• Health Policy and Management
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• v.24 no.1
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• pp.71-84
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• 2014

Background: Informal care is increasingly recognized as placing a significant burden on the lives of family caregivers. The purpose of this study is to investigate factors related to family caregivers' burden with the community-dwelling disabled elderly under the long-term care insurance system, using the Stress Process Model developed by Pearlin (1990). Methods: Total 1,233 family caregivers with the disabled elderly, using the long-term care services in their home from May to June 2009, completed questionnaires finally. The questionnaire of this study consists of a total of 32 questions, including 11 questions related to background and context, 17 questions related to objective stressors, and 4 questions related to coping resourses. Family caregivers' burden is measured by the Korean Revised Caregiving Appraisal Scale (K-RCAS, Cronbach's alpha=0.86). To investigate factors related to family caregivers' burden, multiple regression analysis was conducted. Results: The average score of caregivers' burden was 22.0 (${\pm}6.12$). In multiple regression analysis, there were statistically significant factors affecting on the family caregivers' burden, that are related to background and context (region, living status, education level, relationship with beneficiary), objective stressors (duration of caregiving), coping resourses (caregiver's health status). Conclusion: This study found that family caregivers experience a considerable burden. The findings suggest that policies must be taken to relieve family caregivers of their duties temporarily, and to support them with counselling and education.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.4
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• pp.203-210
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• 2018

The UK is famous for being the first country in Europe to adopt the policies of marketisation regarding social welfare. Numerous other countries, including social democratic countries, have followed suit, and South Korea has also adopted the marketisation of care through the introduction of long-term care insurance. The aim of this study is to examine recent reforms concerning adult social care market in the UK, and to determine policy recommendations to further develop the Korean long-term care insurance market. Findings show that the UK has actively regulated and managed the care market. In particular, after the sudden bankruptcy of nursing homes, the CQC systematically analyzes the risks of bankruptcy of big service providers in terms of financial conditions and quality of services according to the six steps detailed in the Care Act 2014. If some service providers experience high levels of risk, the CQC reports results to local authorities in order to manage the risk of bankruptcy of these service providers. Such reforms in the UK suggest a number of policy measures for South Korea in which the problems of long-term care market are prevalent, including increased system management, introduction of a new inspection system, the expansion of public-based inspection organizations, and disclosure of information by the National Health Insurance Corporation.

• Korean Journal of Adult Nursing
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• v.27 no.4
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• pp.418-427
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• 2015

Purpose: Focus group interviews were conducted to explore the current status and barriers of health care services in nursing home from the viewpoint of staffs taking care of nursing home residents. Methods: A qualitative thematic analysis using the focus group interview method was used. A total of 32 health care professionals (19 nurses and 13 social workers) from thirteen nursing homes in South Korea attended (5 focus groups) in 2014. Results: The two main themes were identified: 'minimal health care services that left personal care needs unmet' which has three subthemes of 'stereotyped and fragmented care by types of care providers', 'medically-oriented health care services' and 'health care services mixed with social or recreational programs'; and 'barriers to proper and timely care in nursing homes' with four subthemes including 'unmet care needs due to cognitive dysfunction or lack of expression', 'care guides or tools not suitable for long-term care facilities', 'health care needs that are beyond the facility's care boundary', and 'care delay due to lack of understanding on the older adult's status'. Conclusion: The findings from this study should help health care policy makers to recognize the factors that influence health care services and provide direction for nurses and other staffs involved in supporting health care services for nursing home residents.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.12 no.10
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• pp.4493-4501
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• 2011

