• 문화기술의 융합
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• 제8권6호
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• pp.405-411
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• 2022

2008년에 시작된 한국의 노인 장기요양보험은 그보다 8년 먼저 시작된 일본의 개호보험을 원용한 것이다. 양국은 노인의 생활을 지원하기 위하여 지적 정신적으로 약화된 노인의 삶을 지원하기 위한 복지용구 급여제도를 가지고 있다. 본 연구에서는 한국의 복지용품 품목과 일본의 복지용품 품목을 비교·검토하여 한국과 일본의 품목별 특성을 알아보았다. 한국은 배회감지기, 자세변환용구, 요실금팬티 등이 일본보다 앞서서 복지용구로 등록되었으며 일본은 자동소변처리기, 휠체어 전동보조장치, 체위변환기, 이동용 리프트 등이 한국보다 먼저 복지용구로 지정되었다. 또한 일본 후생노동성은 배설예측지원기기의 복지용구 지정을 예고한 상태이다. 한국과 일본이 복지용구 품목들을 발전 시키기 위하여 협력한다면 초고령사회에 양국의 노인의 삶의 질을 향상시키는데 많은 도움이 될 것이다.

• 치위생과학회지
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• 제20권1호
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• pp.1-8
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• 2020

Given that the demand for dental care for elderly individuals is expected to increase according to demographic changes, long-term roadmaps for the current health insurance system should be actively planned. The study aimed to investigate the health insurance system in Korea, compared to that of Japan, and suggest directions for the work of dental hygienists to provide basic data on efficient improvements in the health insurance system. Based on the collected data, the website was used to collect additional related data from Korea and Japan. The most common cause of death in Korea was malignant neoplasms, and most patients were hospitalized for diseases and disorders of the musculoskeletal system and connective tissue. Dental care covered by Korean medical insurance for individuals aged 65 years or older was treatment oriented, such as dentures and implants, while in Japan, treatment-intensive items, such as visiting a dental hygienist for guidance and provision of home-care professional oral hygiene treatment, were covered. The percentages of remaining teeth in Korea and the percentage of remaining 20 teeth were 68.9% in those aged 65 to 74 years and 51.2% in those aged 75 to 84 years in Japan. A strategy for promoting oral health among elderly individuals should be established, and a multilateral intervention approach is required to prevent oral problems from leading to deterioration of whole-body health. The role of dental hygienists in providing comprehensive assessment to elderly individuals is important. In order to provide systemic oral care, it is necessary to introduce oral care systems according to the national policy.

• 보건행정학회지
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• 제32권4호
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• pp.347-355
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• 2022

Background: Since November 2019, long-term care hospitals have been able to provide patients with discharging programs to support the elderly in the community. This study aimed to identify both patient- and hospital-level factors that affect successful community discharge from long-term care hospitals. Methods: A multilevel logistic regression model was performed using hospitals as a clustering unit. The dependent variable was whether a patient stayed in the community for at least 30 days after discharge from a long-term care hospital. As for the patient-level independent variables, an agreement between a patient and the family about discharge, length of hospital stay, patient category, and residence at discharge were included. The number of beds and the ratio of long-stay patients were selected for the hospital-level factors. The sample size was 1,428 patients enrolled in the discharging program from November 2019 to December 2020. Results: The number of patients who were discharged to the community and stayed at least for 30 days was 532 (37.3%). The intraclass correlation coefficient was 22.9%, indicating that hospital-level factors had a significant impact on successful community discharge. The odds ratio (OR) of successful community discharge increased by 1.842 times when the patients and their families agreed on discharge. The ORs also increased by 3.020 or 2.681 times, respectively when the patients planned to discharge to their own house or their child's house compared to those who didn't have a plan for residence at discharge. The ORs increased by 1.922 or 2.250 times when the hospitals were owned by corporate or private property compared to publicly owned hospitals. The ORs decreased by 0.602 or 0.520 times when the hospital was sized over 400 beds or located in small and medium-sized cities compared to less than 200 bedded hospitals or located in metropolitan cities. Conclusion: The results of the study showed that the patients' and their family's willingness for discharge had a great impact on successful community discharge and the hospital-level factors played a significant role in it. Therefore, it is important to acknowledge and support long-term care hospitals to involve active in the patient discharge planning process.

• 보건행정학회지
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• 제32권4호
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• pp.368-379
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• 2022

Background: This study aimed to establish a strategy to improve the poor working environment and working conditions among long-term healthcare workers in Korea. Methods: A total of 600 questionnaires with which long-term health care workers participated in the targeted base areas of each city and province nationwide were distributed directly and 525 responses were collected and 506 responses were analyzed. Surveys, on-site field visits, and in-depth interviews were also conducted to understand the working environment as well as conditions and establish a strategy for improving the working environment among long-term healthcare workers to understand the demands of working conditions and working conditions. Results: Korean long-term care workers firstly and mostly enumerated their risk factors for ill-health when lifting or moving elderly recipients directly by hand (69.9%), followed by increased physical workload with old beds, tools, and facilities (42.3%) in the workplaces, shortage of manpower (32%), and source of infection (30%). To improve the working environment as well as conditions, Korean long-term care workers considered improving low-wage structures, ergonomic improvements to solve excessive physical loads, and increasing various bonus payments as well as implementing the salary system, positive social awareness, and increasing resting time. Of 506 responses, 92.3% replied that the long-term care insurance system for the elderly should be developed to expand publicization at the national level. Conclusion: This study proposes to improve the low-wage structure of Korean long-term care workers, automation and improvement of facilities, equipment, and tools to eliminate excessive physical loads (beneficiary elderly lifting), and reduction of night labor.

