• 한국보건간호학회지
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• 제29권2호
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• pp.203-218
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• 2015

Purpose: The purpose of this study is to find and suggest ways to invigorate operation of visiting nursing centers. Methods: SWOT analysis was performed based on the status of use of visiting nursing centers and opinion survey on the centers' nursing experts. Results: SO strategy was drawn to improve service satisfaction, develop standardized manuals, and improve the areas of visiting nursing services, and WO strategy was drawn to establish reliability, strengthen promotion or marketing strategy, strengthen management ability, and reinforce the governmental support of visiting nursing services. ST strategy was drawn to recover the functionality of health management, secure competitive advantage, and simplify the issuance of visiting nursing directions, and WT strategy was drawn to provide customized service, establish the cooperative system of related agencies, and adjust fees. Conclusion: For invigoration of visiting nursing centers, people must recognize the importance of the visiting nursing service and institutional standards should be established so that visiting nursing service, which is currently provided as an option according to Standard Long-Term Care Plan, can be provided on a mandatory basis.

• Journal of Korean Academy of Oral Health
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• 제42권4호
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• pp.204-209
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• 2018

Objectives: This study was conducted to identify the demand and willingness to pay for oral hygiene services among elderly people with long-term care insurance. Methods: Our study was a cross-sectional analysis. Subjects comprised 126 elderly individuals from long-term home-care centers. A total of 28 centers were selected through convenience sampling from among 78 centers in ${\bigcirc}{\bigcirc}$. For analysis, semi-structured questionnaires that required about 20-30 minutes to complete were used. Analysis was performed using SPSS 23.0 software. Results: The overall demand for oral hygiene services was 44.4%, and willingness to pay was 31.0%. Thirty-three people (58.9%) of elderly those who have demand for an oral hygiene service were willing to pay for the service, and 64 people (91.4%) who did not have a demand were not willing to pay for it. Among those with partial dependence on brushing, 65.6% had demand for oral hygiene services and 50.0% were willing to pay costs. Among basic livelihood beneficiaries, 69.6% were willing to pay for oral hygiene services; general subjects and relievers were less willing to pay. Conclusions: The overall demand for oral hygiene services among elderly people was 44.4%, and the willingness to pay was as low as 31.0%.

• 한국콘텐츠학회논문지
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• 제18권1호
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• pp.76-89
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• 2018

본 연구의 목적은 노인장기요양보험 이용자의 장기요양등급 유지 및 변경특성을 분석하고, 장기요양서비스 이용자의 등급유지에 영향을 미치는 요인을 파악하는 것이다. 이를 위해 국민건강보험공단 노인장기요양보험의 원자료(인정 및 급여자료)를 활용하여 2008-2014년 장기요양 급여를 이용한 자를 분석 대상으로 로지스틱 회귀분석을 실시하였다. 분석 대상자를 등급집단(1-3등급)별로 구분하여 인구사회학적 요인, 질병요인, 서비스 요인으로 분석하였다. 분석 결과, 인구사회학적 요인에서 1, 3등급에서 64세 미만자가 80세 이상자보다 등급을 유지할 가능성이 높게 나타났다. 3등급에서 독거자가 비독거자에 비해, 농어촌거주자는 대도시거주자에 비해 등급을 유지할 가능성이 높게 나타났다. 질병 요인에서 1등급에서 치매보유자가 등급유지 가능성이 높게 나타났으나, 2, 3등급에서 반대로 나타났다. 2등급에서 중풍, 골절 보유자가 등급유지 가능성이 높게 나타났고, 3등급에서 암보유자가 등급유지 가능성이 높게 나타났다. 서비스요인에서는 2, 3등급에서 갱신횟수가 높을수록 등급유지 가능성이 높게 나타났다. 1등급에서 시설이용일수가 높을수록 등급유지 가능성이 높게 나타났고, 2등급에서 재가이용일수가 높을수록 등급유지 가능성이 높게 나타났다. 이상의 분석결과를 통해서 장기요양서비스 이용자를 위한 제도개선에 대한 이론적, 정책적 시사점을 제시하였다.

