• 한국노년학
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• v.39 no.1
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• pp.1-20
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• 2019

Recently, the Ministry of Health and Welfare has emphasized the necessity to build community care, and the interest of health care- long-term care-social welfare system continues. In order to examine the future vision of long-term care for elderly people, which can be a core system in establishing community models for elderly people in the future, we will implement aging in place as a national policy project. It is meaningful to analyze in depth the case of Japan's policy implementation through the amendment process of long-term care insurance system. The purpose of this study is to examine the concept definition, operating system, and major promotion process of the Integrated Care System in Japan and to suggest policy implications for the future Korea long-term care insurance system. As a result of reviewing the operation status and revision process of the long-term care insurance system for establishing the Integrated care system in Japan, it is necessary to clarify the basic principles and construction of community care system, diversification of residence type and upgrading work, establishment of linkage network of health care-long term care-social welfare, expansion of support for family and self-mind.

• 한국노년학
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• v.31 no.2
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• pp.259-276
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• 2011

If frail elderly could use home care services adequately, quality of their life might improve and their costs of service would be decreased. The purpose of this study is to examine the factors on institutionalization of elderly using home care services in Korean long-term care insurance system. This study used the data of '2009 satisfaction survey of Korean long-term care system'. The survey proceeded using sampling data by region, level of long-term care need, and insurance type among beneficiaries from August 2009 to September 2010. The onset dates of institutionalization of 1,230 participants were ascertained from long-term care insurance claim data. This study calculated hazard ratio through Cox Proportional Hazard Model. The results showed that if elderly using home care services suffer a fracture, the hazard ratio of institutionalization is higher significantly. Although not significant, if older persons have more items of damaged cognitive functions, the hazard ratio of institutionalization is higher. The results have policy implications to supplement of home care service system and postpone institutionalization of elderly.

• 한국노년학
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• v.29 no.3
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• pp.917-933
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• 2009

This study examined the factors affecting forms of long-term care service use by elderly and the forms of use are classified facility care service, home care service, and unused. It is used data from the 2nd pilot program for the Long Term Care Insurance scheme and it is analysed 5,497 cases. Multi-nominal regression is used. According to the results, women use formal service more than man do, and wowen use facility care than home care. Those who eligible for National Basic Livelihood Security System(NBLSS) are shown to have higher use of formal care(especially facility care) than the middle income class, and the low income class than the middle income class has lower use of formal care. In addition, higher the family care is available, lower the taking part in the service. The big cities and mid sized cities than rural are used the formal service and moreover mid sized cities are used facility care than home care. Furthermore, the level of care need is determinants of service use and function of ADL, IADL, and abnormal behavior is also determinants of formal service(especially facility care). But nursing need and rehabilitation need are not determinants of formal service use. Based on the results, the recommendations are developed and implemented for the improvement the elderly long-term care insurance.

• 한국노년학
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• v.30 no.4
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• pp.1345-1357
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• 2010

This research, with the participants of the female elderly using a home-visit bath among long-term care services, made an in-depth analysis of what they experience while getting a home-visit bath. We conducted in-depth interviews with 8 elderly people. According to the result, the female elderly experienced the absence of a caregiver, difficulty in carrying out daily life due to physical diseases, getting what they need by themselves, getting comfortable in body and mind, accepting their given situation though feeling shame at getting a bath, and expressing their desires. In addition, they had a close relationship with a care helper. On the basis of the results, a systematic training system which could intensify the professionalism of care helpers was suggested. For the enhancement of the elderly's emotional stability in a long-term care, an integrated case management system was also suggested, which supports the family by organizing an integrated network by region between a long-term care service, home-visit care service, welfare center, and the National Health Insurance Corporation.

