• 가정간호학회지
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• 제12권1권
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• pp.70-91
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• 2005

Purpose: Long-term care facilities have a responsibility to provide care service that enables residents to maintain their maximal functional capacity and quality of life. Also their needs must be reflected to the service programs. In oder to provide an adequate service, we should assess the elderly's physical, psychological and social health status and the need. In addition to this, the long-term care facilities must be defined clearly by the type of services. This study would contribute to conduct appropriate services in public long-term care policy for the older population in the future. This study would provide informations of long-term care facilities' services and older persons' needs for long-term care. Method: To achieve this objectives, this paper investigates the types, service programs of long-term care institutes and job descriptions of workers. The subjects were consisted of 150 long-term care institutes. 150 institutes of long-term care facilities were drawn from all over the country by a nonrandom, convenience sampling. The data were analyzed by frequency, percentage, $x^2$-test using SPSS program. The instruments of this study were self-reported questionnaires for long-term care institutes. The data were collected from March 1, 2004 to may 31, 2004. Results: Service programs of long-term care institutes were not enough for residents' demands. The job descriptions among nurse, social worker and physical therapist were not clearly defined. The nurse's main role was medication and checking vital sign(49.7%), that of social worker's was observation and supervising (31.2%). The most significant problems were lacking of diverse service programs for residents. Conclusion: Considering these findings and conclusion, the needs of long-term care services should be provided by individual physical and psychological level. And the professional manpower for elderly should be educated in multi disciplines.

• 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.

• 한국보건간호학회지
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• 제19권1호
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• pp.148-160
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• 2005

Presented here are policy alternatives for understanding home health care for the long-term health care insurance system which is being developed for elderly people starting 2007. The summary of issues concerning home health nursing care under the long-term care insurance system include; 1) absence of comprehensive and systematic policy in home health care deliverly systems; 2) absence of community based home health agencies that are considered as the community residents in general. In order to overcome these problems and Issues, policy alternatives of home health care should 1) establish a comprehensive home health care policy for homebound persons; 2) establish the foundations for home health care nurses and community based home health care systems; 3) establish home health care facilities and infrastructure; and 4) promote research and development concerning home health care. Conclusively, a home health care system should be built on a comprehensive policy vision based on health policy, especially long-term care insurance system in the near future. Every homebound residents service has to be constructed systematically under suitable facilities considering the consumer characteristics and health conditions. By doing this, the consumer based comprehensive community home health care delivery system can be constructed in view of the long-term health care insurance system for elderly people.

• 한국콘텐츠학회논문지
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• 제19권1호
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• pp.587-597
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• 2019

우리나라 인구의 빠른 고령화와 일상생활이 어려운 노인들이 증가하여 사회적 연대를 위한 노인장기요양 제도가 실시되었다. 제도 도입 후 나타난 장기요양제도의 구조적 문제 해결을 요구하고 있으며 기관 및 급여유형별로 통합된 요양서비스 제공체계, 노인의료-요양의 연속성 부족에 따른 요양병원-시설 간 기능정립 문제 등도 제기되고 있다. 이 연구에서는 문제점을 개선하기 위하여 입소정원, 종사인력, 제공서비스와 관련한 연구문제를 설정하였으며 FGI를 실시하였다. 연구결과 지역 내 노인 인구와 인정자 수, 노인성 질환자수 등 장기요양 수요를 반영, 지역별 적정 기관 및 인력 수급 정책 방향 제시하고, 지자체별 목표와 수급계획을 수립하여, 장기요양기관 지정요건 절차 강화 및 지정 갱신제 등 인증제도 도입이 검토되어야 하며, 남성요양보호사 육성 및 수가 인상 등을 통한 종사자 처우개선을 통하여 원활한 인력수급이 필요하다고 보았다. 급식비의 보험적용과 유관기관과의 연계를 통한 프로그램 확대제공, 원활한 입소관리를 위한 의료외 사고 중재기구가 필요하다고 나타났다.

• 융합정보논문지
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• 제10권3호
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• pp.134-140
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• 2020

본 연구의 목적은 노인요양시설 거주 노인과 비거주 노인의 구강건강상태를 비교하는 것이었다. 연령, 성별, 기초생활수급상태가 동일한 469명을 매칭하여 구강건강상태를 비교분석하였다. 노인요양시설 거주 노인들은 시설 비거주 노인보다 치아우식 우병률(p=0.019), 우식영구치수(p=0.001), 상실영구치수(p=0.047)가 더 높았고 충전영구치수(p<0.001)는 더 낮은 것으로 확인되었다. 시설 거주 노인들은 비거주 노인들보다 치아우식에 유병될 확률이 1.93배 더 높았고, 충전치아를 가지게 될 확률은 0.73배였다. 의치를 장착하게 될 확률은 상악이 0.15배, 하악이 0.13배였으며, 의치필요도는 상악이 5.61배, 하악이 5.65배였다. 의치 장착여부 및 필요도에 대한 보정된 오즈비는 모두 유의한 것으로 나타났다. 이 결과를 바탕으로 노인요양시설 거주 노인의 구강건강증진을 위한 구강보건정책 수립을 위한 근거 자료로 활용할 수 있을 것으로 생각된다.