• Clinical Nutrition Research
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• 제13권2호
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• pp.108-120
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• 2024

The study aimed to investigate the basic data to derive plans for snack provision to improve the nutritional status of older adults living in long-term care facilities (LFs) or long-term care hospitals (LHs). The 252 respondents (118 from LHs and 134 from LFs) were included in the study. The questionnaire of nationwide cross-sectional survey was developed by the authors and registered dietitians. The written questionnaire was sent to the food service managers across 800 LFs or LHs. The online survey was introduced using the online platform and network site for dietitians. More than 70% of live-in and non-live-in LFs provided snacks, which were mainly provided one to two times a day. Most institutions provided fruits one to three times a week. The main considerations when providing fruit were in the order of residents' preference, cost, and ease of consumption. The reasons for not serving fruit included cost and differences in the residents' eating and mastication abilities. Most institutions also provided dairy products at a frequency of one to three times a week. The reasons for not serving dairy products included cost and the lack of awareness of the need to provide them. To improve the quality of life and the offer benefits of fruits and dairy products to older people, efforts are needed to propose a plan to expand the provision of snacks in appropriate quantities and varieties.

• 사회복지연구
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• 제40권3호
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• pp.5-40
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• 2009

2008년 6월 현재 전국의 노인요양시설 충족률은 96.4%로, 장기요양인프라 확대정책은 양적인 측면에서 가시적인 성과를 이루었으나 여전히 시설 인프라의 부족, 지역적 편중, 정부의 책임성 저하 등 정책집행의 실효성 문제가 지적되고 있다. 본 연구는 장기요양보장 인프라 확대정책의 집행과정과 이에 영향을 미친 요인을 규명하여 정책집행과정에서 나타난 문제점을 살펴보고 향후 인프라 확대정책의 발전방안을 제시하고자 수행되었다. 연구방법은 중앙정부가 수립한 인프라 확대정책을 확인하기 위해 문헌을 검토하였고, 지방정부차원의 실질적인 집행과정을 살펴보고자 K도, C시, C시 내 노인요양시설 4곳을 대상으로 사례연구를 진행하여, Alexander(1985)의 분석틀로 정책집행의 영향요인을 분석하였다. 연구결과, 정책목표의 명확성과 적절성, 서비스 공급주체의 성격, 정부 간 역할과 책임 등 정책변수와 재정부담 및 예산배정 의지, 예산의 신속한 집행 및 절차의 간소화, 재량권, 집행기관 간 상호관계 등 집행변수가 정책집행의 주요 영향요인으로 나타났다. 이에 지역 실수요를 기초로 한 시설필요도 산출, 민간참여에 대한 보완 등 몇 가지 정책개선과제를 제언하였다.

• 대한간호학회지
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• 제44권4호
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• pp.418-427
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• 2014

Purpose: Objectives of this study were to investigate the association between efficiency and quality of health care in Long-term Care Hospitals (LTCH) and determine related factors that would enable achievement of both high efficiency and high quality at the same time. Methods: Major data sources were the "2012 Korean Assessment of Propriety by Long-term Care Hospitals" obtained from the Health Insurance Review & Assessment Service. Cost variables were supplemented by a National Tax Service accounting document. First, data envelopment analysis was performed by generating efficiency scores for each LTCH. Second, matrix analysis was conducted to ascertain association between efficiency and quality. Lastly, kruskal-wallis and mann-whitney tests were conducted to identify related factors. Results: First, efficiency and quality of care are not in a relationship of trade-offs; thus, LTCH can be confident that high efficiency-high quality can be achieved. Second, LTCH with a large number of beds, longer tenure of medical personnel, and adequate levels of investment were more likely to have improved quality as well as efficiency. Conclusion: It is essential to enforce legal standards appropriate to the facilities, reduce turnover of nursing staff, and invest properly in human resources. These consequences will help LTCH to maintain the balance of high efficiency-high quality in the long-run.

