• Journal of the Korean Dietetic Association
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• v.28 no.2
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• pp.67-84
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• 2022

This study aimed to explore the status of food service outsourcing behavior of long-term care institutions (LTCIs) through a cross-sectional survey using a questionnaire administered between July 16th and August 7th, 2020. The survey respondents were either dietitians or facility managers, who worked at 731 nursing homes, 477 group homes, and 673 day-care centers. Approximately 25.9% of nursing homes, 11.7% of group homes, and 33.1% of day-care centers used a managed-services company to operate their food service units. The main reason for outsourcing food service by nursing homes was related to the staffing of dietitians and cooks, whereas group homes and day-care centers outsourced food services due to factors relating to meal costs and the cooking process. Almost all the LTCIs entered into private contracts for outsourced food services. Only a few food service contracts included the types of meals, nutrition standards such as protein and calories per meal, and the parameter or ratio of food cost. Of the respondents, 84.5% from nursing homes, 87.5% from group homes, and 87.1% from day-care centers agreed that the quality of outsourced food services of the LTCIs should be regulated. Meals are essential for maintaining the health and functional status of LTCI users. As more LTCIs outsource their food services, we suggest the following: (1) Increasing the minimum dietitian staffing standards for LTCIs as per the Welfare of Senior Citizens Act and requiring at least one dietitian for every nursing home, (2) Making it mandatory to use a standard food service contract template when drafting food service contract, and (3) Developing realistic standards for food service operations considering the size and operation type of the LTCIs.

• The Korean Journal of Applied Statistics
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• v.24 no.1
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• pp.145-159
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• 2011

National long-term care insurance started in July, 2008. We try to make up for weak points and develop a long-term care insurance system. Especially, it is important to upgrade the rating model of the category of need for long-term care continually. We improve the rating model using the data after enforcement of the system to reflect the rapidly changing long-term care marketplace. A decision tree model was adpoted to upgrade the rating model that makes it easy to compare with the current system. This model is based on the first assumption that, a person with worse functional conditions needs more long-term care services than others. Second, the volume of long-term care services are de ned as a service time. This study was conducted to reflect the changing circumstances. Rating models have to be continually improved to reflect changing circumstances, like the infrastructure of the system or the characteristics of the insurance beneficiary.

• 한국노년학
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• v.34 no.2
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• pp.369-386
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• 2014

The purpose of this study was to develop the classification of home-based long-term care activities and to test its validity. In this study, the taxonomy of long-term care activities was structured according to the service domain and process. Two expert groups participated in making a draft of the taxonomy that was composed of 7 service domains, 22 care needs, 22 service objectives, and 114 activities. Reliability and validity of the taxonomy was tested in a sample of 152 elderly subjects who used the home-based long-term care services. Based on the factor analysis of 114 activities, 21 factors were extracted from 114 activities. Internal consistency of the factors was high. Content validity was confirmed by the CVI. Long-term care insurance grade was used to assess the criterion validity. Among 21 care needs, 12 cares needs were significantly different from their grade. The classification of home-based long-term care activities demonstrated reliability and validity. In conclusion, the use of this classification is recommended while communicating with the elderly subjects, service providers, and the 3rd party payers.

• Journal of Korea Entertainment Industry Association
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• v.14 no.3
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• pp.411-419
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• 2020

With the increasing number of skin care shops, service quality development that can meet the customer needs is needed to obtain differentiated competitive advantage. Accordingly this study was attempted to provide basic data on marketing necessary for operating a skin care shop by identifying the impact of service quality on perceived reciprocity and long-term relationship orientation among the customers using a skin care shop. This study conducted a survey of 290 female customers using skin care shops located in Seoul and Gyeonggi province, Jeollanamdo and Jeollabukdo, and Gyeongsangnamdo and Gyeongsangbukdo through personal visit, e-mail, and post service, and the collected data were analyzed with SPSS Ver. 18.0 and Amos Ver. 18.0. As a result, it was proven that overall goodness-of-fit to the theoretical model of the research hypotheses set in this study is good. In Hypothesis 1, "Skin care specialist's work ability, facility and sanitation, and care products had a significant positive (+) impact on perceived reciprocity," which was partially adopted. In Hypothesis 2, "Skin care specialist's work ability, care products, and devices and tools had a significant positive (+) impact on long-term relationship orientation," which was adopted. In Hypothesis 3, "Perceived reciprocity had a significant positive (+) impact on long-term relationship orientation," which was adopted. Therefore, it can be concluded that skin care specialist's work ability, facility and sanitation, care products, and devices and tools are the service quality elements for allowing customers to feel thankful or encouraging them to visit the skin care shops continuously.