This study was performed to determine the levels of MMSE-K among the elderly people affiliated with long-term care insurance services in rural areas, and to reveal its association with related variables. The interviews were performed, during the period from March 1st, to May 31th, 2009, to 410 elderlies in rural areas. As a results, The prevalence of cognitive functions among all subjects were 80.5% of severe cognitive impairment, 11.7% of mild cognitive impairment, and 7.8% of normal. The prevalence of cognitive functions were lower according to the higher grade of long-term care insurance. And the prevalence of cognitive functions were lower in the group of lower educational level, unemployed, live alone, lower monthly income, bear for living expenses by sons and daughters and medical aid, lower visual acuity, with urinary incontinence, with amnesia, without regular exercise and lower frequency of going out than their respective counterparts. The hierarchial multiple regression analysis was used to reveal the explanatory powers of factors influencing on the cognitive functions level. Such factors as age, bear for living expenses, visual acuity, urinary incontinence, amnesia, regular exercise and grade of long-term care services were significantly influenced with cognitive functions. especially the factors of health status were significantly influenced with cognitive functions.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.4
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• pp.2674-2683
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• 2015

This study was performed to determine the levels of depression(CES-D) and its related factors among the elderly people affiliated with long-term care insurance services in urban areas. The interviews were performed, during the period from March 1st, to May 31th, 2012, to 388 elderlies. As a result, the levels of depression among all subjects were 21.6% of normal group, and 78.4% of depression group. The distribution of depression according to the grade of long-term care insurance were 83.6% in Grade I, 82.1% in Grade II and 67.0% in Grade III, and the level of distribution were significantly higher according to the higher grade of long-term care insurance. For the results of multiple logistic regression analysis, the odds ratio was increased in older age group, in the poor health status group, and in the group of seldom in activity of hobbies than their counterparts, but it was decreased in the higher monthly income group than lower group. Above results suggested that the depression was significantly related with the variables such as sociodemographic characteristics, economic status, health related factors and health status.

• Journal of Yeungnam Medical Science
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• v.36 no.1
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• pp.1-7
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• 2019

The number of people with chronic diseases has been increasing steadily but the indicators for the management of chronic diseases have not improved significantly. To improve the existing chronic disease management system, a new policy will be introduced, which includes the establishment of care plans for hypertension and diabetes patients by primary care physicians and the provision of care coordination services based on these plans. Care coordination refers to a series of activities to assist patients and their families and it has been known to be effective in reducing medical costs and avoiding the unnecessary use of the hospital system by individuals. To offer well-coordinated and high-quality care services, it is necessary to develop a service quality assurance plan, track and manage patients, provide patient support, agree on patient referral and transition, and develop an effective information system. Local governance should be established for chronic disease management, and long-term plans and continuous quality improvement are necessary.

• Proceedings of the Korean Institute of Interior Design Conference
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• 2005.05a
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• pp.217-222
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• 2005

The considerable increase of the elderly with dementia is expected annually and when we think about the family members' and the patients' suffering, it could be painful. Above all things, it imposes heavy economic burdens on the family members that have patients who suffer from diseases of age like dementia or paralysis that caring them at home and also, it is not desirable for those old people in point of physical or environmental circumstances for medical care. Thus, it is needed urgently that the expansion of specified facilities and improvement of services for these old people. Under this present condition, it is the special feature that the subject of research is people/facilities that offer services, not the elderly with dementia-the main user of those facilities. Thus, it is the time that we need various accessing plans that can grasp the patiences' activities and specialties and solve these problems in view of designing interior space. So, I tried to make designs that manage the elderly with dementia effectively and adequate to run facilities with considerations on the state of domestic specialized long-term care facilities for the elderly with dementia and researched guiding principles on physical healing surroundings with analysis that focused on the patients' activities, especially.

