consisted of 27,606 cases of elderly inpatients in long-term care hospitals. Results : The survey scores for the elderly inpatients were as follows: 57.6% 'Needed much and total help' with ADL, followed by 26.6% who 'Needed much help', and 15.8% who 'needed minimal supervision' in long-term care hospitals. The ADL score was high in the following categories: women, old age, referred visit, health insurance type, not-recovered & death, transferred, corporate hospitals, small hospital size, low number of physicians per 100 beds, and high number of nursing staff per 100 beds. The inpatients with 'diseases of the nervous system', 'diseases of the circulatory system' and 'diseases of the genitourinary system' were more likely to have high ADL scores. Conclusions : The results of this study suggest that long-term care hospitals should provide active and proper care for patients with high ADL scores and improve medical personnel training as well provide more medical care.

뇌졸중 환자들의 노인전문병원 및 노인요양시설 선택요인과 이용만족도 (A Study of Preference and Satisfaction Factors between Senior Specialized Hospitals and Senior Care Facilities for Senior Stroke Patients)

  • 안광호;손태용;오현주
    • 보건의료산업학회지
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    • 제5권1호
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    • pp.147-158
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    • 2011
  • This study compares the degree of satisfaction and the causes of selecting facilities for stroke patients in the senior specialized hospitals and other senior care facilities. The research results are followed. First, The patients who held the level of senior long-term care used senior specialized hospitals, while the patients who had the level of 2 or 3 degree used senior care facilities. The patients helped by cooperative care service used senior care facilities, and the patients helped by private service or family service used senior specialized hospitals. Second, The patients in senior specialized hospitals had affirmative attitude for their service system, while the patients in senior care facilities preferred their various service systems. In the satisfaction of the facilities, the patients in senior care facilities felt more satisfaction to staff, environment, service, and other factors than the patients in hospitals did. Third, in the result of logistic analysis, the patients had an affirmative attitude in case that they had spouse, experience of senior specialized hospitals or senior care facilities, without senior long-term care insurance. They also valued the service standard and the staff quality. As this study points out, the overall preference is higher in the senior care facilities. So, the stroke patients recognized the new role between the hospitals and the facilities after the establishment of long-term senior medicare system. This research had some limitation for the research areas and numbers. So the data analysis for the types of facility and the responses may not be generalized. However, the standard of choosing facility and satisfaction will be a guideline for establishing a new future role between hospitals and facilities. This result will be used as a basic data for the renovation of long-term senior medicare insurance.

노인복지시설의 급식관리 및 영양 건강 증진에 관한 연구 - 급식과 건강관리 - (Management of Food Service and Health Care in Long-Term Care in Korea - Food Service and Health Care -)

  • 김화영;양은주;원혜숙
    • 한국식생활문화학회지
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    • 제12권3호
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    • pp.331-339
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    • 1997
  • With increases in senior citizens and changes in family structure, the need for long-term care system for elderly is increasing, however, the capacity and environment of Korean facilities are very limited. Health and nutritional status of long-term care residents are worse than free-living elderly. In this study, general food service management and health care practices in long-term care systems were investigated. Questionnaire were sent to the directors of all 162 long-term care facilities in Korea and 81 returned the complete answers. The results showed 1) There are slow but steady increase in long-term care systems in Korea, however, the capacity is far from adequate. Less than 10,000 elderly were resided in the facilities. Most of the systems were free-nursing homes and supported by the goverment. Staffing structure revealed that most of the facilities had a director, a secretary, nurses, but only 21% of the systerm hired a dietitian. It showed the shortage of nurses, physical therapists, and dietitians. Therefore, food purchasing, menu planning, food delivery, and the other food service management processes are handled by non-professionals, such as director, secretary, or cooks. Modified fool frequency questionnaire were used to get the frequencies of each food items used in menu and a menu-analysis was made on the one-day menu provided by the facilities. The results showed relatively satisfactory in nutrients content and food frequencies., however, this was about what was used in menu, not what was eaten by the residents. Therefore this results did not tell that the food intake status of individuals. In most facilities general health checkup was done on a regular basis, and had residents with various chronic degenerative diseases, such as hypertension, neuralgia, stroke, arthritis, diabetes. But the items checked on health checkup included weight, height, blood and urine tests, X-ray test, which suggested that the checkup lists should be revised to accomodate the health problem of the aged today.

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노인 장기요양기관에 대한 현행 평가제도가 조직구조 및 활동에 미치는 영향 (The New-Institutionalism Perspective for Long-term Care Service Evaluation System)

  • 권현정
    • 한국사회복지학
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    • 제66권2호
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    • pp.5-29
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    • 2014
  • 본 연구는 사회학적 신제도주의 관점에서 노인장기요양서비스를 제공하는 조직들이 평가제도를 어떻게 채택하고 집행하는지를 동형화와 분리현상으로 해석하였다. 이를 위해 장기요양서비스를 제공하고 있는 7개 기관을 대상으로 심층인터뷰를 한 자료를 질적 내용분석 하였다. 분석결과, 평가제도가 장기 요양기관의 공식적인 구조에 있어서는 동형화를 이끄는 것으로 나타났다. 그러나 장기요양기관 평가제도가 의도한 공급기관 간 경쟁을 통한 효율성을 촉진하는 방식으로 채택되기보다, 정부자원에 의존하기 위해 강압적으로 평가제도를 채택하는 것으로 나타났다. 이러한 결과는 평가제도가 정부규제에 의해 장기요양서비스를 표준화하는 양상으로 집행되고 있음을 확인시켜주었다. 또한, 동형화에 수반되는 조직의 공식구조와 실제 활동의 분리현상도 부분적으로 관찰되었다. 무엇보다 분리현상은 정부역할로서 조직의 이중구조에서 발생할 수 있는 비효율성의 문제를 개선할 수 있는 평가체계의 운용이 요구되며, 특히 돌봄 서비스의 고유성을 반영한 평가지표에 대한 개선이 시급함을 보여준다.

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요양병원 요양보호사의 치매노인에 대한 낙상 지식, 낙상예방 자기효능감이 낙상예방행위 및 낙상관리행위에 미치는 영향 (The Influence of Fall-Related Knowledge and Fall Prevention Self-Efficacy of Care-Givers Working in Long-term Care Hospitals with Older Adults with Dementia on Fall Prevention Behaviors and Fall Management Behaviors)

  • 임정옥;구미옥
    • 보건의료산업학회지
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    • 제12권4호
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    • pp.155-172
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    • 2018
  • Objectives: The purpose of this study was to investigate the influence of fall-related knowledge and fall prevention self-efficacy of care-givers working in long-term care hospitals on fall prevention behaviors and fall management behaviors for older adults with dementia. Methods: Participants were 125 care-givers working in long-term care hospitals. Data were collected with structured questionnaires from August 7 to 14, 2018. Data were analyzed by t-test, ANOVA, $Scheff{\dot{e}}$ test, Pearson's correlation coefficients, and multiple regression analysis using SPSS 18.0. Results: Fall prevention self-efficacy influence fall prevention behaviors(${\beta}=.55$, p<.001), while fall-related knowledge impacted fall management behaviors(${\beta}=.43$, p<.001). Conclusions: The results suggest that an education program for fall prevention of older adults with dementia in long-term care hospitals should focus on improving the fall-related knowledge and fall prevention self-efficacy of care-givers to increase both the fall prevention behaviors and fall management behaviors of care-givers.