• Title/Summary/Keyword: Long-term Care Insurance for the Elderly

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A Taxonomy of Geriatric Hospitals Using National Health Insurance Claim Data (건강보험청구자료로 본 요양병원의 기능 유형)

  • Min Kyoung Lim;Sun-Jea Kim;Jeong-Yeon Seon
    • Korea Journal of Hospital Management
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    • v.28 no.2
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    • pp.9-20
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    • 2023
  • Purpose: This study classified the actual functions of geriatric hospitals and examined the differences in their characteristics, in order to provide a basis for discussions on defining the functions of geriatric hospitals and how to pay for care. Methodology: This study used various administrative data such as health insurance data and long-term care insurance data. Cluster analysis was used to categorize geriatric hospitals. To examine the validity of the cluster analysis results, we conducted a discriminant analysis to calculate the accuracy of the classification. To examine cluster characteristics, we examined structure, process, and outcome indicators for each cluster. Findings: The cluster analysis identified five clusters. They were geriatric hospitals with relatively short stays for cancer patients(cluster 1; cancer patient-centered), geriatric hospitals with relatively large numbers of patients using rehabilitation services(cluster 2; rehabilitation patient-centered), geriatric hospitals with a high proportion of relatively severe elderly patients(cluster 3; severe elderly patient-centered), geriatric hospitals with a high proportion of mildly ill elderly patients with various conditions(cluster 4; mildly ill elderly patient-centered), and geriatric hospitals with a significantly higher proportion of dementia patients(cluster 5; dementia patient-centered). The largest number of geriatric hospitals were categorized in clusters 4 and 5, and the structure and process indicators for these clusters were generally lower than for the other clusters. Practical Implications: We have confirmed the existence of geriatric hospitals where the medical function, which is the original purpose of a geriatric hospital, has been weakened. It has been observed that the quality level of these geriatric hospitals is likely to be lower compared to hospitals that prioritize enhanced medical functions. Therefore, it is suggested to consider the conversion of these geriatric hospitals into long-term care facilities, and careful consideration should be given to the review of care-giver payment coverage.

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Long-Term Care Utilization among End-of-Life Older Adults in Korea: Characteristics and Associated Factors (생애말기 노인의 장기요양서비스 이용 특성과 영향요인)

  • Yoon, Nan-He;Kim, Hongsoo;Kwon, Soonman
    • Health Policy and Management
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    • v.26 no.4
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    • pp.305-314
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    • 2016
  • Background: The purpose of this study is to examine the characteristics of and factors associated with long-term care (LTC) utilization under public long-term care insurance (LTCI) among end-of-life older adults in Korea. Methods: Using a 5% sample of older people aged 65 or older and their health and LTC insurance data, two-part model analyses were conducted. We compared LTC uses and their determinants during the last year of life among decedents in the year 2010 with those of survivors. We also compared the medical uses of the same sample with their LTC uses. Results: The end-of-life elderly were more likely to use LTC, and their expenditure on LTC was higher than their counterparts. Whether or not older people used LTC during their last year of life was significantly affected by age, sex, health insurance, household income, and living alone; however, LTC costs of the decedents were only affected by functional status, which may have been due to the reimbursement scheme of the current LTCI, which is mainly based on functional dependency level. For the survivors, having chronic diseases significantly increased the likelihood of LTC use, which was not the case for the decedents. End-of-life elderly with relatively low social economic status were more likely to use the LTC other than medical services, while the health conditions affected their medical uses most significantly. Conclusion: The study findings provide key information for predicting demand related to the increasing LTC needs of Korean older people at the end of life.

Policy Implications for Home-Visit Nursing(HVN) of the Korean Long Term Care Insurance through the implications of the Japanese HVN (한국 장기요양 방문간호의 정책적 함의와 일본 방문간호의 시사점)

  • Ryu, Hosihn;Arita, Kumi
    • Journal of Korean Public Health Nursing
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    • v.29 no.3
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    • pp.403-411
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    • 2015
  • Due to lack of an information system regarding the status of using home-visit nursing (HVN), it has barriers of providing improvement of the HVN for management of elderly health care in Korea. The twofold aims of the current review are to expose the existing agendas for HVN and to suggest the political implications for HVN of Korea based on the transition process and revised HVN system of Japan. This review suggests that an information evaluation system has to precede for HVN services in detail. And, the service provided per manpower should be assessed by separating the code of manpower (registered nurse, nurse aide, dental hygienist) as well as securing detailed and precise information on the HVN services. The other suggestion, development of a community-based home health care nursing model in order to provide necessary services for long-term health insurance beneficiaries. In addition, a master plan for health care for elderly should be established at the national level in order to establish an effective home health nursing delivery system.

