• 가정∙방문간호학회지
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• 제24권2호
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• pp.181-188
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• 2017

Purpose: The aim of this study was to compare between performance and requirements of visiting nursing care in long-term care insurance using the OMAHA system. Methods: The subjects were 72 nurses who had worked in a visiting nursing care center in long-term care insurance. Data were collected from December 5, 2016 to January 31, 2017 using self-recorded questionnaires. The collected data were analyzed using descriptive statistics and paired t-tests. Results: Four dimensions of the OMAHA system showed statistically significant differences between performance and requirements of visiting nursing care in long-term care insurance. The requirements of visiting nursing care were higher than was performance on all 40 items of the OMAHA system. The greatest difference was in environmental domain and then the psychosocial domain. Conclusion: Based on the results, we found that the environmental and psychosocial domains were the largest gap areas. Therefore, with the reality of elderly people living alone and the increase in elderly couples, active intervention connected with the community is needed in residential areas. Further, we suggest that the OMAHA system can be utilized as an integrated conceptual framework for developing and enhancing visiting nursing care in long-term care insurance.

• 보건행정학회지
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• 제15권4호
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• pp.136-160
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• 2005

Before introducing the national long-term care insurance in 2008, the want for long term care service has to be estimated and analysed. This study estimates the demand and analyses what determines the want of long term care service. This study investigated data of 3f6 elderlies, that was collected by age stratified random sampling. The elderies resided in Onyang 4 - dong (urban area) and Dogo-myun (rural area) In the city of Asan. The researchers visited the elderlies and their care giver, and assessed their demand for the long term care service and examined physical, mental, socio-economic status by the assessment tools for Korean Long-Term Care System. $64\%$ of the those who are entitled to be served refuse the long term care service. $26.7\%$ of them wants for home care service and $7.9\%$ want facility care service. It is estimated that the want of home care service are three or four times as much as that of facility care service. The demand for long term care service is 5.155 times higher for those who live in rural area (p=0.000), 3.040 times higher for those who do not have spouse(p=0.057), and 3.356 times higher for the people who is in medicaid than medical insurance(p=0.029). However, income(p=0.782), means(p=0.614), living alone(p=0.223), number of family to live with (p=0.341) and age of the elderly(p=0.420) are not related with the demand of long term care service. The assessment tools for Korean Long-Term Care System for need evaluation of the long term care service can reflect the demand well.(p=0.024) If medical care will cover $80\%$ of total cost, the willingness to pay of the out of pocket money of the people with medical insurance is 67,400 Korean Won(66.77 US$) for the home care service and 182,500 Korean Won(180.78 US$) for the facility care service. There is possibility that long term care demand is still small after Introducing the long term care Insurance due to the care given by family members. When developing service delivery system of long term care insurance, rural area has to be given more consideration than urban area because of the higher demand. The people who do not have spouse or are in medicaid have to be given special consideration as well.

• 한국직업건강간호학회지
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• 제29권3호
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• pp.202-207
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• 2020

Purpose: COVID-19 infections have been erupting in places of worship, long-term care facilities, and call centers in Korea since January 2020. This study aims to diagnose and present an infection control system solution for long-term care facilities where at-risk elderly individuals are actively engaged in communal life. Methods: We conducted comparative analyses of infection control systems between long-term care facilities and medical institutions respective of relevant laws and this study's evaluation system. Results: To prepare for future infectious diseases, it is necessary to establish a long-term care facility infection control system and strengthen the standards thereof, to strengthen long-term care facility evaluation standards and to newly establish medical charges for infection control. Conclusion: Systematic procedure fortification and financial support provisions are necessary for infection control at long-term care facilities.

• 보건행정학회지
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• 제20권4호
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• pp.126-138
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• 2010

Objectives : The purpose of this study is to evaluate the effects of assistive products usage on activity of daily living for the beneficiary older adults people in Korean long-term care insurance system. The study subjects were divided to assistive products users and non-users among the beneficiary older adults based on Korean long-term care insurance system to compare function improvement of the activity of daily living. Methods : In national wide 12 community elderly care center enrolled the National Health Insurance Corporation, The numbers of 281 beneficiary older adults(long-term care Grade I: 66, Grade II: 58, Grade III: 157) participated in this study. This survey assessment tool for activity of daily living was used the long-term care assessment instrument of the physical functions in the law of Korean long-term care insurance. The function items of Activity of daily living were included in clothing, washing, tooth brushing, bathing, eating, posture converting, stand sitting, move sitting, out of room, using toilet, controlling of stool, controlling of urine, washing hair. According to independence to complete dependence functioning level, remarks pointed 1 to 3 points. The data were analyzed by chi-square, two-way anova using SPSS V. 12.0. Results : The results appeared that the mean score of the functions in activity of daily living of assistive products users was a 27.60, and that of non-users was a 30.66. Assistive products were not effected in Grade I and II recipients, but that effected in Grade III recipients. Conclusion : Preparing for activation of assistive products based Korean long-term care insurance system, the result application as follows is possible. The usage of assistive products could improve the function of daily living activity in older adults. Related to Grade III beneficiary elderly people were improved function in activity of daily living by using assistive products, it is necessary to extend coverage the non-eligible elderly people in Korean long-term care insurance system.