• 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.

• 한국사회복지학
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• 제60권3호
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• pp.129-150
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• 2008

본 연구는 노인장기요양보험제도 2차 시범사업 결과를 바탕으로 우리나라 노인의 요양시설 서비스 이용에 영향을 미치는 요인을 탐색해 보고자 하였다. 이론적 모형으로는 앤더선과 뉴만(Andersen and Newman)의 행동주의 모델을 토대로 하여 영향요인을 구분하였으며, 연구방법은 의사결정분석을 이용하였다. 분석결과 서비스 이용에 가장 큰 영향을 미치는 것은 대상 노인의 서비스 이용의향이었으며, 이러한 선행요인 다음 중요한 요인으로 자원 요인(수발자 있음 및 동거가족 여부)으로 나타났다. 욕구요인으로는 인지장애가 있는 경우, 치매로 인한 문제행동이 있는 경우, 기본적 일상생활수행능력에 있어 완전도움을 받아야 하는 경우로 나타났다. 이러한 분석결과는 앤더슨과 뉴만의 행동주의 이론의 과정을 그대로 보여주고 있음을 알 수 있는데, 즉 선행요인과 자원요인에 의해 서비스 이용형태가 달라지며, 이러한 선행요인과 자원요인은 욕구요인과 결합하여 실제 서비스 이용에 영향을 주는 것으로 나타났다. 이를 통해 본 연구는 시설 서비스 이용 대상자의 욕구요인을 정확히 파악하여 이에 적절한 서비스 내용을 구축하고 지역사회 내 시설서비스 이용노인을 선별하는데 기초 자료를 제공하는데 기여하고자 한다.

• 응용통계연구
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• 제26권5호
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• pp.725-736
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• 2013

최근 노년기의 삶에 대비하기 위한 은퇴자금 마련이 중요한 개인적, 사회적 문제로 부각되고 있다. 특히, 앞으로 노년인구의 비율이 지속적으로 상승할 것이라는 전망과 더불어 이러한 개인의 재무설계 및 그와 관련한 리스크와 관련한 문제는 그 중요성이 날로 커질 것이다. 노년기의 질병에 따른 의료비 지출은 특히 재무적인 리스크와 밀접한 관련이 있는데, 유병 기간이 상대적으로 긴 질병의 경우에는 수발비용을 포함한 장기적인 의료비 지출로 인하여 재무적인 위험을 증가시키고 노년기의 삶의 질을 크게 떨어뜨릴 수 있다. 따라서, 각 개인이 장기적인 비용 지출을 요하는 질병에 대하여 예상되는 비용의 규모를 파악하고 이를 사전에 대비할 수 있는 방안을 모색하는 것이 필요하다. 본 연구에서는 노인장기요양보험의 실적 자료와 다중상태모형을 토대로, 노년기에 노인장기요양보험을 통하여 장기요양보호가 필요한 기간과 이에 따른 비용 규모의 추정을 통하여, 각 개인이 장기간병을 위해 준비해야 하는 필요금액을 도출하여 보았다.

• 가정간호학회지
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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.

• 대한간호학회지
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• 제34권2호
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• pp.278-289
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• 2004

Purpose: The purpose of this study was to classify the elderly in long-term care facilities using the Resource Utilization Group(RUG-III) and to examine the feasibility of a payment method based on the RUG-III classification system in Korea. Method: This study measured resident characteristics using a Resident Assessment Instrument-Minimum Data Set(RAI-MDS) and staff time. Data was collected from 530 elderly residents over sixty, residing in long-term care facilities. Resource use for individual patients was measured by a wage-weighted sum of staff time and the total time spent with the patient by nurses, aides, and physiotherapists. Result: The subjects were classified into 4 groups out of 7 major groups. The group of Clinically Complex was the largest (46.3%), and then Reduced Physical Function(27.2%), Behavior Problems (17.0%), and Impaired Cognition (9.4%) followed. Homogeneity of the RUG-III groups was examined by total coefficient of variation of resource use. The results showed homogeneity of resource use within RUG-III groups. Also, the difference in resource use among RUG major groups was statistically significant (p<0.001), and it also showed a hierarchy pattern as resource use increases in the same RUG group with an increase of severity levels(ADL). Conclusion: The results of this study showed that the RUG-Ill classification system differentiates resources provided to elderly in long-term care facilities in Korea.