Residents' Nursing Care Needs and Provision of Nursing Care by the Size of Long Term Care Facilities (장기요양시설 규모별 간호서비스 요구 및 제공현황 비교)

  • Lee, Jung Suk;Hwang, Rah Il;Park, Se Young;Han, Eun Jeong
    • Journal of East-West Nursing Research
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    • v.26 no.1
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    • pp.28-38
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    • 2020
  • Purpose: The aim of this study was to provide information on the extent and variations of elderly residents' nursing care needs, and provision of nursing care across long term care facilities. Methods: A nationwide survey was conducted on nurse managers from 1,041 long term care facilities, by e-mail or fax, from August 16 to September 30 in 2017. A self-reported questionnaire consisting of 5 domains was used to collect data. Results: Facilities with more than 30 residents were more likely to need skilled nursing services and to obtain the nursing staff such as a registered nurse and a nurse's aide. Awareness and satisfaction of hospital-based home nursing care was high in all facilities. In addition, there are some differences in nurse managers' perceptions of the level of healthcare resources and required action by facility size. Nurse managers of senior congregate housings were more likely to have considerable difficulty in dealing with healthcare needs of residents and recognizing the healthcare resource shortage. A majority of nurse managers agreed on the need to employ a registered nurse. Conclusion: This study confirmed that it is essential to increase nurse staffing level and to reform the long term care insurance for enhancing the accessibility of healthcare services, especially for the residents in small long term care facilities. There is also a need to provide diverse education and training opportunities for nursing staff working in long term care facilities.

A recommendation system for assisting devices in long-term care insurance (의사결정나무기법을 활용한 장기요양 복지용구 권고모형 개발)

  • Han, Eun-Jeong;Park, Sanghee;Lee, JungSuk;Kim, Dong-Geon
    • The Korean Journal of Applied Statistics
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    • v.31 no.6
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    • pp.693-706
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    • 2018
  • It is very important to support the elderly with disability ageing in place. Assisting devices can help them to live independently in their community; however, they have to be used appropriately to meet care needs. This study develops an assisting device recommendation system for the beneficiaries of long-term care insurance that include algorithms to decide the most appropriate type of assisting device for beneficiaries. We used long-term care (LTC) insurance data for grade assessment including 8,084 beneficiaries from July 2015 to June 2016. In addition, we collected standard care plans for assisting devices, that power-assessors made, considering their performance and ability that could subsequently be matched with grade assessment data. We used a decision-tree model in data-mining to develop the model. Finally, we developed 15 algorithms for recommending assisting devices. The findings might be useful in evidence-based care planning for assisting devices and can contribute to enhancing independence and safety in LTC.

Current status and future tasks of visiting oral health care services for elders (우리나라 노인 방문 구강건강관리 서비스의 현황과 향후과제)

  • Lee, Sue-Hyang;Bae, Soo-Myoung;Shin, Bo-Mi;Lee, Hyo-Jin;Shin, Sun-Jung
    • Journal of Korean society of Dental Hygiene
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    • v.20 no.4
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    • pp.457-467
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    • 2020
  • Objectives: This study confirms the current status of visiting oral health-care services for the elderly to draw policy implications for revitalization of the visiting oral health care services in the future. Methods: First, a survey was conducted on health centers about the current status of the elderly visiting oral health-care service and how to revitalize it. Next, the number of oral hygiene services provided to the elderly was checked in the long-term care insurance system. Results: Oral health education (100%) was the most common practice in visiting oral health-care service for the elderly, and the most difficult thing in providing services was the lack of dental hygienists (38.9%). The status of oral health-care services in the long-term care insurance system for elderly revealed that the total number of service claims has been confirmed to be zero since the introduction of the system. Conclusions: Despite the existence of a system that provides elderly visiting oral healthcare services, to revitalize it, the law must be amended to secure a dental hygienist as the main agent of the activity and to further take responsibility for autonomous authority and performance.

Home Health Care in Korea - Home Health Care Nursing, Visiting Health Care Nursing, Visiting Health Care - (한국의 가정건강관리(Home Health Care) - 가정간호, 방문간호, 방문건강관리 -)

  • Ryu, Ho-Sihn
    • Journal of Home Health Care Nursing
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    • v.14 no.2
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    • pp.98-105
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    • 2007
  • Home health care system in Korea has been classified into three types of home care programs based on different laws and regulations; for example, home health care nursing(HHCN) is based on medical laws, visiting health care nursing (VHCN) is based on long-term health care insurance, and visiting health care(VHC) is based on the regional health care act. HHCN in Korea has taken on an important role under the mandate of the national health care system since 2000. VHCN will commence its role under the long term health care insurance system in 2008. The strengthening of VHC commanded health promotion and prevention for vulnerable families in the community in 2007. This is an important turning point for increasing quality management for home health care program; it suggests certain possibilities for building a foundation for further changes in the service delivery structure. Accordingly, the home health care policy makers in Korea have a major function and role that consists of developing an agenda and alternatives for policy making in a systematic manner and clearly presenting implementation strategies for elderly health care system.

