• The Journal of Korean Physical Therapy
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• v.24 no.1
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• pp.35-40
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• 2012

Purpose: This study was to analyze the factors that affect the service relationship of long term care workers for the elderly and to provide basic resource for the successful connection of long term care services. Methods: 259 subjects who were engaged in long term care units completed a self-administered questionnaire that measured the extent of service linkage among one another. The Cronbach's ${\alpha}$ score determined the internal consistency of the acquired data and the discriminated validity was estimated by Pearson's correlation coefficient. Multiple regression analysis was conducted to investigate the influence of the known factors on the service linkage. Results: Acceptance and participation negatively influenced on the service linkage. Reliance, comprehension, recognition on service, and frequent contact with others positively activated the service linkage of long term care workers. Conclusion: The establishments of systemic training courses providing education that emphasizes reliability and recognizes other services, including work environment to contact easily are needed to improve the service-linkage of long-term care workers for the elderly.

• Health Policy and Management
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• v.24 no.3
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• pp.283-290
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• 2014

Background: This study aimed to examine the relationship between home-visit nursing services and health care utilization under the public long-term care insurance program in Korea. Methods: We analyzed the long-term care need assessment database and the long-term care and the health insurance claim databases of National Health Insurance Service between July 2011 and June 2012. The sample includes a total of 20,065 home-visit nursing recommended-older beneficiaries who use home-visit nursing and/or home-visit care, based on a standard benefit model developed by the Health Insurance Policy Institute of National Health Insurance Service. The beneficiaries were categorized into home-visit nursing use and non-use groups, and the home-visit nursing use group was again divided into high-use and low-use groups home-visit nursing, based on their total annual home-visit nursing expenditure. Two-part models and negative-binomial regression models were used for the statistical analysis. Results: The home-visit nursing use was negatively associated with the number of outpatient visit and cost, while adjusting for all covariates. The home-visit nursing use was also negatively associated with the inpatient cost among the high home-visit nursing use group. Conclusion: The findings implies home-visit nursing use prevents health care utilization. Further studies and policy strategies that can promote and strengthen home-visit nursing services under the public long-term care insurance are necessary in Korea.

• Health Policy and Management
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• v.12 no.1
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• pp.21-53
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• 2002

The purpose of this study is to measure the resource use of the elderly in long-term care services and to examine the effects of patient and facility characteristics on their use of resources. The data were collected from 510 old people over sixty years of age, residing in five long-term care hospitals and two skilled nursing homes during the period between December 1, 2000 and February 28, 2001. For a full sample, when the first level of RUG(Resource Use Group)-III categories were employed as the proxy of patient severity, facility characteristics, such as location, size and ownership, have large effects on the resource use measured by service intensity, whereas patient characteristics such as severity have little or no effect. The resource use is significantly high if the facility: (1) is located in rural areas (gun): (2) has mare than 200 beds; (3) is a long-term care hospital; (4) is private; and (5) has a low percentage of medical aid patients. The analysis of the resource use in each RUG-III categories, for which ADL(Ability of Daily Living) were employed as the prosy of patient severity, shows a similar result. The loose relationship between the needs of residents and the resource use seems to be closely associated with the ineffective reimbursement system for providers. The current reimbursement system has no provision for quality improvement and reimburses facilities simply according to their types: fee-for-service for long-term care hospitals, and monthly-flat-rate or full-coverage-national-aid for skilled nursing facilities. It will be necessary to develop a more reasonable reimbursement system that takes patient's severity into account and gives incentives for long-term care providers to offer cost-effective services.

• Journal of Korean Academy of Nursing
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• v.40 no.6
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• pp.903-912
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• 2010

Purpose: This study was conducted to examine whether the level of classification for long-term care service under longterm care insurance reflects resource utilization level for residents in nursing homes. Methods: From 2 long-term care facilities, the researchers selected 95 participants and identified description and time of care services provided by nurses, certified caregivers, physical therapists and social workers during a 24-hr-period. Results: Resource utilization level was: 281.04 for level 1, 301.05 for level 2 and 270.87 for level 3. Resource utilization was not correlated with level. Differences in resource utilization within the same level were similar with the coefficient of variance, 22.7-27.1%. Physical function was the most influential factor on long-term care scores (r=.88, p<.001). The level for long-term care service did not reflect differences in resource utilization level of residents on long-term care insurance. Conclusion: The results of this study indicate that present grading for long-term care service needs to be reconsidered. Further study is needed to adjust the long-term care classification system to reflect the level of resource utilization for care recipients on the long-term care insurance.

• Research in Community and Public Health Nursing
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• v.27 no.3
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• pp.272-283
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• 2016

Purpose: This is a comparative study using secondary data from the Korean national long term care (LTC) insurance. Methods: Visiting nursing (VN) service users (n=666) and non-users (n=4,375) were extracted and compared in terms of medical expenditures, length of hospitalization, and annual number of ambulatory care visits to investigate effects of VN services in LTC. Results: Total health care expenditures were compared between the two groups and it was found that VN service users spent about $ 1700 than non-users for their medical costs between 2009 and 2011. The average length of in-hospital stay for VN service users was 19.4 days shorter than that of non-users. However, using VN services did not significantly influence the annual number of ambulatory care visits. Conclusion: The study has found that VN services are effective ways of providing community-based LTC services. We recommend LTC policy makers to further utilize VN services to deliver cost effective health care services.

