• Journal of Preventive Medicine and Public Health
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• 제43권4호
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• pp.319-329
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• 2010

Objectives: This study was performed to determine the levels of quality of life (QOL) according to the grade of long-term care service for the elderly people who were admitted from long-term care insurance, and to reveal its association with the physical and mental functioning such as the Activity of Daily Living (ADL), the Instrumental Activity of Daily Living (IADL), the Center for Epidemiologic Studies Depression Scale (CES-D), and the Mini-Mental State Examination-Korean version (MMSE-K). Methods: The interviews were performed during the period from March 1 to May 31, 2009, for 958 elderly people in urban and rural areas. The questionnaire items included various indices such as the ADL, IADL, CES-D, and MMSE-K, as independent variables and the index of QOL, as the dependent ones. For statistical analysis, t-tests were used for the mean scores of QOL according to gender and the grade of long-term care services, and Spearman's correlation was used for each variable. The effects of physical and mental functioning for QOL were assessed by covariance structure analysis. The statistical significance was set at p<0.05. Results: The mean scores of QOL among all the subjects was $55.4{\pm}15.62$ (Grade I: $49.7{\pm}14.17$, Grade II: $56.8{\pm}14.62$, Grade III: $59.4{\pm}16.36$), and it was lower according to the higher grade of long-term care insurance. In terms of the correlation matrix of the QOL and the physical and mental function factors, the QOL showed positive correlation with the ADL, IADL and MMSE-K, while it had negative correlation with depression. On the analysis of covariance, mental functioning (depression and the MMSE-K) had a greater influence on the level of QOL than the physical functioning (ADL and IADL). Conclusions: The level of the QOL in the elderly people who were admitted from long-term care insurance was lower according to higher the grade of long-term care insurance. Also, the mental functioning (depression and MMSE-K) was more influential on the level of the QOL than the physical functioning (ADL and IADL).

• 치위생과학회지
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• 제18권3호
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• pp.172-181
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• 2018

In accordance with the aged society, oral health care for the elderly is considered important to maintain general health. Although the role of dental hygienists is essential for proper health management of the oral cavity, research on the care system for the elderly people's oral health and on the role of dental hygienists in the field of elderly welfare is still insufficient. Hence, the aim of this study is to investigate the status of Korean elderly welfare system and dental hygienists by comparing them with those in Japan, a precedent of aged society. First, we compared and investigated the Japanese long-term insurance system, which provides an institutional basis for a long-term care system for the elderly in Korea. Second, the elderly welfare law and care system, focusing on oral care, were examined. Lastly, in elderly care, we analyzed the distinctions between Korea and Japan regarding dental hygienists' role and scope of work. Taken together, as a precedent of aged society, Japan has shown well-specialized and systematic welfare for the elderly compared with Korea. With the development of the welfare system for the elderly in Japan, the role and the work scope of dental hygienists have been expanded to improve quality of life of elderly people, as a key professional for elderly oral care. Therefore, we should perceive the need for improvement of long-term care insurance and the expansion of dental hygienists' work in Korea. In conclusion, these results could be used as basic data for improving the elderly welfare system and developing dental hygienists in Korea.

• 보건행정학회지
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• 제32권3호
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• pp.258-271
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• 2022

The rapidly aging trend of Korea is a major factor that threatens the sustainability of the long-term care insurance system. Therefore, looking at how Japan and Germany mitigated the financial burden when they managed similar long-term care insurance systems will provide important implications for improving the Korean system in the future. The study was conducted using the literature review method, and the "country" was set as a unit for the case analysis. The three countries selected are Korea, Japan, and Germany. Recently in Korea, the insurance premium rates of all subjects have been rapidly rising, which can exacerbate the issue of intergenerational equity. On the other hand, Japan has responded to the aggravating finances for long-term care insurance due to aging by raising coinsurance for selected groups like the wealthy elderly. Germany is selectively raising the insurance premium rates by additionally increasing the premium rate for childless recipients. A more preventive and quality-oriented care service plan can be promoted by referring to the recent changes in Japan and Germany. In addition, a more effective and selective increase in payment burden in Japan and Germany could be considered in response to a recent equity issue in Korea.