• 지역사회간호학회지
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• 제19권2호
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• pp.260-269
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• 2008

Purpose: The purpose of this study was to identify differences in health status and the utilization of long-term care service between urban and rural aged residents in Korea. Methods: Through convenience sampling, 1,405 elders (829 from urban areas and 576 from rural areas) were selected during March 1 to May 31 in 2004. All the subjects agreed to participate and filled out the survey questionnaire after signing the consent form. The instruments utilized in this study were the impairment of physio-sensory function, ADL IADL, cognitive function, and psycho-social function scale. This instrument was developed by modifying the scab developed by Gurland & Wilder (1984). Data was analyzed using the SPSS Win program. Results: There were significant differences in economic status, duration of living and type of medical insurance between rural and urban elderly(p<.05). Physio-sensory functions (t=4.53. p<.001), ADL (t=3.61. p<.001), IADL (t=2.45, p=.014), cognitive functions (t=-2.63. p=.024) and psycho-social functions (t=3.69. p<.001) were significantly different between the two groups. The utilization of long-term care facility in the urban elderly was significantly higher than that in the rural elderly ($x^2=10.14$, p<.001). Conclusion: Considering these findings. the need for long-term care should be assessed by residence characteristics. Because of different utilization of long term care facility according to the elderly's needs, long-term care services should be considered the residence characteristics.

• 한국병원경영학회지
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• 제18권1호
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• pp.42-58
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• 2013

The purpose of this study was to investigate the awareness of long-term care hospitals on pay for performance(P4P) program in Korea. We conducted a cross-sectional, self-administered, the internet based survey from September to October in 2010. The questionnaire was consisted of the levels of awareness and agreement about the program, their preferred design and its possible effects and unintended consequences etc. Among 837 eligible long-term care hospitals in Korea, 114 hospitals(13.6%) were participated in the survey. About one-thirds of long-term care hospitals were not aware of P4P, namely it is important to heighten an awareness of P4P. There were pros and cons on introduction of P4P in Korea. The two major reasons of objections of P4P were the concerns of unintended consequences and the possibility of strengthening government control by implementing P4P. In conclusion, to successfully implement P4P to long-term care hospitals, the Health Insurance Review & Assessment Service(HIRA) in Korea should obtain the long-term care hospitals'opinion as to implementation of P4P.

• 한국지역사회생활과학회지
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• 제21권4호
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• pp.469-479
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• 2010

Using data from the 2001 National Long-Term Care Survey database, this study analyzed gender differences in factors affecting caregiver burdens of spouse caregivers in Korea. Multiple regression was used to estimate factors influencing caregiver burdens of caregiving wives and caregiving husbands respectively. The results showed that there was a significant variability in predictors of caregiver burdens of spouses who take care of the impaired elderly. ADL functional status of care recipients and social support were significant for both the caregiving wives model and caregiving husbands model in influencing caregiving burdens. It was noticeable to report that a caregiver's self-rated health status, monthly caregiving expenses, a care recipient's self-rated health status were unique predictors for the caregiving wives model. These findings suggest that it is vital for planners and providers to take gender differences in spousal caregiving into account when designing and formulating community-based long-term care service programs.

• 한국치위생학회지
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• 제17권5호
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• pp.705-719
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• 2017

Objectives: The purpose of this study is to look into the health insurance systems and application in Korea and Japan in order to improve elderly people's quality of life. Their quality of life can be improved by upgrading the long term care systems; and extending treatment and prevention. Methods: This study is to examine long term care systems articles through content analysis in the National Health Insurance Service. Data were collected from the printed Internet and analyzed. Results: A part-time dentist system in elderly care facilities has trouble in taking care of old people's oral health due to both lack of time and operational difficulties. It is urgent to arrange dental experts who can permanently stay in care facilities and to build systems which can be managed periodically and continually. Conclusions: As having staff training for the efficiency and using the manpower in care facilities (care workers), it is necessary to solve the unequal medical service in oral health care for the elderly in Korea.