• Journal of The Korea Institute of Healthcare Architecture
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• v.17 no.4
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• pp.15-23
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• 2011

Long-term care Insurance system for the Elderly was started to respond to the aged society on July 2008 in Korea. So responsibility of the care for the old is being changed from the family to the society. The introduction of that insurance system has brought the growth of demand for care service. To improve the level of quality for care service providers in long-term care, the role of care worker in providers is recognized as important. But welfare system for the care worker seems to be poor. So the Seoul Metropolitan Council is preparing an ordinance for the care worker and the purpose of this study is for the ordinance as well. Questionnaires, interviews, documentary surveys were used to carry out this study. The results of this study are summarized as follows. The job stability is the most important thing for the care worker, so local government has to make efforts to promote the job stability of care worker. A welfare center for care workers is needed for the health for care workers in the local government. And the local government has to supervise service providers more strictly and evaluate them in treatments of care worker.

• Journal of Korean Academy of Nursing
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• v.34 no.1
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• pp.191-201
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• 2004

Purpose: This study aimed to evaluate economic viability of public health center visiting nurse services for the low-income elderly with long-term care needs. Method: The sample consisted of 252 community dwelling elderly who enrolled in public health center visiting nurse services for three months or more. Data was collected on physical (ADL and IADL) and cognitive impairments of the elderly, contents and frequency of visiting nurse services, cost per visit, and costs of alternative services for long-term care. Result: The mean score of ADL and IADL levels of the elderly was 2.80.4904, which indicated these patients were mostly independent. Eighty four percent of the elderly subjects were cognitively intact. Among visiting nurse services supplied, providing assessment was 34%, followed by education and counseling 26%, medication 22%, and referral. The mean cost per visit was 17,824.1 won, which transformed into a total cost per person per year of 161,130.2 won. Comparing the cost of a visiting nurse service with those of other long-term care alternatives, the visiting nurse service was the least costly alternative, followed by an outpatient clinic, hospital based home care, and nursing home. Conclusion: Overall, the results of the study provide evidence of the economic viability of visiting nurse services for the low-income elderly among long-term care alternatives.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.10
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• pp.336-343
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• 2017

In this study, we analyze the relationship between long-term care workers' emotional labor, professional quality of life, and service quality. The subjects of this study were 211 long-term care workers working in long-term care facilities. Self-administered questionnaires were used. In the research model, emotional labor(surface behavior, internal behavior) was verified using independent variables, with professional quality of life (compassion satisfaction, compassion fatigue) as the parameters and service quality as the dependent variables. The results of this study are as follows. First, the fit of the model was good. Second, the direct effects of emotional labor on service quality were not significant. However, there was a positive correlation between internal behavior and service quality, and a negative correlation between surface behavior and service quality. Third, professional quality of life(empathy satisfaction) was the most influential variable in terms of service quality. The results of this study demonstrate the necessity to payclinical and academic attention to long-term care workers' emotional labor and quality of life.

• Research in Community and Public Health Nursing
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• v.27 no.3
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• pp.272-283
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• 2016

Purpose: This is a comparative study using secondary data from the Korean national long term care (LTC) insurance. Methods: Visiting nursing (VN) service users (n=666) and non-users (n=4,375) were extracted and compared in terms of medical expenditures, length of hospitalization, and annual number of ambulatory care visits to investigate effects of VN services in LTC. Results: Total health care expenditures were compared between the two groups and it was found that VN service users spent about $ 1700 than non-users for their medical costs between 2009 and 2011. The average length of in-hospital stay for VN service users was 19.4 days shorter than that of non-users. However, using VN services did not significantly influence the annual number of ambulatory care visits. Conclusion: The study has found that VN services are effective ways of providing community-based LTC services. We recommend LTC policy makers to further utilize VN services to deliver cost effective health care services.

• Korean Journal of Social Welfare
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• v.66 no.1
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• pp.221-249
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• 2014

This paper has the objectives to define the concept of 'Good Care' which is the service goal we are aiming essentially for the improvement of long-term care service quality, to find out the components for 'Good Care', and to explore the conditions that create a good care. In addition, we tried to find the answer about what is the best way to measure the service quality. For this, I referred the advanced researches which explored the fundamental properties of care and tried to find the answer from the accumulated wisdom of service field through the 5-year long term care service experience. As a result of research, the good care can be defined as helping someone to be able to maintain his own life as maximum as possible with the goal to assure total quality life. The most important condition for good care is making 'a good care relationship'. Without damaging the relationship between care provider and care receiver, the individualized service focusing on the demand of care receiver based on mutual reliability, mutual respect and smooth communication should be provided. For the evaluation system, it is reasonable to set the standard according to the size of each institution for the core quality of facility service and establish the certification system of absolute standard to carry out the quantitative evaluation rather than the relative evaluation in the whole. For the part over the absolute certification standard, it is reasonable for each institution to characterize its own characteristics autonomously and carry out the qualitative evaluation for this. For the evaluation of home visit care service, it is recommended to contain the evaluation contents such as user satisfaction, satisfaction of care worker, how well the case management system of home care service center is operated etc.

