• Journal of dental hygiene science
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• v.18 no.3
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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.

• Journal of Preventive Medicine and Public Health
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• v.43 no.4
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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).

• Health Policy and Management
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• v.32 no.3
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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.

• Korean Journal of Occupational Health Nursing
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• v.16 no.1
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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.

• Health Policy and Management
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• v.21 no.3
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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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• v.39 no.1
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• pp.1-20
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• 2019

Recently, the Ministry of Health and Welfare has emphasized the necessity to build community care, and the interest of health care- long-term care-social welfare system continues. In order to examine the future vision of long-term care for elderly people, which can be a core system in establishing community models for elderly people in the future, we will implement aging in place as a national policy project. It is meaningful to analyze in depth the case of Japan's policy implementation through the amendment process of long-term care insurance system. The purpose of this study is to examine the concept definition, operating system, and major promotion process of the Integrated Care System in Japan and to suggest policy implications for the future Korea long-term care insurance system. As a result of reviewing the operation status and revision process of the long-term care insurance system for establishing the Integrated care system in Japan, it is necessary to clarify the basic principles and construction of community care system, diversification of residence type and upgrading work, establishment of linkage network of health care-long term care-social welfare, expansion of support for family and self-mind.

• 한국노년학
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• v.31 no.2
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• pp.259-276
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• 2011

If frail elderly could use home care services adequately, quality of their life might improve and their costs of service would be decreased. The purpose of this study is to examine the factors on institutionalization of elderly using home care services in Korean long-term care insurance system. This study used the data of '2009 satisfaction survey of Korean long-term care system'. The survey proceeded using sampling data by region, level of long-term care need, and insurance type among beneficiaries from August 2009 to September 2010. The onset dates of institutionalization of 1,230 participants were ascertained from long-term care insurance claim data. This study calculated hazard ratio through Cox Proportional Hazard Model. The results showed that if elderly using home care services suffer a fracture, the hazard ratio of institutionalization is higher significantly. Although not significant, if older persons have more items of damaged cognitive functions, the hazard ratio of institutionalization is higher. The results have policy implications to supplement of home care service system and postpone institutionalization of elderly.

• Journal of the Korea Convergence Society
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• v.9 no.7
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• pp.95-103
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• 2018

The purpose of this study was to awareness of dental care services in the elderly long-term care insurance system and retirement preparation of middle-aged people. The survey respondents had a 56.1% saving for old age life, And showed a tendency to they don't like depend on one's family(41.8%), elderly care was intended to use facility services and nursing care. 36.7% of respondents answered "I know a little" about the system. Also, the need for dental care services within the system was high (98.5%), If the service is provided, 92.3% of the respondents said that they would participate, otherwise unrecognized rate of dental care services in long-term care insurance was 85.2%. Therefore, it is necessary to expand the awareness of the part of dental care service in the system. The results of this study can be used as basic data for the improvement of the system of dental care services in long-term care insurance for elderly.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.12
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• pp.5976-5985
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• 2012

This study was performed to determine the levels of physical and mental functioning and to reveal its association with related factors in the elderly people received long-term care insurance services. The interviews were performed, during the period from February 16, to March 31, 2011, to 350 elderlies admitted long-term care insurance dwelling in Daejeon city and Chungchung provinces. As a results, the levels of IADL and MMSE-K in the elderly received home care insurance services was significantly higher than that of the elderly received facility care insurance services. But the levels of ADL and CES-D was not significant. Concerning correlation of ADL, IADL, CES-D and MMSE-K, the level of ADL was positively correlated with the level of IADL and MMSE-K, whereas negatively correlated with the level of CES-D. IADL was positively correlated with the level of MMSE-K, whereas negatively correlated with the level of CES-D. As a results of multiple regression analysis, the factors of influence with the level of ADL and IADL were selected the variables of amnesia, regular exercise and MMSE-K. The factors of influence the level of CES-D and MMSE-K were selected the variables of subjective health status, amnesia and IADL. AS a above results, the levels of physical and mental functioning in the elderly people received long-term care insurance services implies closely related with the health status and health-related behaviors.

• Health Policy and Management
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• v.22 no.4
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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.