• Health Policy and Management
• /
• v.21 no.3
• /
• pp.381-396
• /
• 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.

• Health Policy and Management
• /
• v.21 no.1
• /
• pp.115-131
• /
• 2011

Several common issues are encountered by countries - Germany, Japan, and the United States - that adopted long-term care (LTC) system. First, the demand for LTC and its associated costs have steeply risen following the implementation of the LTC policy. Second, ensuring the quality of services have been difficult. Third, the coordination of services among providers and between LTC and medical care has been inadequate. Learning from their experience, we suggest ways to improve the LTC system in Korea. The basic approach aims for efficiency over equity in the system. This would require promoting provider competition and consumer choice. We propose several policy options according to the major stakeholders. For consumers, cash benefits at fixed rates and personal savings accounts are feasible options to self-contain the demand and cost of services. On the insurer's side, creating an environment of multiple insurers will engender competition, leading to cost savings and quality care. For providers, delivery of quality services through competition, cost-containment through capitated reimbursements, and coordination of services through integrated delivery system can be achieved. From the assessors' perspective, establishing an information system to monitor the activities of insurers and providers would be important, empowering consumers with information to choose cost-effective service providers. In summary, the suggested approach would provide cost-effective LTC services by guaranteeing consumer choice and promoting major stakeholder accountability. Further studies are needed to test the feasibility of this model in ensuring quality LTC in Korea.

• Journal of the Korea Society of Computer and Information
• /
• v.25 no.8
• /
• pp.119-128
• /
• 2020

In this research, a survey was done on two hundred and forty-six elders who receive care through LTC to verify the effect of market attributes on the user satisfaction of the Long-therm Care Service. The collected data were analyzed through SPSS 23.0 statistics program. This study reveals the following results: First, in service tangibility, competitiveness, administrative regulation, organizational process, and autonomy in choice all have a positive relation with user satisfaction. Second, in the aspect of credibility, house ownership, competitiveness, administrative regulation, and freedom in choice show a positive-relation with user satisfaction. Third, in responsiveness, the scale of the organization, monthly income, competitiveness, administrative regulation, organizational process, and autonomy in choice have a positive effect on user satisfaction. Forth, in assurance ability, monthly income, competitiveness, administrative regulation, organizational process, and autonomy in choice also positively affected user satisfaction. Lastly, in the aspect of perceptual openness, competitiveness, administrative regulation, organizational culture, organizational process, and autonomy in choice show a positive relationship with user satisfaction.

• 한국노년학
• /
• v.31 no.4
• /
• pp.871-884
• /
• 2011

Standard Long-term care(LTC) Utilization Plan is a kind of care plan, which aims to help beneficiaries and their family choose services to meet their care needs. The objective of this study is to determine the relationships among family caregivers' perceived quality, overall satisfaction and utilization in Standard LTC Utilization Plan. Data were gathered from family caregivers with beneficiaries who have used community service in long-term care insurance system. A national cross-sectional descriptive survey was conducted in December 2008, using proportionate quota sampling. Finally, 351 family caregivers completed questionnaires which included demographic characteristics, perceived quality(9 items), overall satisfaction(1 item) and utilization(2 items). Path analysis was conducted to find a causal relationship. This study shows firstly, the quality of Standard LTC Utilization Plan was categorized into three dimensions, that is, assessment of care needs, recommended care plan, and management of monthly benefits. Secondly, reliability and validity of quality items were satisfied. Finally, in the effect of perceived quality and satisfaction for utilization, assessment of care needs(indirect effect, path coefficients=0.077) and overall satisfaction(total effect, path coefficients=0.324) were statistically significant. The findings of this study would be helpful in developing the strategies, which is needed to improve the role of Standard LTC Utilization Plan.

• The Korean Journal of Applied Statistics
• /
• v.30 no.3
• /
• pp.391-401
• /
• 2017

This study develops an indicator to manage regional variations of approval rates for long-term care (LTC) service. We used LTC insurance data for grade assessment that include 433,155 applicants from 227 LTC centers across Korea in 2015. The approval rate for each center was defined as the proportion of the numbers of approved applicants out of all applicants. We assumed that the approval rates depended on the characteristics of applicants. We estimated the 'standard' approval rates from a multiple linear regression analysis using the characteristics of applicants as independent variables. The difference between the observed and the standard rates was then defined as an indicator for deviation. A center having a large difference could be considered as a center with a potential error in grade assessment. We also examined if the characteristics of investigators affected the approval rates. We found that the socio-demographic characteristics of applicants and reapplication rate for LTC grade were independent factors affecting the approval rates. Centers having the management indicator values falling outside the middle 95% of the distribution were identified as centers with an error in grading. We expect that this study will contribute to enhancing reliability and equity in LTC grading.

