• The Journal of the Convergence on Culture Technology
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• v.9 no.5
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• pp.349-355
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• 2023

This study attempted to examine the effect of Korean and Japanese college students' perception of welfare for the elderly, dementia perception, and dementia attitude on dementia policy. The main results are as follows. As a result of analyzing the impact of Korean-Japanese college students on their perception and attitude of dementia policy, it was found that Korean-Japanese college students' perception of welfare for the elderly and dementia attitude had a positive (+) effect on dementia policy perception. As a result, I would like to present the following implications. Korea and Japan have developed social insurance systems for the elderly in a low birth rate and aging society, and are developing and implementing support services suitable for the culture of both countries. In the perception of dementia policies of college students in Korea and Japan, the influence of long-term care insurance for the elderly in Korea and nursing care insurance in Japan has led to changes in the perception of dementia among college students. However, it has been shown that dementia awareness does not affect dementia policy awareness, indicating that college students lack dementia awareness. Dementia awareness can increase the demand for the development of various dementia-related services or dementia policies, but low dementia awareness can lead to misunderstanding or negative perceptions of dementia. This can also affect the perception of dementia policies, and services and policies such as social support, prevention, and treatment related to dementia may not be sufficiently developed. In order to compensate for these problems in the future, efforts should be made to improve awareness through the provision of various information such as the government and society to help improve and understand dementia awareness for college students.

• 한국노년학
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• v.38 no.4
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• pp.1035-1055
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• 2018

The purpose of this study is to investigate the relationship between public care and family care. Public care for older adults began in 2008 with the implementation of the Long-Term Care insurance in South Korea. Although the expansion of public care has the purpose of reducing the care burden for the family, it is not easy to say whether the developments of public care system reduce the amount of family care for older family members. Theoretically, public care and family care are expected to have various relationships depending on the degree of the role and function(substitution, hierarchical compensatory, task specific, supplementation, complementarity). And literatures have showed inconsistent results depending on the country, data, and methods. In this study, we analyzed the relationship between two care types focusing on home care services for older persons. Analyses were based on data from the second(2008) to sixth(2016) waves of Korean Longitudinal Study of Ageing(KLoSA). To investigate elderly care dynamics in the households, we pooled the data for four changes between two periods(2008-2010, 2010-2012, 2012-2014, and 2014-2016). This study used an analytic sample of 262 older adults, who are aged 55 over and experienced public care at least one point of time. We used Fixed-Effects(FE) model to analyze the differences within the same individuals under the condition that time-invariant unobserved factors are controlled. This study distinguished the cases of entry into public care and other cases of exiting public care. The results showed that older people who are dependent on public care are less dependent on family care than before. In both entry and exit groups, negative relations were maintained, but in the entering stage of public care, the degree of negative relations was relatively small, whereas in the stage of maintaining or departing from public care, relatively negative relations were strong. At the beginning periods, even though public care increased, family care did not decrease significantly. On the other hand, at the time of ending public care and relying on family care, family care increased significantly. The results of this study show that the relationship between public care and family care is close to hierarchical compensatory model and varies according to the stage of caring transition. Also, it was found that the cases of transition from public care to family care have the biggest burden of elderly care than other groups.

• Korea Journal of Hospital Management
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• v.13 no.1
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• pp.24-41
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• 2008