• The Korean Journal of Health Service Management
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• v.8 no.3
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• pp.103-112
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• 2014

The purpose of this study is to explore and classify the types of the attitude on a good death of nurses in long-term care hospitals. Q-methodology, which is effective in scientifically measuring individual subjectivity, was used. 151 Q-population were selected through the processes of review of research articles, newspaper articles and interviews. 34 Q-sample were selected from the 151 Q-population and 27 nurses in long-term care hospitals were invited as the P sample. The result of the Q-sort was analyzed using PC QUANL Program. The types of attitude on a good death of nurses in long-term care hospitals was categorized into three. 1) Death in supportive environment 2) a comfortable death in real life 3) Dignity guaranteed death By identifying 3 attitude patterns toward a good death of long-term hospital nurses, this study provides an opportunity for their reflection and recognition toward a good death based on this result and suggests to think about ways to improve the quality of nursing in the current increasing long-term hospitals.

• Journal of Korea Entertainment Industry Association
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• v.15 no.1
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• pp.199-206
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• 2021

As the super-aged society is imminent, the number of people with senile diseases is also increasing, resulting in a lack of facilities and policies as a social problem. National Health Insurance Service is being talked about as a realistic alternative to medical coverage. Long-term care hospitals are classified into acute-stage hospitals and long-term care facilities and are acting as an alternative to reducing medical expenses. However, in long-term care hospitals, which are the core of maintenance rehabilitation, the quality of service issues have been raised seriously. Currently, there is a problem of mass production of refugees from rehabilitation due to a problem of the medical system. In particular, in the preceding study in 2015, the status of long-term care hospitals in Jeollabuk-do was the worst. Therefore, using public data, the general status of long-term care hospitals in Jeollabuk-do, status of frequent disease, status of rehabilitation services, and status of occupational therapy services are to be explored.

• Journal of Korean Academy of Rural Health Nursing
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• v.16 no.2
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• pp.60-68
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• 2021

Purpose: This case report was attempted to present the process of the end of life nursing care provided by the visiting nurse. Methods: The subject was a person who was decided the long-term care Grade 1 and received a visiting nursing service, and the service was terminated on the death, and then was selected as a case with the consent of his family. The data were collected through long-term care benefit provision records and interviews with the visiting nurse. The nursing process was presented by applying the Omaha System. Results: The subject had digestion-hydration problems and respiration problems in the physiological domain, and the problems of role change, caretaking/parenting, spirituality, and grief in the psychosocial domain were identified. Depending on the problem, the end of life nursing care was provided to the subject and family members through activities on physical symptoms/signs, dietary management, end-life care, and coping skills. Conclusion: We expect that if the visiting nurse provides anticipatory guidance on the death process, the subject will be able to prepare for death comfortably with the family at home instead of vague fear of death.

• Communications for Statistical Applications and Methods
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• v.28 no.4
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• pp.393-410
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• 2021

The Korean Long-Term Care Insurance (K-LTCI) provides financial support for long-term care service to people who need various types of assistance with daily activities. As the number of elderly people in Korea is expected to increase in the future, the demand for long-term care insurance would also increase over time. Projection of future expenditure on K-LTCI depends on the number of beneficiaries within the grading system of K-LTCI based on the test scores of applicants. This study investigated the suitability of mixture distributions to the model K-LTCI score distribution using recent empirical data on K-LTCI, provided by the National Health Insurance Service (NHIS). Based on the developed mixture models, the number of beneficiaries in each grade and its variability under the current grading system were estimated by simulation. It was observed that a mixture model is suitable for K-LTCI score distribution and may prove useful in devising a funding plan for K-LTCI benefit payment and investigating the effects of any possible revision in the K-LTCI grading system.

• Health Policy and Management
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• v.12 no.1
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• pp.21-53
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• 2002

The purpose of this study is to measure the resource use of the elderly in long-term care services and to examine the effects of patient and facility characteristics on their use of resources. The data were collected from 510 old people over sixty years of age, residing in five long-term care hospitals and two skilled nursing homes during the period between December 1, 2000 and February 28, 2001. For a full sample, when the first level of RUG(Resource Use Group)-III categories were employed as the proxy of patient severity, facility characteristics, such as location, size and ownership, have large effects on the resource use measured by service intensity, whereas patient characteristics such as severity have little or no effect. The resource use is significantly high if the facility: (1) is located in rural areas (gun): (2) has mare than 200 beds; (3) is a long-term care hospital; (4) is private; and (5) has a low percentage of medical aid patients. The analysis of the resource use in each RUG-III categories, for which ADL(Ability of Daily Living) were employed as the prosy of patient severity, shows a similar result. The loose relationship between the needs of residents and the resource use seems to be closely associated with the ineffective reimbursement system for providers. The current reimbursement system has no provision for quality improvement and reimburses facilities simply according to their types: fee-for-service for long-term care hospitals, and monthly-flat-rate or full-coverage-national-aid for skilled nursing facilities. It will be necessary to develop a more reasonable reimbursement system that takes patient's severity into account and gives incentives for long-term care providers to offer cost-effective services.