• Communications for Statistical Applications and Methods
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• 제18권1호
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• pp.137-146
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• 2011

노인장기요양보험은 고령이나 노인성질병 등으로 인하여 혼자서 일상 생활을 수행하기 어려운 노인 등에게 신체활동 또는 가사지원 등의 장기요양급여를 사회적 연대원리에 의해 제공하는 사회보험 제도로써, 우리나라에서는 2008년 7월부터 시행하고 있다. 신뢰성있는 등급판정을 위하여, 안정적인 수급자의 요양인정점수를 산출하는 것은 노인장기요양보험제도의 시행에 있어 매우 중요한 요소라고 할 수 있다. 본 연구에서는 요양인정점수 산출과 등급판정에 의사결정나무 모형을 사용하였고 안정적인 모형을 위해 원자료의 변환 및 절사, 다양한 분리기준(splitting criterion), 정지규칙(stopping rule)을 적용하였다. 본 연구에서 생성한 모형이 기존의 모형보다 안정적임을 확인하였다.

• 한국산학기술학회논문지
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• 제13권12호
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• pp.5816-5825
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• 2012

인구가 고령화되면서 치매환자는 매년 급증하고 있고 이로 인한 치매환자의 치료 및 관리비용 등 사회적 비용은 크게 늘고 있어 이에 대한 대책이 절실하다. 외국에서도 국가차원에서 치매에 관한 국가전략을 수립하거나 효율적인 치매관리를 위한 국가차원의 대책을 세우거나 관련 법제도를 마련하고 있다. 치매에 대한 법제도적 대응방안으로 노인복지법, 노인장기요양보험법, 치매관리법이 존재한다. 보다 효과적인 치매관리 대책을 위해 관련법과 정책의 추진에 있어서 다음과 같은 개선이 필요하다. 첫째, 치매 검진을 65세 이상노인에 대한 국민건강보험의 건강검진 항목에 반드시 포함시키고 1차 검진에서 이상이 발견되면 진료를 계속 받을 수 있도록 하는 것이 필요하다. 둘째, 치매의 특성상 치매는 증상이 심해질수록 치료 효과가 적고 가족들의 부담도 급격히 증가한다. 치매예방사업과 조기 검진을 통해 치매 발병을 예방하거나 발병 시기를 늦추고 조기 발견하여 치료를 받도록 하여 사회적 비용을 최소화하는 것이 필요하다. 셋째, 현재와 같은 노인장기요양보험법상의 장기요양급여내용의 획일성으로는 경증 치매 등 요양노인의 욕구를 다양하게 충족시키기 어려우므로 등급판정기준 완화와 서비스 이용대상의 확대가 필요하다.

• 한국산업보건학회지
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• 제31권2호
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• pp.156-172
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• 2021

Objectives: To investigate the trends of industrial injuries among long-term health care workers in Korea Methods: T7866 injuries were selected from the total industrial injuries approved by the Industrial Accident Compensation Insurance Act(Occupational Safety and Health Act) among long-term health care workers between 2007 and 2016 in Korea. We analyzied the trends of industrial injuries according to work process, occurrence type, and causes. Results: The industrial injuries among long-term health care workers increased since 2012. The mostly occurred area for industrial injuries were low back areas, which is related that the most serious industrial injuries occurred when the one long-term healthcare worker lift manually the recipient, from bed(ondol, Korean floor heating system) to a wheelchair, bed to bath bed, and wheelchair to bath chair. In addition to this, lack of workforce, increased work intensity due to overwork contributed the increasing of occupational injury. Conclusions: This study suggests that the main causes of industrial injuries were Lack of facilities and equipment for small private long-term care institutions, The physical load that goes into lifting the recipient directly, work intensity such as excessive workload and increased work speed. We suggest that the social publicization of long-term care service for the elderly, avoiding ways to lift recipients directly, introducing lifting machines as well as improving working methods, and reducing the workload of caregivers are required.