This research is aimed at analyzing and understanding the perception and attitudes of inpatients in a general hospital in Seoul towards the activation of private health insurance. Survey was conducted against 231 inpatients, results of which were analyzed in the methods of frequency analysis, chi square test, and logistic regression. The results are summarized as follows; First, better-educated population who finished college education at least, higher-income population, and people who had more knowledge about private health insurance showed more perception about activation of private health insurance. Second, better-educated population who finished college education at least, higher-income population, those who are insured in existing private insurance, oncological patients, and people who had more knowledge about private health insurance showed more positive attitude towards private health insurance paying for actual damages, long-term care insurance, and income security insurance. Third, age and education were the factors affecting perception about activation of private health insurance. The older the age is, perception was 1.035 times positive towards activation of private health insurance, and those who finished college education or above showed 3.148 times positive perception towards the same. Forth, surgical patients showed 1.087 times more positive attitude towards private health insurance paying for actual damages than internal medicine patients, while oncological patients showed 2.314 times more positive attitude than internal medicine patients. Further, understanding on the activation of private health insurance was 6.014 times higher in the higher understanding group than in the lower understanding group. Intention to use long-term care insurance was 2.692 times stronger in the male group than in the female group, and 3.616 times stronger in the oncological patients group than in internal medicine patients group. Further, understanding on the activation of private health insurance was 3.881 times deeper in the higher understanding group than in the lower understanding group. Intention to use income security insurance was 3.185 times stronger in those who have academic background of under the high school than those over the college, and 4.175 times higher in the group those whose monthly average income is over 4 million won than those under 4 million won. Also, intention to use income security insurance was 4.323 times higher in the group those who are insured by existing private insurances than those who are not insured by those insurances and it was 5.234 times higher in the group of oncological patients than in the group of internal medicine patients. Further, intention to use income security insurance was 3.559 times higher in the group those who thought that out-of-pocket money of the National Health Insurance is too much to bear than those it is quite endurable. Understanding on the activation of private health insurance was 4.875 times deeper in the higher understanding group than in the lower understanding group. There were some suggestions could be made based on the results of this research. First, reinforced publicity and education is needed for the low-educated or low-income group, as there are gaps in the understanding on the activation of private health insurance depending on the degree of education and income. Second, government should prepare administrative complementary measures to solve the problem of adverse selection by the consumer which is foreseen when private health insurances are activated. Third, government should suggest the desirable course of development of private health insurance items to ensure efficient use of enormous fund of private insurance market for health security of the people. Further, institutional complementary measures are needed to convert existing cancer insurances or specific disease insurances to private health insurances paying for actual damages guaranteeing against every kind of disease. Forth, it judged that, not only private health insurances paying for actual damages, but also long-term care insurances and income security insurances are prospective as fields to create fresh demand for insurance industry.

• The Journal of the Korea Contents Association
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• v.17 no.5
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• pp.366-375
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• 2017

The purpose of this study is to analyze the use of hospital, hospitalization, medical service, discharge and power of medical care patients who are concerned about moral hazard. We conducted focus group interview with 3 medical care patients and their families and 5 workers who had worked for more than 4 years in a nursing hospital. The main results and implications are as follows. First, admission to nursing hospitals was mostly based on the linkage between the medical institutions and the competition to attract the patients rather than the choice of the patients. Second, the main cause of the long-term hospitalization of medical assistance patients was the lack of social protection measures such as absences of residence and care giver, although there are factors that cause moral hazard such as low self-pay. Third, most of the patients were in need of treatment, but they were admitted to the hospital even though their needs were not higher than those of the health insurance patients. Fourth, the rehabilitation service is the mainstay of the medical service of the nursing hospital, and the roles of nursing staff and care givers are important. Fifth, medical care patients are paying medical expenses for nursing hospitals due to cost of living and family support, but they are exempted from the hospital expenses or the burden of their own expenses in the hospital. Sixth, public institutions and social welfare institutions have not managed continuously since commissioning patients to nursing hospitals and have neglected the connection with community services after discharge.