• 한국사회정책
• /
• v.25 no.1
• /
• pp.287-320
• /
• 2018

This study aimed to analyze the characteristics and problems of the quasi-market for welfare technology in the long-term care service area in South Korea. The qualitative interviews to the developers of welfare technology were conducted. The main results are as follows. First, the long-term care insurance (LTC) in South Korea has helped to create the limited amount of the effective demands for welfare equipments with low technology. Second, the systemic features of the LTC, however, have constraint the quantitative expansion as well as qualitative growth of the quasi-market for welfare technology. The low level of financial support combined with strict regulations has obstructed qualitative competition in the market. Third, they tend to develop the standardized and minimum welfare equipments for the serious needy for long-term care instead of welfare technology promoting independency of the elderly. Based on the results, this study provided the predictions for the growth of welfare technology and suggested some policy implications.

• The Journal of the Convergence on Culture Technology
• /
• v.5 no.4
• /
• pp.99-104
• /
• 2019

The purpose of this study is to investigate the effect of emotional labor behavior of employee at geriatric long-term care(LTC) facilities on job burnout and service quality focusing on the emotional leadership of superior to improve the working environment of LTC employee and provide the high-quality service to seniors. First, it is appeared that between emotional labor behaviors deep acting has a negative effect on job burnout, in contrast surface acting has a positive effect on job burnout. and, emotional labor behavior has positive influence on service quality. Second, self efficacy has partial mediating effect of tangibility, reliability, assurance and empathy on service quality only for the deep acting between emotional labor behaviors. Third, between emotional labor behavior, emotional leadership has moderating effect on emotional depletion and deterioration of personal accomplishment. In contrast, moderating effect of emotional leadership is not appeared on surface acting and depersonalization. In conclusion, further study is required to improve service quality of elderly in LTC facility and working environment of LCT facility workforce.

• Journal of the Korea Convergence Society
• /
• v.10 no.9
• /
• pp.343-349
• /
• 2019

This study used data from the 3rd and 11th year of the Korean Welfare Panel to evaluate the effects of the Long-Term Care Insurance(LTCI) system on the consumption and expenditure of LTCI users' households. The study consisted of program group using LTCI and control group not using. Chi-square and t-test were used for the characteristic differences among the groups, and the difference of consumption expenditure was identified by multiple regression analysis. As a result, LTCI had a statistically significant effect on the health care costs of LTCI users' households, resulting in an increase in health care costs(${\beta}=3.06$). However, there was no statistically significant effect on the total cost of living, basic cost, education cost, and recreation/entertainment cost. Therefore, in order to show the effect of LTC system, we should try to reduce of self-pay and improve the contents and quality of the service of the LTC system.

• Health Policy and Management
• /
• v.27 no.2
• /
• pp.167-176
• /
• 2017

Background: This study aimed to analyze the impact of community health care resources on the place of death of older adults with dementia compared to those with cancer in South Korea, using public administrative big data. Methods: Based on a literature review, we selected person- and community-level variables that can affect older people's decisions about where to die. Data on place-of-death and person-level attributes were obtained from the 2013 death certification micro data from Statistics Korea. Data on the population and economic and health care resources in the community where the older deceased resided were obtained from various open public administrative big data including databases on the local tax and resident population statistics, health care resources and infrastructure statistics, and long-term care (LTC) insurance statistics. Community-level data were linked to the death certificate micro data through the town (si-gun-gu) code of the residence of the deceased. Multi-level logistic regression models were used to simultaneously estimate the impacts of community as well as individual-level factors on the place of death. Results: In both the dementia (76.1%) and cancer (87.1%) decedent groups, most older people died in the hospital. Among the older deceased with dementia, hospital death was less likely to occur when the older person resided in a community with a higher supply of LTC facility beds, but hospital death was more likely to occur in communities with a higher supply of LTC hospital beds. Similarly, among the cancer group, the likelihood of a hospital death was significantly lower in communities with a higher supply of LTC facility beds, but was higher in communities with a higher supply of acute care hospital beds. As for individual-level factors, being female and having no spouse were associated with the likelihood of hospital death among older people with dementia. Conclusion: More than three in four older people with dementia die in the hospital, while home is reported to be the place of death preferred by Koreans. To decrease this gap, an increase in the supply of end-of-life (EOL) care at home and in community-based service settings is necessary. EOL care should also be incorporated as an essential part of LTC. Changes in the perception of EOL care by older people and their families are also critical in their decisions about the place of death, and should be supported by public education and other related non-medical, social approaches.

• The Korean Journal of Applied Statistics
• /
• v.28 no.6
• /
• pp.1063-1073
• /
• 2015

In the long-term care insurance (LTCI) system, National Health Insurance Service (NHIS) provide counseling services for beneficiaries and their family caregivers, which help them use LTC services appropriately. The purpose of this study was to develop a Target Selection Model for the Counseling Services based on needs of beneficiaries and their family caregivers. To develope models, we used data set of total 2,000 beneficiaries and family caregivers who have used the long-term care services in their home in March 2013 and completed questionnaires. The Target Selection Model was established through various data-mining models such as logistic regression, gradient boosting, Lasso, decision-tree model, Ensemble, and Neural network. Lasso model was selected as the final model because of the stability, high performance and availability. Our results might improve the satisfaction and the efficiency for the NHIS counseling services.