• Title/Summary/Keyword: Long-term care services

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Factors Associated with Length of Stay in Elderly Inpatients in a General Hospital in Seoul (서울소재 3차 의료기관에 재원 중인 노인 환자의 재원기간에 영향을 미치는 관련 요인)

  • Kim, Sun-Ja;Yu, Seung-Hum;Oh, Hyohn-Joo
    • Korea Journal of Hospital Management
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    • v.12 no.2
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    • pp.25-42
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    • 2007
  • To identify characteristics of elderly inpatients who had long term hospitalization in a general hospital, this study categorized into two groups who were hospitalized for less than 30 days and a group hospitalized for more than 30 days. To compare the groups the independent variables were the sociodemographical characteristics, the medical care utility characteristics, and the disease characteristics and finally analyzed factors affecting the hospitalization period. The data of 18,727 inpatients who were older than 65 years of age by the year 2005 were used and the data were analyzed using SPSS for Windows 12.0. With the results, it is necessary to provide intensive and positive management to elderly inpatients who belong to the more than 30 days group and also necessary to share roles and functions of hospital by medical network with local hospitals and clinics in order to manage long-term elderly inpatients and offer continuous post-management to discharged patients by encouraging them to use a long-term care center or by implementing an early discharge program. This study should provide many studies on how to manage the period of hospitalization efficiently on long-stay elderly inpatients in the future.

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Moon Jae-in Government Health Policy Evaluation and Next Government Tasks (문재인정부의 보건의료정책 평가와 차기 정부의 과제)

  • Tchoe, Byongho
    • Health Policy and Management
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    • v.31 no.4
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    • pp.387-398
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    • 2021
  • Moon Jae-in Care can be seen as a 2.0 version of Roh Moo-Hyun Care. Just as Roh Care failed to achieve its coverage rate goal and 30% share of public beds, Moon Care also failed to achieve its expected goal. The reason is that it followed Roh Care's failed strategy. Failure to control non-covered services has led to a long way to achieve a 70% coverage rate and induced the expansion of voluntary indemnity insurance, resulting in increased public burden. The universal coverage of non-covered services caused an immediate backlash from doctors. And Moon government also failed to control the private insurance market. The expansion of publicly owned beds has not become realized and has not obtained public support. Above all, it failed to overcome the resistance of doctors and failed to obtain consent from budget power groups in the cabinet for public investment. It was also insufficient to win the support of civic groups. Communication with interested groups failed and the role of private health care providers was neglected. The next government should also continue to strengthen health care coverage, but it should prioritize preventing medical poor and create a consensus with both medical providers and consumers for the control of non-covered services. Ahead of the super-aged society, the establishment of linkage between medical services and long-term care and visiting health care or welfare services is an important task. All public and private provisions and resources should be utilized in the view of a comprehensive public health perspective, and public investment should be input in sectors where public medical institutions can perform more effective functions. The next government, which will be launched in 2022, should design a new paradigm for health care in the face of a period of transformation, such as the coming super-aged society in 2026 and the Fourth Industrial Revolution, and recognize that the capabilities of the health care system represent the nation's overall capacity.

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.

Relationship Between Status of Physical and Mental Function and Quality of Life Among the Elderly People Admitted from Long-Term Care Insurance (장기요양 인정자의 신체적 및 정신적 기능 상태와 삶의 질과의 관계)

  • Kim, Hyeong-Seon;Bae, Nam-Kyou;Kwon, In-Sun;Cho, Young-Chae
    • 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).

Verification of effectiveness of evaluation of long-term care institution (장기요양기관(시설급여) 평가의 효과성 검증)

  • Kim, Yun-Jeong;Kim, Young-Jea;Lee, Sang-Jin
    • Asia-pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology
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    • v.9 no.5
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    • pp.781-791
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    • 2019
  • The purpose of this study was to evaluate the evaluation of long - term care institutions (evaluation rating, evaluation rating, suitability of evaluation index), quality of service of caregivers, Quality satisfaction, life satisfaction, and facility choice. After receiving the IRB, in January and February of 2018, the survey was completed for 79 long-term care institution managers, 381 nursing care workers, and 381 elderly people. The survey carried out an allocation sample reflecting the 2015 long - term care (facility benefit) evaluation results. The results of this study are as follows. First, it is found that the institutional evaluation (evaluation level, change of evaluation level, recognition of suitability of the index) has a greater impact on the quality of life of the elderly, appear. However, the intention of reselecting the facility after discharge was more influenced by the quality of services of caregivers. Therefore, except for the intention to reschedule the facility, it can be said that the evaluation of the National Health Insurance Corporation was partially validated.

Long-term Policy Development for the Aged on Medical and Health Care Security (노인의료보장 및 건강관리를 위한 장$cdot$단기 대책)

  • Rhee Seonja;Lee Yoon Sook
    • Journal of Korean Public Health Nursing
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    • v.5 no.1
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    • pp.70-95
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    • 1991
  • The ageing problem of the population has been emerging in Korea since 1970's so that it is expecting the elderly 65 years and over among the total population from $4.5\%$ in 1988 to be $6.3\%$ in year 2000. This study was conducted to provide secure policy development in coming years for the aged on medical and health care aspects based on the examining current status of the aged problems and health care policies and systems. The study divided into four parts; The first part examined the medical insurance program and public assistance program of the health services in relation to the aged. The second part emphasized on reduction of medical care cost for the aged. The third part studied the regular health check-up program and health education for the aged. The fourth part examined the chronic disease management programs for the aged and strategies of the health care service quality improvement and specialized programs. The following recommendations made as the results of the study. 1. At present, the medical insurance program and public assistance program for the medically indigent is not appropriate to the elderly because it is a part of general medical insurance program so that Health Security Law for the Aged is proposed. 2. Medical cost will be increased due to the high occupancy rate of hospital beds and long stay of the elderly so that it is recommended to develop an early discharge program, home health care program, Health hospice and an althernative programs. 3. At present, a regular health check-ups for the elderly is not included in medical insurance program so that it is recommended to be included in the insurance program and at the same time health education program thoroughly developed for the aged. 4. To make proper medical and nursing services on chronic diseases for the elderly, it is recommended manpower development, specialized clinics or hospitals, nursing homes and an equivalent long term care facilitices should be established on the community based and a research institutions also to be related to supper the care programs.