• 응용통계연구
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• 제24권1호
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• pp.145-159
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• 2011

노인장기요양보험은 2008년 7월에 시작된 이후 제도의 안정적 정착과 발전을 위해 여러 가지 면에서 보완해야할 부분이 많은 상태이다. 그 중에서도 장기요양급여의 진입장벽을 결정하는 등급결정모형을 지속적으로 보완하는 것이 가장 중요하다. 본 연구는 제도 시행 이후 급속히 변화하는 장기요양 시장의 현실을 등급결정모형에 반영하고자 제도 도입 이후의 자료를 활용하여 등급결정모형을 구축하여 현행 모형을 보완하고자 하였다. 등급결정모형을 개발하기 위해 데이터마이닝 기법 중 의사결정나무기법을 활용하였으며, 이것은 현행 모형과 비교가 용이하도록 하기 위한 것이다. 이 모형은 기능상태가 나쁜 사람일수록 장기요양서비스량이 많을 것이라는 가정을 전제로 하고 있으며 장기요양서비스량을 서비스 제공시간으로 보았다. 이 연구는 변화된 현실을 충분히 반영하기 위해 등급결정모형을 보완 하였다는 점에서 의의를 갖는다. 그러나 향후에도 서비스 인프라, 급여 이용자의 특성 등 계속 변화하는 환경을 반영하여 등급결정모형을 보완하고 발전시키는 것이 지속적으로 필요하다고 본다.

• 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.

• 대한간호학회지
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• 제40권6호
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• pp.903-912
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• 2010

Purpose: This study was conducted to examine whether the level of classification for long-term care service under longterm care insurance reflects resource utilization level for residents in nursing homes. Methods: From 2 long-term care facilities, the researchers selected 95 participants and identified description and time of care services provided by nurses, certified caregivers, physical therapists and social workers during a 24-hr-period. Results: Resource utilization level was: 281.04 for level 1, 301.05 for level 2 and 270.87 for level 3. Resource utilization was not correlated with level. Differences in resource utilization within the same level were similar with the coefficient of variance, 22.7-27.1%. Physical function was the most influential factor on long-term care scores (r=.88, p<.001). The level for long-term care service did not reflect differences in resource utilization level of residents on long-term care insurance. Conclusion: The results of this study indicate that present grading for long-term care service needs to be reconsidered. Further study is needed to adjust the long-term care classification system to reflect the level of resource utilization for care recipients on the long-term care insurance.

• 한국노년학
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• 제39권1호
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• pp.1-20
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• 2019

최근, 보건복지부가 커뮤니티케어 구축에의 필요성을 강조하면서 보건의료-요양-사회복지계의 뜨거운 관심이 이어지고 있다. 이에 본 연구에서는 향후 노인대상의 커뮤니티모델을 구축함에 있어서 노인장기요양보험이 어떠한 미래적 비전을 갖고 재검토되어야 하는지를 살펴보기 위해 국책사업으로 지역포괄케어시스템(aging in place) 구축을 추진하고 있는 일본의 정책추진사례를 심층적으로 분석해 보는 것은 그 의미가 있다고 볼 수 있으며 본 연구는 일본의 개호보험제도 개정과정을 문헌검토를 통해 심층적으로 분석하였다. 일본의 지역포괄 케어시스템 구축을 위한 개호보험제도 운영현황과 개정과정을 살펴본 결과, 향후 우리의 경우 1)커뮤니티케어시스템 구축의 기본적인 원리를 보다 명확히 할 필요가 있고 2)노인장기요양보험의 재가서비스 확충, 3)거주유형의 다양화 및 고도화 작업 추진, 4)케어매니지먼트체계 구축, 5)당사자와 가족지원 확대 등의 정책추진이 보다 적극적으로 이뤄져야 할 것으로 사료된다.

• 보건행정학회지
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• 제33권4호
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• pp.479-488
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• 2023

Background: By applying the suggested criteria for needs-based chronic medical care and long-term care delivery system for the elderly, the current status of delivery system was identified and regional delivery systems were categorized according to quantity and quality of delivery system. Methods: National claims data were used for this study. All claims data of medical and long-term care uses by the elderly and all claims data from long-term care hospitals and nursing homes in 2016 were analyzed to categorize the regional medical and long-term care delivery system. The current status of the delivery system with a high possibility of transition to a needs-based appropriate delivery system was identified. The necessary and actual amount of regional supply was calculated based on their needs, and the structure of delivery systems was evaluated in terms of the needs-based quality of the system. Finally, all regions were categorized into 15 types of medical and care delivery systems for the elderly. Results: Of the total 55 regions, 89.1% of regions had an oversupply of elderly medical and care services compared to the necessary supply based on their needs. However, 69.1% of regions met the criteria for less than two types of needs groups, and 21.8% of regions were identified as regions where the numbers of institutions or regions with a high possibility of transition to an appropriate delivery system were below the average levels for all four needs groups. Conclusion: In order to establish an appropriate community-based integrated elderly care system, it is necessary to analyze the characteristics of the regional delivery system categories and to plan a needs-based delivery system regionally.

• 보건행정학회지
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• 제11권3호
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• pp.31-45
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• 2001

With an economic development and epidemiologic transition, the burden of disease due to chronic diseases and accidents is increasing. However, in most of developing countries, long-term care facilities are not available, therefore acute care facilities should provide both acute and long-term care services. It is also true in Korea. The demand for long-term care services needs to be estimated to establish the adequate supply system of health resources. This article introduces the reclassification methodology of inpatients' healthcare utilization to acute and long-term care services. All discharged patients from hospitals for one month were analyzed. The distribution of inpatients' hospital days were fitted to Chi-squared distribution by ICD disease categories, and they were grouped in five clusters. For each cluster, the lower and upper limit of classification criteria to acute and long-term care services were chosen. Summarizing all hospital days corresponding to acute and long-term care respectively, 24 to 28 percent of inpatient services fumed out to be long-term care services. The study results are consistent with those of the existing studies. They can be used practically in the allocation of long-term care resources.