• Journal of Korean Public Health Nursing
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• v.30 no.2
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• pp.259-273
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• 2016

Purpose: The purpose of this study was to explore the barriers and solution of providing long-term care (LTC) services at home for the beneficiaries with mild dementia. Methods: The data were collected by interviewing three focus groups consisting of 10 home-visit nurses and analyzed through the analytic process by Morgan and Krueger. Results: The barriers of providing LTC services for clients were identified as follows: inadequateness of the current LTC model for elderly individuals with mild dementia and inappropriateness of the personal environment for home care. The solutions for these barriers were suggested as follows: building up a safe environment for home care and maintaining an appropriate standard utilization plan of LTC service. Conclusion: The current service model for the beneficiaries with mild dementia should be modified in order to provide comprehensive long-term care services based on their complex needs.

• Research in Community and Public Health Nursing
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• v.22 no.1
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• pp.33-44
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• 2011

Purpose: This study examined the characteristics and service utilization of home nursing care beneficiaries under the Korean Long-Term Care Insurance (LTCI). Methods: We used assessment data and claim data of National Health Insurance Corporation from July to August 2008. Data were composed of subjects who were the beneficiaries of home nursing care. Results; A total of 634 subjects were analyzed. Of the subjects, 57.1% were 75 years and over. The average score of nursing care need was only 0.71 and the percentage of those whose nursing care need score was zero was 58.0%. More than half of the subjects had partially dependent musculoskeletal conditions, and 75.5% had two or more comorbidities. A third of them usedonly home nursing care, and another third used both home nursing care and general home care at the same time. Those who needed sore care used the largest home nursing care benefits. Conclusion: Home nursing care of LTCI performs community-based healthcare services under LTCI. Throughout the past two years, however, it has not been active. Understanding the characteristics of its users is important in order to develop effective strategies for activating home nursing care.

• Korean Journal of Community Nutrition
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• v.18 no.2
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• pp.142-153
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• 2013

The purpose of the study was to examine nutritional management and nutritional care demands of home-visit care service and the nutritional status of serviced elderly. The survey was carried out from $5^{th}$ to $21^{st}$ of January, 2011 among 37 In-Home Service institutions. The number of elderly surveyed by 143 care helpers was 281. Analysis was performed for 203 subjects (male: 44, female: 159). The age distribution was from 50 to 99 years. The grading by long-term care insuranceshowed 18,2% on level 1 and 2, and 81.8% on level 3. For the disease treatment, the proportion of implementing diet treatment turned out to be very low. The proportion of subjects living with their children was 45.3%, and living alone was 29.1%. The proportion of home-visit care among types of In-Home Service was 70%. Subjects who needed additional necessary diet management service turned out to be 40.9%. Diet management was the most necessary services from all levels. MNA (specifiy MNA) scores were significantly (p < 0.001) associated with BMI, mid-arm circumference (MAC), calf circumference (CC), intake problems, and weight loss during the last 3 months. For studied elderly, 45.3% were malnourished, and 46.8% were at the risk of malnutrition by MNA score. Based on the result of this survey, the nutritional care was not systematic on the In-Home Service. Prevention and management of the disease was much better than the treatment to improve the quality of life. We conclude that nutrition management is necessary for the elderly. To improve nutritional status of elderly in home care services, systematic nutrition management should be implemented.