• 대한물리치료과학회지
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• 제14권1_4호
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• pp.25-36
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• 2007

The results of researching on duties of physical therapist, understanding of elderly diseases and policies related with elderly welfare came out from the survey before beginning of education to physical therapists who attended National Elderly Welfare Physical Therapist Workshop during Sep. 11th to 14th, 2007. They have already understood about long-term elderly care insurance from the policy, and responded that those policies will bring more advantage to elders. On contrary, negative response had reason of low service quality. About elderly care system, there were positive answer of appropriate alternatives to support them, but also other critics had opinion of inevitable choice for living conservation. About understanding of elderly diseases, there were more comprehension of diseases as age gets higher, but most did not understand dementia and paralysis. Past experience and process of medical treatment for their disease were such arthritis, paralysis, broken bone, and dislocation of joint. Prognosis of technical training was mostly answered positively, but linking with other related disease programs were not welcomed. Most respondents thought that professional training were needed. The results of understanding diseases during senescent had high percentage of understanding as age and education was high, and it had eye upon statistics of the survey (p < 0.05) Most of those questioned responded that it is appropriate to have six working days per week and eight hours of daily work, however, present wage is not reasonable. Most of those questioned had negative response of work independence, and had an-swered that there should be certificates needed in related fields. For difficulties during work period, they had hardship instituting direction of treatment by lack of program, level of wage, and physical difficulties. Physical therapists averagely wished to have fewer than thirty patients per therapist. After the research, physical therapists who work in those facilities of elderly care systems agreed on policies, though it should not lower service quality. In addition, they were pros to have elderly care system, yet they are still inevitable option to maintain living. For work environment, the period of work was appropriate, but had different opinions for work independence and regular number of patients. Therefore, there should be more organized treatment program that also should be linked to other practical programs at this beginning point of the policy enforcement and the time that many therapists hope to work in elderly care system.

• 한국노년학
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• 제30권4호
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• pp.1345-1357
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• 2010

본 연구에서는 장기요양보호 서비스 중 방문목욕을 이용하는 여성노인을 대상으로 방문목욕을 받으면서 경험하게 되는 신체적, 심리적 변화는 무엇인가에 대해 심층적으로 분석코자 하였다. 이를 위해 장기요양보호서 비스를 이용중인 8명의 여성노인을 대상으로 심층면접하고 서비스 이용과정 중 경험하게 되는 신체적, 심리적 경험을 질적자료로 활용하여 자료를 분석한 탐색적 연구이다. 연구결과를 살펴보면 다음과 같다. 첫째, 여성노인의 신체적 측면에서는 방문목욕서비스를 받는 동안 변화된 여성노인의 신체적 요인을 살펴보면 서비스 이용 후 몸이 건강해지고 편해졌으며 신체적으로도 나아지고 있다고 믿고 있었다. 둘째, 심리적 측면에서는 자신의 신체적 장애로 인해 방문목욕을 받는 것에 대해 자신의 몸을 보이는 것을 추잡하고 부끄럽게 여기다가 방문목욕을 편하게 여기게 되었다. 또한 요양보호사와의 상호작용을 통해 목욕서비스 이외에 정서적측면에서 지지를 받음으로 자신에 대한 존재가치를 긍정적으로 바라보는 모습이 나타났다. 그 결과 장애로 인해 부끄럽고 불편하며 추잡스럽게 자신을 여기던 부정적 태도에서 장애를 지닌 자신의 신체적 상태를 수용하고 받아들임으로 방문목욕서비스를 편하게 받아들이게 되는 변화의 과정이 나타나 장애수용이 현실적응에 큰 영향을 미치게 되는 계기임을 알 수 있었다. 이상의 결과를 근거하여 다음과 같이 제언하였다. 첫째, 장기요양보호에서 노인에 대한 체계적인 관리 및 정서적 안정을 높이기 위해서 자신의 장애를 수용하여 현실에 적응할 수 있도록 사회복지사의 개입과정이 도입되어야 할 것이다. 둘째, 노인에게 있어 긍정적 정서에 많은 영향을 미치는 대상이 요양보호사임을 고려할 때 단지 요양보호사로써의 역할을 벗어나 노인의 강점과 긍정성을 발견하고 강화시키는 멘토의 역할을 감당할 수 있도록 요양보호사에 대한 체계적인 교육시스템의 마련이 제안되어야 할 것이다. 셋째, 지역사회를 중심으로 장기요양기관, 방문요양기관, 복지관 등과 건강보험관리공단이 통합네트워크를 구성하여 권역별로 장기요양보호를 이용하는 가정 및 긴급·위기가정에 대해 지원하는 통합사례관리체계가 마련되어야 할 것이다.

• 한국농촌건축학회논문집
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• 제17권1호
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• pp.65-72
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• 2015

Recently the concerns of aging & care according to the aged Society were on the increase about Home for the elderly facility. In order to moment, the purpose of this study is to analyze planning direction and Architectural Environments in medium and small scale Elderly Care Facilities. This survey are used to investigate with latest building data, which is Long-term Care Insurance Code for the Elderly was started on July 2008 in Korea. The results of this paper are as follows. First, various type of home for the elderly and the elderly group homes are spread out, attached to day care center type, nursing home type, city region type, countryside rural type, near the university and remodeling type. Secondly, per capita room area-$6.32m^2$ are sufficient in regal comparison with $6.6m^2$. Thirdly, Sunlight environments is inappropriate condition as south direction proportion-41.95%. According to the present situation various facility type and model for our baby boomers generation should be more developed with preemptive systems of senior welfare concept.