• Korean Journal of Social Welfare
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• v.58 no.2
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• pp.273-302
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• 2006

The introduction of cash payments for care is a distinct trend that characterizes changes in care policies since the 1990s. Recently, many developed countries have newly introduced or extended cash payments for care that allow care users to be able to plan themselves for their cares instead of receiving direct care services from the state. Cash payments for care can be said to be one of the alternative policies by which user choices are extended, and it becomes possible to establish demand-cantered care delivery systems more economically and effectively, hence addressing the issue of the financial limitations and rigid systems that are common in modern welfare states, which make it difficult to response to various needs. However, the design and administration of cash for care vary across different countries. Such variations of cash for care policies influence on the combination of consumerism (based on liberal market values intrinsic in the care market) and citizenship based on social solidarity. Those variations eventually produce impacts on the balance of responsibilities and the roles of families, the state and market regarding care in other words, balancing of welfare pluralism. This paper has attempted to find general meanings and particularity of cash for care polices in modem welfare states by means of looking at the characteristics of cash for care policies of four different countries (Netherlands, France, Germany and Italy) and their impacts on their care market. If the four countries are ranked by the degree that they emphasize citizenship in light with social rights, the Netherlands, France, Germany and Italy could be placed in due order. From an economic point of view and in terms of cost containment, those countries will be placed in an inverse order, It is apparent that in the course of planting cash for care policies in the existing social systems involving different socio-cultural conditions and labour markets, sometimes more emphasis is placed on the citizenship of care users, family carers and care providers than on cost containment issue, and sometimes vice versa. Behind this lies the process of different social valuation on what care is about; who can better deliver care; who should be responsible for care; how responsibilities should be shared and so on.

• 한국노년학
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• v.38 no.3
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• pp.569-592
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• 2018

This study purported to investigate the current state of human rights of older adults residing in rural areas of Korea. The study utilized, as an analytic framework, 4 priority directions (1. "older persons and development", 2. "rural area development", 3. "advancing health and well-being into old age", and 4. "ensuring enabling and supportive environments") with 13 task actions recommended by Madrid International Plan of Action on Ageing (MIPAA). Furthermore, the study examined gender differences in all items included in the analytic framework. Data was collected by the face-to-face survey on 800 subjects aged 65 and over. Statistical analyses were conducted using STATA 13.0 program. The main results were summarized in order of 4 priority directions as follows. First, average working hours per day were 6.2, and men reportedly participated in economic activities and needed job training more than women, while women participated in lifelong education programs more than men. Awareness of fire and disaster prevention facilities was low in both genders. Second, accessibility to the support center for the elderly living alone as well as protective services for the vulnerable elderly was found to be low. IT-based services and networking were used more by men than women, and specifically, IT-based financial transactions and welfare services were least used. Third, medical check-ups and vaccinations were well received, while consistent treatments for chronic illnesses and long-term care services were relatively less given. In addition, accessibility to mental health service centers was considerably low. Fourth, although old house structures and the lack of convenience facilities were found to be circumstantial risk factors for these elders, experiences of receiving housing support services were scarce. The elderly were found to rely more on informal care, and concerns for their care were higher in women than men. Plus, accessibility to elderly abuse services was markedly low. Based on these results, discussed were implications for implementing policies and practical interventions to raise the levels of the human rights for this population.

• Journal of Internet Computing and Services
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• v.21 no.3
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• pp.133-144
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• 2020

The number of elderly people with dementia is increasing as fast as the proportion of older people due to aging, which creates a social and economic burden. In particular, dementia care costs, including indirect costs such as increased care costs due to lost caregiver hours and caregivers, have grown exponentially over the years. In order to reduce these costs, it is urgent to introduce a management system to care for dementia patients. Therefore, this study proposes a sensor-based abnormal behavior detection system to manage dementia patients who live alone or in an environment where they cannot always take care of dementia patients. Existing studies were merely evaluating behavior or evaluating normal behavior, and there were studies that perceived behavior by processing images, not data from sensors. In this study, we recognized the limitation of real data collection and used both the auto-encoder, the unsupervised learning model, and the LSTM, the supervised learning model. Autoencoder, an unsupervised learning model, trained normal behavioral data to learn patterns for normal behavior, and LSTM further refined classification by learning behaviors that could be perceived by sensors. The test results show that each model has about 96% and 98% accuracy and is designed to pass the LSTM model when the autoencoder outlier has more than 3%. The system is expected to effectively manage the elderly and dementia patients who live alone and reduce the cost of caring.