• 한국직업건강간호학회지
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• 제16권1호
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• pp.58-66
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• 2007

Purpose: A national long-term care system for elderly and the disabled has its unique evolution in each country. Japan, Germany and the United States may be the typical examples of respective social insurance system. This paper reviews the counterpart examples of Japan, Germany and the United States and looks at their accumulated long-term care system experiences and personal care system under workers' compensation. Methods: Literature review and website searching were conducted. Key words as 'workers' compensation insurance', 'personal care benefit' and 'long term care' were used in searching the related literatures. Results: Though the personal care benefit under current Workers'Compensation in Korea is very similar to Japan's, the long-term care system of Korea is not as well established. Germany and the United States have the provision of personal care benefit for injured workers within long term care system. Conclusions: We recommend some key issues to take into account for improving personal care benefit system in workers' compensation in Korea as follows: providing a comprehensive coverage through the linkage of long term care, introducing an assessment & evaluation system for the appropriate benefits, establishing insurer's role for quality management of personal care service, and developing a policy for family caregivers.

• 보건행정학회지
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• 제21권3호
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• pp.381-396
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• 2011

This study is to investigate the factors affecting the regional rate of certification for long-term care insurance benefits. Analyzed data were the 253,935 certified beneficiaries (equivalent to 4.9% of total elderly population) as long-term care degree (LTC degree) 1~3 extracted from the applicants for long-term care in the beginning stage of the system from April 15 2008 to July 1 2009. Although the data were collected from individuals, after restructured into regional data and then analysed in the unit of 225 administrative regions for the Korean Long-term Care Insurance. The rate of certification was operated as the percentage of people of LTC degree 1~3 to the elderly population in each region. The average rate of certification among regions was 4.91%, and ranged from 2.20% to 8.32%. In the analysing regression models, most socio-demographic variables, applicants' disease characteristics, regional service infrastructure, and the certification interviewer's characteristics were included. The most influencing variables were the disease factors of applicants, especially dementia or cerebrovascular disease rather than arthritis, osteoporosis, or fracture patients were strong factors for the regional rate of certification. However, advanced studies adding more explainable factors on the regional variance of certification rate would be necessary to provide political agenda and measures for evidence-based certification process with high reliability and validity for a sustainable LTC system in Korea.

• 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.

• 한국노년학
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• 제31권2호
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• pp.259-276
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• 2011

다른 사람의 도움을 받아야 하는 노인도 적절한 재가서비스를 받으면서 가능한 오래 가정에 머물 수 있다면 그들의 삶의 질을 향상시키고 비용을 절감할 수 있다고 알려져 있다. 이 연구는 노인장기요양보험제도를 시행한 후, 재가서비스 이용자가 시설서비스로 전환하여 입소하는 것에 대한 결정요인을 살펴보고자 한 종적 연구이다. 이 연구는 장기요양급여 이용자와 주수발자를 대상으로 한 '2009년 노인장기요양서비스 만족도 조사' 자료를 활용하였다. 이 연구의 분석대상자는 총 1,230명으로, 이들은 시도별, 장기요양등급별, 의료보장형태별로 비례할당으로 추출된 것이다. 종속변수는 연구대상자가 재가서비스를 이용하다가 시설로 입소하는 데까지 걸린 시간이고, 이것은 노인장기요양급여DB를 연계하여 파악하였다. 또한 이 연구는 Cox Proportional Hazard Model을 이용하여 hazard ratio를 산출하였다. 연구결과에 의하면, 다른 변수들을 보정한 후에도 이용자가 골절을 앓고 있는 경우에는 시설에 입소할 확률이 유의하게 높은 것으로 나타났다. 또한 통계적으로 유의하지는 않았지만 저하된 인지기능의 항목수가 많을수록 시설에 입소할 확률이 높은 것으로 나타났다. 이러한 영향요인들을 감안하여 향후에는 이용자의 욕구를 충족시키는 재가서비스 이용체계를 구축하고 보완하는 정책개발이 필요하다.

