• Korean Journal of Social Welfare
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• v.64 no.4
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• pp.31-56
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• 2012

The main purpose of this study is to examine the rewards for "Family Care" from the Japanese Long-Term care policy, to investigate the effects of "The commodification of Family Care" after the introduction of "The Long-Term Care Insurance", and to find out the institutionalization of reward system for "Family Care". First of all, the socialization of "The Long-Term Care" is redefined to be the commodification of family care in this study. Based on this definition, the commodification of family care and the government's involvement are analyzed in conjunction with considering the role of family in the process of Long-Term Care supply, the social evaluation for family care, the family carers' home environment and the position in the labor market. In result, the commodification structure of family care in the Japanese Long-Term Care policy is found, and it helps to understand the reason why the cash payments was just partially introduced.

• The Korean Journal of Health Service Management
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• v.5 no.4
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• pp.161-175
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• 2011

The purpose of this study was to expand the home-based rehabilitation services in the long term care insurance. This study was reviewed on the home-based physical therapy in the OECD. The way of this study was literature search and review. This was to reviewed Proquest, Sciencedirect, SpingerLink, Pubmed. Kew word is "home-based therapy". This was collected 71 articles and final analyzed article was 49. The results were as follows; The article number is seven in Canada, fifteen in USA, five in UK, six in Australia, three in Sweden, five in New Zealand, two in Netherlands, one in Turkey, South Korea, Japan, France, Spain, Italy respectively. Randomized controlled trial is fifty, case-control study is eleven, interview is three, literature review is two, and case report, cost-analysis, cost-effectiveness, pilot study, single blinded parallel design, demonstrative study, survey is one respectively. Physical therapist played an important role in home-based rehabilitation among OECD than nurse. Therefore, we must introduce home-based physical therapy in long term care insurance in South Korea.

• The Journal of Korean Physical Therapy
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• v.34 no.5
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• pp.224-233
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• 2022

Purpose: In Japan, the Long-Term Care Insurance Act has stipulated visiting rehabilitation since 2000. This study aimed to identify the actual conditions of visiting rehabilitation in Japan through a literature review of reports published by the Japanese government. Methods: This literature review was conducted on eight articles among various government reports on the topic of the actual conditions of visiting rehabilitation. These reports were published by the Ministry of Health, Labor and Welfare of Japan based on their own investigations or reports from an external agency entrusted with the task, and were issued between 2000 and 2021. Results: The characteristics of the visiting rehabilitation offices, their number, manpower allocation, the number of users, and their visits to each office were identified. Also, the characteristics of the users, number of users, age and required degree of long-term care, causative disease, and required medical care were identified. To evaluate the actual status of the visiting rehabilitation service, the service use time, frequency, period of use, intervention by doctors and the degree of such intervention, therapist's service content, visitors' address before the use of the service, reason, and timing of the service introduction, evaluation of the service effectiveness, combination of services and transfer destination after termination, and status after service termination were checked. Conclusion: Based on the Japanese experience where visiting rehabilitation was introduced and applied to long-term care insurance, it would be meaningful to review the factors that required benchmarking among the Japanese service models while designing a similar model in Korea.

• 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.

• Health Policy and Management
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• v.31 no.2
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• pp.173-179
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• 2021

Background: In Korea, the length of stay and medical expenses incurred by medical aid patients are increasing at a rate faster than the national health insurance. Therefore, there is a need to create a management strategy for each type of hospitalization to manage the length of stay of medical aid patients. Methods: The study used data from the 2019 National Health Insurance Claims. We analyzed the factors that affect the length of stay for 186,576 medical aid patients who were hospitalized for more than 31 days, with a focus on the type of hospitalization in long-term care hospitals. Results: The study found a significant correlation between gender, age, medical aid type, chronic disease ratio, long-term care hospital patient classification, and hospitalization type variables as factors that affect the length of hospital stay. The analysis of the differences in the length of stay for each type of hospitalization showed that the average length of stay is 291.4 days for type 1, 192.9 days for type 2, and 157.0 days for type 3, and that the difference is significant (p<0.0001). When type 3 was 0, type 1 significantly increased by 99.4 days, and type 2 by 36.6 days (p<0.0001). Conclusion: A model that can comprehensively view factors, such as provider factors and institutional factors, needs to be designed. In addition, to reduce long stays for medical aid patients, a mechanism to establish an early discharge plan should be prepared and concerns about underutilization should be simultaneously addressed.