• Journal of Digital Convergence
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• v.18 no.12
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• pp.389-399
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• 2020

Diverse official policies in community are available for caregivers to take care of the elderly in the US and the UK. This study aims to examine the recent changes in government supports based on The Recognize, Assist, Include Support and Engage (RAISE) in the US, and those by Carer Act 2014 in the UK, to take any good lessons for Korean policy. Caregivers will play a new role to develop innovative treatment for patient-centered care. The UK strengthens to provide various efforts for working carers while assuring economic efficiency in labor market with empirical evidence. The major four ways to support carers were developed agreed with the acknowledge of caregiving value and their human right; financial support, direct services for carers, flexible work time, and advocacy. Korean supports policies for carers in long-term care and social welfare will be more effective in community care system if more evidence based policies are prepared.

• Quality Improvement in Health Care
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• v.5 no.2
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• pp.324-334
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• 1998

Background : Strategic planning is an organizationwide or systemwide, ongoing look into the future usually of 2~3 years, based on objective analysis of the current environment and trends, but it can incorporate both short-term and long-term goals. The strategic planning process includes external analysis, internal analysis, issue analysis, development of mission, vision and values, and lastly development of organizational goals and objectives. As a part of the strategic quality planning process, certain service lines, important organizationwide functions, or key processes supporting these functions can be prioritized to expedite and roll out certain strategic goals. This is called strategic quality initiatives. Methods : We organized a quality improvement team, a subgroup of 21st century vision planning corps of our medical center, and pursued QI activities for improvement of healthcare environment, particularly in the admission setting. We developed a strategic quality initiative based on the results of patient satisfaction surveys, and carried out functions of self-directed work team. Results : The strategic goal was to be the benchmark for peer group hospitals in Korea for providing cost-effective best-practice. The QI team included 3 medical doctors, 1 nurse, 1 social worker, and 1 QI consultant as well as many operational members to support services and quality initiatives met every Tuesday for 18 weeks. Outcome objectives were to improve patient satisfaction score. The issues included in the objectives were comfort, temperature, noise, cleanliness of the admission wards, quality and education of patient meals, matters regarding the admission process, and an appurtenant facility such as restaurant or convenience store. Every issue was discussed and recommendations, conclusions and opportunities were implemented. Conclusions : By developing a strategic quality initiative as a part of the strategic quality planning process, and pursuing a self-directed work team, certain sen/ice lines, important organizationwide functions, or key processes supporting these functions can be improved effectively within a short period. Strategic quality initiatives serve to support, or roll out, certain strategic goals that are relevant to performance improvement and development of specific measurable outcome objectives, and associated performance measure for each initiative. Each strategic quality initiative should include a statement of intent outcome objectives, and performance measures. We will come back with follow up of the strategic quality initiative, for improvement of healthcare environment, and results of patient satisfaction re-survey.

• Korean Journal of Social Welfare
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• v.67 no.4
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• pp.251-277
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• 2015

This qualitative study is designed for the reconstruction of the experience of single mothers in poverty based on the bottom-up approach. Welfare dependency is identified as vital help to protect their own and children's lives, through their stories telling that welfare services provided by government and community take care of them "in place of their husbands", and "raise them up by hand." What is self-sufficiency to them is more of a process-orientation through welfare dependency than a state out of it, and a way to look through building their self-esteem and working to discover their self-worth except their economic power. Restoring their potential to self-sufficiency through dealing with their psycho-social stresses and expanding services for them related to child-care(education) and occupation ability development for long-term self-sufficiency, rather than hasty focusing on welfare exit, should be built on the foundation of helping them self-sufficient. In order for the self-sufficiency program to overcome the participant's images of "subordination and stigma" and to convey the original meaning of "welfare to work", the performance and evaluation system of self-sufficiency programs that reflects the insider's perspectives on their participation motive and process, and the self-sufficiency program customized for their needs and interests should be encouraged to develop.