• 한국융합학회논문지
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• 제9권7호
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• pp.95-103
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• 2018

본 연구의 목적은 중년층의 노후 준비계획과, 노인장기요양보험제도, 노인장기요양보험제도 내에서 치과의료서비스 분야의 인식도를 확인하고자 하였다. 설문응답대상자들은 노후생활비를 미리 저축하는 비율이 56.1%였으며, 가족들에게 노후 부담을 주기 싫어하는 경향을 나타냈으며,(41.8%) 노후 보살핌은 시설서비스, 간병 제도 등을 이용하고자 하였다. 노인장기요양보험제도에 대해 "조금 알고 있다"는 응답이 36.7%로 나타났다. 또한 장기요양보험제도 내 치과의료서비스의 필요성이 높다고 생각하였다 (98.5%), 만약 서비스가 이루어진다면 참여하겠다고 하는 응답이 92.3%로 나타났으며, 장기요양보험 내 치과의료서비스에 대한 인식 하지 못한 비율이 85.2%로 나타났다. 따라서 노인장기요양보험 내 치과의료서비스부분의 인식 확대가 필요하다. 본 연구결과는 노인장기요양보험 내 치과의료서비스 부분의 추후 제도 개선 시 기초자료로 사용될 수 있을 것으로 사료된다.

• 한국산학기술학회논문지
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• 제13권12호
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• pp.5976-5985
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• 2012

본 연구는 장기요양서비스의 질 제고를 위해 장기요양서비스 이용 노인들의 신체적 및 정신적 기능 상태를 평가해 보고, 그에 영향을 미치는 관련 요인을 규명하고자 시도하였다. 조사대상은 대전지역에 거주하는 65세 이상 노인 중 장기요양서비스 이용자 350명(재가급여 178명, 시설급여 172명)으로 하였으며, 자료 수집은 2011년 2월 16일부터 3월 31일까지의 기간 동안에 표준화된 무기명식 면접조사용 설문지를 사용하여 면접조사를 통해 이루어졌다. 연구결과, 재가급여 노인의 IADL과 MMSE-K는 시설급여 노인보다 유의하게 높았으나 ADL과 CES-D는 유의한 차이를 보이지 않았다. ADL, IADL, CES-D 및 MMSE-K 상호 간의 상관관계를 보면, 재가 및 시설급여 이용노인 모두 ADL은 IADL 및 MMSE-K와 양의 상관관계를 보인 반면, CES-D와는 음의 상관관계를 나타내었다. IADL은 MMSE-K와 양의 상관관계를 보인 반면, CES-D와는 음의 상관관계를 나타내었다. 다중회귀분석 결과 재가 및 시설 급여 이용 노인 모두 ADL과 IADL에 유의하게 영향을 미치는 변수로는 건망증 증상 유무, 규칙적 운동 및 MMSE-K가 선정되었다. 또한 CES-D와 MMSE-K는 주관적 건강상태, 건망증 증상 유무 및 IADL이 유의하게 영향을 주는 것으로 나타났다. 이상과 같은 결과는 장기요양서비스 이용 노인들의 신체적 및 정신적 기능은 개인의 건강상태나 건강관련행위 특성과 밀접한 관련성이 있음을 시사하고 있다.

• 보건행정학회지
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• 제22권4호
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• pp.522-537
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• 2012

The purpose of this study was to analyze the level of the cognitive function and activities of daily living of the beneficiary older adults at home based on Korean Long-term Care Insurance System. A cross-sectional descriptive survey was conducted from November 2010 to May 2011, the final respondents were 1,026 beneficiary older adults taking home visit care covered in Korean long-term care insurance system. The questionnaire included general characteristics of subjects, cognitive function, ADL(Activity of daily living). The data was analyzed using the SPSS 20.0 version. There was significant difference in cognitive function and ADL between 1st Grade, 2nd Grade and 3rd Grade of long-term care classification. The correlated factors of cognitive function were ADL, long-term care grade, disability of arm and leg, limitation of joint, bed sore and tube feeding. The correlated factors of ADL were cognitive function, long-term care grade, disability of arm and leg, bed sore and tube feeding. This study suggests that cognitive functions have to be mainly considered in long-term care grade. It is necessary to make an effort to develop long-term care grade in Korean long-term care insurance system an cognitive function improvement program for the beneficiary older adults. Above all things government will be seriously contemplating of revise contents for long-term care grade to provide quality of care for the older adults.