• Health Policy and Management
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• v.32 no.4
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• pp.368-379
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• 2022

Background: This study aimed to establish a strategy to improve the poor working environment and working conditions among long-term healthcare workers in Korea. Methods: A total of 600 questionnaires with which long-term health care workers participated in the targeted base areas of each city and province nationwide were distributed directly and 525 responses were collected and 506 responses were analyzed. Surveys, on-site field visits, and in-depth interviews were also conducted to understand the working environment as well as conditions and establish a strategy for improving the working environment among long-term healthcare workers to understand the demands of working conditions and working conditions. Results: Korean long-term care workers firstly and mostly enumerated their risk factors for ill-health when lifting or moving elderly recipients directly by hand (69.9%), followed by increased physical workload with old beds, tools, and facilities (42.3%) in the workplaces, shortage of manpower (32%), and source of infection (30%). To improve the working environment as well as conditions, Korean long-term care workers considered improving low-wage structures, ergonomic improvements to solve excessive physical loads, and increasing various bonus payments as well as implementing the salary system, positive social awareness, and increasing resting time. Of 506 responses, 92.3% replied that the long-term care insurance system for the elderly should be developed to expand publicization at the national level. Conclusion: This study proposes to improve the low-wage structure of Korean long-term care workers, automation and improvement of facilities, equipment, and tools to eliminate excessive physical loads (beneficiary elderly lifting), and reduction of night labor.

• Research in Community and Public Health Nursing
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• v.10 no.1
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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.

• Journal of Korean Biological Nursing Science
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• v.16 no.3
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• pp.244-250
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• 2014

Purpose: The purpose of this study was to investigate medication and related factors including: gender, age, duration of hospitalization, MMSE, and ADL in elderly who were hospitalized in long-term care facilities. Methods: A total of 282 elderly people who were hospitalized for more than a month were asked to fill in a structured questionnaire which was used to collect data regarding their gender, age, duration of hospitalization, MMSE, ADL, and medication. Results: The average number of drugs per patient was 7.50. Subjects taking 6-7 medications were the highest ranking (23.7%). According to multiple regression analysis, the most significant factor relating to the number of drugs prescribed for each subject were the ages of the subjects (p=.007). Conclusion: We found that the number of prescribed drugs taken by those who were hospitalized were related to age. A tailored strategy is needed to decrease the number of drugs according to age and to control the medicines prescribed to the elderly who are hospitalized in long-term care facilities.

• The Journal of the Korea Contents Association
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• v.21 no.11
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• pp.646-656
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• 2021

This study examined effects of attitude toward the elderly, empathy and job stress on quality of service among caregivers in long-term care facilities. The participants were 133 caregivers in C province. Data were collected from May 1 to August 31, 2019 through self reported structured questionnaire. Data analysis was performed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficient, and stepwise regression. Empathy correlated negatively with job stress and correlated positively quality of service. Attitude toward the elderly and job stress were negatively correlated with quality of service. Job stress, empathy and attitude toward the elderly explained 31.6% of variance in quality of service among caregivers in long-term care facilities. The findings indicate that caregivers' job stress, empathy and attitude toward the elderly are important factors to be considered for the improving quality of service among caregivers in long-term care facilities.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.2
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• pp.685-693
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• 2012

The purpose of this study was to develop a dysphagia assessment tool and a intervention program for elderly in the long-term care facilities and to evaluate its effect. The dysphagia assessment tool consists of 20 items was developed through literature review, previous studies and discussion with nursing/medical members. The intervention program consisted of 72 items and participants for evaluation were 50 elders who were registered at long-term care facilities in 4 regions of Seoul. Collected data were analyzed using SPSS Statistics 18.0 and Spearman's Correlation, t-test, and $x^2$-test. After the application of the dysphagia assessment tool and intervention program, the weight in experimental group was increased (t=4.913, p=.000) and the total time of swallowing was reduced (t=-4.557, p=.000) than control group. These findings were statistically significant. Considering these results, by applying the dysphagia assessment tool and the intervention program, the lives of the elderly in long-term care facilities are expected to be improved and emergency situations such as aspiration pneumonia and asphyxia will be decreased.

• Journal of Korean Public Health Nursing
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• v.24 no.2
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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.