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Caregiver Burden of Patients with Dementia and Day Care Center of Small Size Model within a Zone of Life (치매환자 부양자부담과 생활권 내 소규모 주·야간 돌봄 서비스 모델)

  • Na, Seung-kwon;Park, Eun-Ju
    • The Journal of Korea Institute of Information, Electronics, and Communication Technology
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    • v.9 no.4
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    • pp.428-438
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    • 2016
  • The aim of this study, in order to reduce the support burden of dementia primary caregiver, within the framework of long-term care insurance system to present its founding model for the development of new services. Previous research as analytical materials and based on the CARE study between 2012 to 2013. Primary caregiver burden of patient are both physical, psychological and economic aspects as well as difficulties in many aspects and had influence on many factors such as age, care burden, economic, health, and social support. It also came high-risk primary caregiver suffer from depression. This primary caregiver to take advantage of the elderly long-term care insurance system implemented at the time of the institutional support necessary for since 2008, presented additional services in this study. Of increasing the small sizes day care center (tentative name) to open an as established in the settlements at a scale of less than nine, within 5 minutes from the residence, limited dementia by expertise in the disease home care services scale model of the current system service It was to improve the quality of existing shares, small group sizes for day care centers and community life apart.

Changes on Hospital-based Home Care Services Utilization After Long-term Care Insurance Launch (노인장기요양보험제도 도입 후 의료기관 가정간호 이용실태 변화)

  • Chin, Young Ran;Hong, Worl Lan
    • 한국노년학
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    • v.31 no.2
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    • pp.371-380
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    • 2011
  • This study was to address changes on hospital-based home care utilization after long-term care insurance(LTCI) was launched. National electronic data information(EDI) on hospital-based home care from Health Insurance Review Agency in 2007.7~2008.6(prior to LTCI) and in 2009(posterior to LTCI) was analyzed. After the launch of long-term care insurance, 40 hospital-based home health care agencies(HHCA) were diminished and regions not having any HHCA were increased from 53% to 59%. Hospital-based home care utilization was decreased in the elderly(clients 13.4%, visits 20.9%) as well as non-elderly(clients 3.5%, visits 3.9%). It is presumed that diminished HHCAs result in decreased accessibility to hospital-based home health care for non-elderly. The clients, visits, and reimbursed cost per agency were not changed. It is presumed that small agencies were closed already. The total reimbursed cost per agency in 2009 was 121,850,000 won. Results suggest that the government has to give support to open more HHCA to increase the accessibility for non-elderly. Also, hospital-based home care services utilization has to be monitoring regularly.

Development of a curriculum for Care Manager Education (케어매니저 양성을 위한 교육과정 개발)

  • Chong, Min-Yeong;Son, Myeong-Dong;Park, Cheon-Gyu
    • Proceedings of the Korea Contents Association Conference
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    • 2009.05a
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    • pp.1064-1069
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    • 2009
  • The aged long-term care insurance for solving problems of the aged increasing rapidly in an aging society is a primary subject which have influence on. So, it is important to develop a curriculum for training care professionals who play an important role in operating of the aged long-term care insurance and especially care managers, because care managers are central professionals who intervene in a whole process of the aged long-term care insurance and provide the recipient with proper services. In this paper, we propose a curriculum for care managers. It includes a process classifying care manager students into a beginner and an experienced man, subdividing it into 3 parts-lecture, practice, field practice, assign time to subjects, train students by it, carry out a written examination, and certify in care manager training.

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Development of Home Visiting Nursing Standards Base on a Long-Term Care Insurance for the Elderly Program (노인장기요양보험제도에 의한 방문간호 표준개발)

  • Kim, Myung-Hee
    • Journal of Korean Public Health Nursing
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    • v.24 no.2
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    • pp.285-301
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    • 2010
  • Purpose: The study was aimed at qualitatively enhancing and promoting a home visiting nursing program established in Korea on July 1, 2008, as part of the Long-Term Care Insurance for the Elderly program. Methods: Structural, procedural and consequential aspects of home visiting nursing care wereclassified on the horizontal axis by applying the standard notions for the evaluation of medical care (Donabedian, 1998). At the same time, the home visiting nursing care service support system and the service provision system weredivided on the vertical axis with reference to the accreditation standards for home visiting nursing care organizations suggested by the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO, 2008). The data were collected from June 4, 2008 to October 27, 2008, and were analyzed using SPSS ver. 15.0. Results: Twenty-two (proposed) standards, centered on the standard elements under the conceptual framework of the study, were developed, and comprised structural aspects (n=10), procedural aspects (n=6) and consequential aspects (n=6). Those criteria and indicators underwent two content validity surveys among groups of home visiting nursing care research and training experts. The research produced 22 proposed standards, 50 proposed criteria and 166 proposed indicators. Conclusion: The home visiting nursing care standards developed pursuant to the Long-Term Care Insurance for the Elderly Act and the applicability of these standards need to be verified by home visiting nurses. These proposed standards should prove useful in developing an assessment tool to encourage the qualitative enhancement of visiting nursing care in Korea.