• Journal of East-West Nursing Research
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• v.25 no.2
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• pp.157-165
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• 2019

Purpose: This study aims to provide basic data for the development of measures and promoting home health nursing by examining the current status and trends in home health nursing for long-term care (LTC) insurance beneficiaries. Methods: Secondary data, including annual LTC insurance statistics reports for 2010-2017 and LTC manpower data, were used to compute current status and trends in the provision of home health nursing. Results: Beneficiaries of home health nursing under LTC insurance, insurance-covered costs for home health nursing, home health nursing provider, and home health nursing providing institution only accounted for 3% of all insurance-covered home care services, and were on a consistent decline since 2010. In particular, vulnerable rural regions with high proportion of individuals had poor infrastructure in terms of home health nursing institutions and manpower, but had a higher home health nursing utilization rate compared to urban regions. Conclusion: In addition to measures to support home health nursing service beneficiaries, policy measures are needed to support home health nursing service personnel and institutions. Furthermore, programs to cultivate the expertise of home health nurses and improve quality of home health nursing services should be developed in order to promote home health nursing utilization in vulnerable rural regions.

• 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.

• Health Policy and Management
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• v.27 no.1
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• pp.56-62
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• 2017

Background: There have been deviations in the regional rate of certification in Korean long-term care insurance (LTCI). This study aimed to explore the determinants of the rate of certification in LTCI. Methods: The panel data of the year 2010-2014 of the 227 National Health Insurance Service (NHIS) regional office were used. Making use of 26 explanatory variables (socio-demographic factors, access to the long-term care services, etc.), we estimated the random effects model using STATA SE ver. 13.0 program (Stata Corp., College Station, TX, USA) and tried to find out the determinants of the regional rate of certification. Results: Estimation results showed that the most important determinants of the regional rate of certification in LTCI are the long-term care infrastructure such as capacity or number of the homecare service institution, sanatorium, or convalescent hospital. The number of the elderly who lives alone and the dimentia patients were positively related to the regional rate of certification in LTCI. Conclusion: The estimation results implied that the regional variation in the rate of certification in LTCI has nothing to do with the NHIS regional offices or their employees. To alleviate the deviation in the regional rate of certification in LTCI, we suggested the analysis of the deviation in the survey checklist. We also proposed to found the regional comprehensive support center to prevent the geriatric illness and to improve the residents' health, etc.

• The Korean Journal of Applied Statistics
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• v.35 no.4
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• pp.457-468
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• 2022

In aged society, it is important to prevent older people from being disability needing long-term care. The purpose of this study is to develop a prediction model to discover high-risk groups who are likely to be beneficiaries of Long-Term Care Insurance. This study is a retrospective study using database of National Health Insurance Service (NHIS) collected in the past of the study subjects. The study subjects are 7,724,101, the population over 65 years of age registered for medical insurance. To develop the prediction model, we used logistic regression, decision tree, random forest, and multi-layer perceptron neural network. Finally, random forest was selected as the prediction model based on the performances of models obtained through internal and external validation. Random forest could predict about 90% of the older people in need of long-term care using DB without any information from the assessment of eligibility for long-term care. The findings might be useful in evidencebased health management for prevention services and can contribute to preemptively discovering those who need preventive services in older people.

• Journal of Korean Physical Therapy Science
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• v.18 no.1
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• pp.21-32
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• 2011

Objective: This study was conducted to describe physical therapists' attitudes and beliefs towards Korean Government's National Long Term Care Insurance Program implemented last July 2008. Design: A survey research. Methodology: Participants were 143 physical therapists working in General Hospitals or University Hospitals in Busan, Korea. Each of the participants completed a questionnaire which was comprised of 22 questions. Among the 22 questions, 7 of these were independent variables such as gender, age, career, etc. while 15 of these questions were dependent variables such as the subject's expectations and reactions on the said program, opinions of the participants on the impact of the program to old people's families and relatives, participant's sentiments on social effects of this program to the society, etc. Data collection was conducted from the $20^{th}$ of July to the $5^{th}$ of August, 2008. Data were analyzed by Chi-square test, frequency and cross tabs using SPSS/PC program. Results: Based on the survey conducted, it showed that 50.3% were female respondents, 53.8% were on their twenties, 31.5% of the total respondents were married and that a percentage of 82.4% had working experiences below 10 years. About 80.4% of respondents were satisfied of their jobs and 32.4%of the respondents graduated from three - year college degree, 49.3% of the respondents graduated from four-year college degree. 95.1% of the total respondents knew the existence of the national long term care insurance program of the government and almost 78% got the information of the said program via internet, news paper or T.V. About 86% of the respondents believe that there will be future improvements in the quality of life in Korea through the said program and 82% said that there will be an increase sense of responsibility among family members to take care of their old relatives. 67.2 % of respondents believe that problems regarding old people will be solved through the government's national long term care insurance program. In aspect of Physical Therapy, 50% of the respondents expected generation of more jobs especially to physical therapists and 95% of the respondents want to work in any position in the said program especially those are more experienced ones. Conclusion: Physical Therapists in Korea are aware of the existence of the National Long Term Care Insurance Program of the Korean Government. Based on the gathered results from the survey, many experienced physical therapists of the country wanted to acquire positions in the said program especially that their expertise are needed in the said field. Through this study, it is evident that many physical therapists of the country have positive vibes on the said program and are optimistic on the outcomes of the said insurance program.