• Health Policy and Management
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• v.30 no.1
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• pp.72-81
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• 2020

Background: The out-of-pocket maximum is one of the distinctive healthcare systems which sets a ceiling on co-payment in order to reduce the burden of households from the unpredictable medical expenditure. However, this leads to an increase in the demand for healthcare services especially in long-term care hospitals (LTCHs) in Korea. Methods: This study analyzed the influence factor of medical service overuse of 165,592 inpatients in LTCHs which out-of-pocket maximum is applied, by utilizing data from the National Health Insurance Service (2016). Based on Anderson Model, the medical service overuse, as a dependent variable, was defined as long-stay admission more than 180 days at the LTCHs. Independent variable was comprised of predisposing factors (gender, age), enabling factors (income level, types of out-of-pocket maximum) and need factors (illness level, patient use of tertiary hospital). Results: The most powerful factor of medical service overuse in LTCHs was availability of pre-payment for the out-of-maximum (odds ratio [OR], 191.66; p<0.001). This tendency was found in high income level status (p<0.001). Furthermore, mild inpatients (OR, 1.50; p<0.001) which had no experience with the tertiary hospitals (OR, 2.06; p<0.001) were more relevant to the medical service overuse in LTCHs, compared to the severe inpatients. Conclusion: It is suggested that a separate standard of out-of pocket maximum with regards to LTCHs is required to secure the beneficial functions of long-term hospitals and prevent unnecessary financial leakage to achieve sustainable and financially sound National Health Insurance.

• Journal of Korean Physical Therapy Science
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• v.16 no.3
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• pp.43-53
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• 2009

Background: The purpose of this study was to investigate the perception of home care team's home based physical therapy in public health center Method: We surveyed 11 questionnaires for hone care team in health center from 1st to 30th, November in 2008. Results: The person who recognized the exclusion fact of home-based physical therapy in long term care insurance was 64.2% in whole 109 people. About necessity of home-based physical therapy, "absolutely necessary" as the person answer was 43.1%. Home-based physical therapy in the insurance must come to be provided with a precedence was 81.3%. About starting time of hereafter home-based physical therapy "after 1 years" the opinion which was 60.7%. Opinion about operation institution of home-based physical therapy "the pubic hospital or health center" was 52.3%. In composition form of the home-based physical therapy team "with the physical therapist and occupation therapist come together" was investigated with 37.4%. Conclusion: As long term care insurance will be developed, discussion about quality- of-service must be continuous and depth. Relates hereupon, the academic, researchers, and the persons concerned must consider the best quality of life improvement of the citizen and prepare the ground which systemic, rational, and actual on starting of home-based physical therapy in long term care insurance.

• Journal of the Korean Home Economics Association
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• v.41 no.6
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• pp.143-156
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• 2003

The present study was initially designed to figure out the general condition of care giving system for the elderly women who need long term care and the level of their depression according to the conditions of care. And This research is intented to present appropriate policy that could help the establishment of supporting system for the fragile elderly women.1 used the data from <2001 National Study on the Needs for the Long-Term Care Elderly> by Korea Health and Population Institute. The results are as follows: First, Two third of all the respondents had serious problems (2-9 activities limits) in Instrumental Daily Living Ability(DAL). Most respondents reported “low” in satisfaction level related to receiving care, meaning the elderly had negative perception for the care from the family. The elderly expected their children to be as the primary care giver and mostly wanted to live with them in the future. Second, The majority of the long term care elderly women haven't used community service facilities very often and said they are not likely going to use the facilities in the future. Third, The respondents reported high in depression level as to lower satisfaction with their children's support, poorer health condition, more reluctant to use service facilities due to the cost, and fewer friends and neighbors resources around them. Therefore I could say that negative factors for the elderly women's psychological health were having unsatisfactory relationship with intimate people, developing physical illness, being in economic difficulties. That is, receiving less help from close family members, shrinking social network, and experiencing economic hardship would have negative effects on elderly women's psychological health. In the basis of these results, I suggest that in the mean time we shouldn't overlook the importance of the private support when we develop the public elderly support system.