• International journal of advanced smart convergence
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• v.12 no.1
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• pp.193-198
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• 2023

The rapid aging of the veterans has reached a level that cannot handle the demand for veterans care through the existing veterans care infrastructure. Therefore, it is urgent to improve the quality of the overall service of veterans due to the deterioration of the quality of nursing services for veterans with various underlying diseases compared to general patients and the long-term waiting for admission to the veterans care center. In this situation, about 640,000 people are admitted to veterans care institutions, but only about 5% of them can enter the veterans care center smoothly. As of June 2020, the number of people waiting to enter the veterans care center exceeds 1,000, including 520 at Suwon Veterans Nursing Home, 1 at Gwangju Veterans Nursing Home, 47 at Gimhae Veterans Nursing Home, 39 at Daegu Veterans Nursing Home, 86 at Namyangju Veterans Nursing Home.. Therefore, in order to predict those who want to enter the Veterans Nursing Home and wait for admission, and to find an important basis for resolving the long-term atmosphere, the ratio of future care providers is predicted in 2022-2050 and 2022-2024 to establish a cooperative system. As a result, 6,988 people in 2022, 6,797 people in 2023, and 6,606 people in 2024 can be admitted when 'preferred linkage', and 12,057 people in 2022 when 'expanded linkage'. It was found that 11,837 people in 2023 and 11,618 people in 2024 could be admitted. This was derived by estimating the percentage of people who wish to enter the Veterans Nursing Home when linking private nursing homes, and eventually "additional acceptance" of 22.5% in 2022, 20.9% in 2023, 19.4% in 2024, and 38.8% in 2023, 36.3% in 2023, and 34.1% in 2024 are most efficiently available.

• Health Policy and Management
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• v.30 no.1
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• pp.72-81
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• 2020

Background: The out-of-pocket maximum is one of the distinctive healthcare systems which sets a ceiling on co-payment in order to reduce the burden of households from the unpredictable medical expenditure. However, this leads to an increase in the demand for healthcare services especially in long-term care hospitals (LTCHs) in Korea. Methods: This study analyzed the influence factor of medical service overuse of 165,592 inpatients in LTCHs which out-of-pocket maximum is applied, by utilizing data from the National Health Insurance Service (2016). Based on Anderson Model, the medical service overuse, as a dependent variable, was defined as long-stay admission more than 180 days at the LTCHs. Independent variable was comprised of predisposing factors (gender, age), enabling factors (income level, types of out-of-pocket maximum) and need factors (illness level, patient use of tertiary hospital). Results: The most powerful factor of medical service overuse in LTCHs was availability of pre-payment for the out-of-maximum (odds ratio [OR], 191.66; p<0.001). This tendency was found in high income level status (p<0.001). Furthermore, mild inpatients (OR, 1.50; p<0.001) which had no experience with the tertiary hospitals (OR, 2.06; p<0.001) were more relevant to the medical service overuse in LTCHs, compared to the severe inpatients. Conclusion: It is suggested that a separate standard of out-of pocket maximum with regards to LTCHs is required to secure the beneficial functions of long-term hospitals and prevent unnecessary financial leakage to achieve sustainable and financially sound National Health Insurance.

• Journal of Korean Academy of Nursing
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• v.44 no.1
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• pp.21-30
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• 2014

Purpose: This study was conducted to explore the impact of registered nurse/nurses' aid (RN/NA) staffing and turnover rate on inpatient health outcomes in long term care hospitals. Methods: A secondary analysis was done of national data from the Health Insurance Review and Assessment Services including evaluation of long term care hospitals in October-December 2010 and hospital general characteristics in July-September 2010. Final analysis of data from 610 hospitals included RN/NA staffing, turnover rate of nursing staff and 5 patient health outcome indicators. Results: Finding showed that, when variables of organization and community level were controlled, patients per RN was a significant indicator of decline in ADL for patients with dementia, and new pressure ulcer development in the high risk group and worsening of pressure ulcers. Patients per NA was a significant indicator for new pressure ulcer development in the low risk group. Turnover rate was not significant for any variable. Conclusion: To maintain and improve patient health outcomes of ADL and pressure ulcers, policies should be developed to increase the staffing level of RN. Studies are also needed to examine causal relation of NA staffing level, RN staffing level and patient health outcomes with consideration of the details of nursing practice.