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Development and Clinical Use of Assessment Indicators for Improving Medication Adherence of Elderly Residents in Nursing Home (노인요양원 입소자의 복약순응도 향상을 위한 평가지표의 개발 및 임상활용)

  • Park, Duck-Soon;Kang, Minku;Bang, Joon Seok
    • Korean Journal of Clinical Pharmacy
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    • v.26 no.1
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    • pp.13-23
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    • 2016
  • Background: South Korea is rapidly being an aging-society and the demand of long-term care insurance services for elderly patients is rising. In addition, because the elderly taking multiple medicines, the adherence is lowered and the adverse events are easily occurred. Therefore, many are interested in introducing the geriatric pharmacy specialist to manage this situation. Purpose: By applying a similar program such as the geriatric pharmacy specialist working in nursing home, we conducted this study to evaluate the potential contribution to both the health insurance services and financial savings for the elderly patients. Methods: We conducted a trial in an elderly nursing home to collaborate between doctor and pharmacist making a checklist for improving medication adherence and establish a consultation system. Also we applied a smart phone application in the pharmaceutical care processes. Results: Thereby completing the drug therapy related checklist apply to nursing facilities in South Korea. And we got a performance that improves medication adherence when used in the clinical practice settings. Conclusion: By introducing a training program of pharmacy care managers and geriatric professionals such as the United States and Japan, we revealed the elderly nursing home residents and vulnerable elderly people living alone were improved the medication adherence and it will contributed to the health and quality of life of the patients.

Factors Related to Quality of Life in the Rural Elderly People Affiliated with Long-term Care Insurance Services (일부 농촌지역 장기요양급여노인들의 삶의 질과 관련 요인)

  • Shin, Min-Woo;Kwon, In-Sun;Cho, Young-Chae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.2
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    • pp.795-804
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    • 2011
  • This study was performed to determine the levels of quality of life(QOL) according to the grade of long-term care service in the elderly people who affiliated from long-term care insurance, and to reveal its association with socio-demographic characteristics, health status and health related behaviors. The interviews were performed, during the period from March 1st, to May 31th, 2009, to 410 elderlies in rural areas. As a results, the levels of QOL were lower in the group of higher grade of long-term care insurance. In hierarchial multiple regression analysis, the factors influencing on the level QOL were age, Living status, Subjective health status, Bed ridden status, Disability of body, Urinary incontinence, Amnesia and Frequency of going out. Especially, the health status variables were higher related with QOL than other variables.

A Study on the Improvement Direction through the Present Status of Nursing Home - Focus on the Nursing Home in Chungcheongbuk-do - (노인요양시설의 건축현황 및 개선방향에 관한 연구 - 충청북도 노인요양시설을 중심으로 -)

  • Lee, Wan-Geon
    • Korean Institute of Interior Design Journal
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    • v.19 no.3
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    • pp.242-250
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    • 2010
  • Recently, the long-term care insurance for the elderly was carried out according to the elderly is increased rapidly and the formation of sympathy that a nation and society try commonly to share health and welfare promotion of the elderly. The purpose of this study is to analyze the present status of nursing home after that the long-term care insurance is enforced in chungcheongbuk-do and to utilize as basic data. The study limited its survey to those facilities that refer to the Ministry of Health and Welfare data, that had the capacity of more than 50 people. The result are as followings. Firstly, most of the nursing home were located on the outskirts of the city. But it must be constructed in the city center if the recent deinstitutionalization trend is reflected. Secondly, notwithstanding the provisions of the Elderly Welfare Law, if the Livability and amenity are considered, the plan of a single or a twin room is needed. The ondol(溫突) system bedroom for the safety of the elderly had to be planned and for the color planning of a bedroom, a heating, the furniture, the form of a door, corridors, etc. should be partly improved. The fastener in which it is appropriate for the main exit, a stair, an elevator, the lighting device, and etc. is needed and the installation of a wandering path for the dementia patient and etc. is required. Thirdly, most of the dining room arranged on the first floor but it is not nearly used and it used for employee or the other use. Therefore, we have to consider the system in which it can deliver the meal to a bedroom. If the smell of the elderly and etc. is considered, the sufficient height of the floor should be reflected for the ventilation equipment. Lastly, The improvement of the existing law are required.