• Korean Journal of Adult Nursing
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• v.26 no.5
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• pp.543-552
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• 2014

Purpose: The purpose of this study was to develop integrated evaluation indicators of home care services in the hope that the increasing group of long-term home care patients could receive quality care services. Methods: The development involves a methodological study on a development phase and a verification phase. The main survey at a verification stage was conducted by the staffs at 146 institutions who agreed to participate on this study. Results: The evaluation index for the integrated home visit care consisted of five categories and 57 indicators including Managing Institution (12), Environment and Safety (3), Right and Responsibility (7), Process of Care (31) and Results of Care (4). The criterion-related validity was verified in regard to the participation in the 2010 evaluation of long-term home-care institutions by the National Health Insurance Corporation. Conclusion: The evaluation index of the integrated home visiting care developed in this study is considered suitable to utilize as evaluating indicators in managing and evaluating the way of how institutions integrate and provide home visit care services as well as home nursing care services.

• Health Policy and Management
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• v.20 no.1
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• pp.37-63
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• 2010

Public expenditures on long-term care are a matter of concern for Korea as in many other countries. The expenditure is expected to accelerate and to put pressure on public budgets, adding to that arising from insufficient retirement schemes and other forms of social spending. This study tried to foresee how much health care spending could increase in the future considering demographic and non-demographic factors as the drivers of expenditure. Previous projections of future long-term expenditure were mainly based on a given relation between spending and age structure. However, although demographic factors will surely put upward pressure on long-term care costs, other non-demographic factors, such as labor cost increase and availability of informal care, should be taken into account as well. Also, the possibility of dynamic link between health status and longevity gains needs to be considered. The model in this study is cell-base and consists of three main parts. The first part estimated the numbers of elderly people with different levels of health status by age group, gender, household type. The second part estimated the levels of long-term care services required, by attaching a probability of receiving long-term care services to each cell using from the sample from current year. The third part of the model estimated long-term care expenditure, along the demographic and non-demographic factors' change in various scenarios. Public spending on long-term care could rise from the current level of 0.2~0.3% of GDP to around 0.44~2.30% by 2040.

• Journal of Korean society of Dental Hygiene
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• v.22 no.1
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• pp.63-72
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• 2022

Objectives: This study was conducted to prepare basic data to propose the necessity and utilization of oral welfare products in the welfare services of the long-term care insurance system, focusing on facility workers working in elderly facilities. Methods: The analysis was conducted on 144 workers working at some local elderly facilities. The questionnaire was constructed by classifying the use of oral welfare tools into 6 questions and the necessity and demand for oral welfare devices into 13 questions. Frequency analysis and technical analysis were performed for data analysis, and one-way ANOVA was performed for differences in the necessity and demand for oral welfare equipment. The statistical significance level was p<0.05. Results: As a result of examining the awareness of the necessity and demand for oral welfare equipment among workers in elderly facilities, the awareness of the necessity of including oral welfare equipment in the items of welfare equipment in the current long-term care insurance system was high at 4.15 points. As a result of analyzing the correlation between awareness of care products and the need and demand for oral welfare equipment, it was confirmed that there was a statistically significant positive correlation (p<0.01). Conclusions: In the long-term care insurance system for the elderly, oral welfare products need to be considered for welfare equipment services. The provision of oral welfare products within the long-term care insurance system for the elderly can provide opportunities and services to select various self-care tools. In addition, it is expected that it will be possible to promote changes in the long-term care insurance system for the elderly and to improve the system in a variety of positive ways.

• Research in Community and Public Health Nursing
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• v.22 no.2
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• pp.141-150
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• 2011

Purpose: The purpose of this study was to examine satisfaction with counseling in long-term care service, and to compare the scores of counseling satisfaction according to variables among beneficiaries of Korean long-term care services. Methods: Questionnaires were completed by 445 beneficiaries of long-term care insurance to measure satisfaction with counseling. Research design was cross-sectional descriptive design. Data were analyzed using descriptive statistics, t-test and ANOVA for evaluating differences in satisfaction with counseling according to variables including economic status, the level of long-term care insurance approval, duration of long term care service, and conditions of counseling. Results: The score of satisfaction with counseling was somewhat high as 71.67. The score of counselor's attitude was highest among the subcategories of satisfaction. The factors that influenced satisfaction with counseling were frequency and time of counseling (F=12.19, p<.001). Conclusion: Home-based individual counseling is necessary for the elderly who need long-term care service. The National Long-term Care Insurance Corporation should offer counseling and assistance to elders and their caregivers about long term care insurance.

• Korean Journal of Occupational Health Nursing
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• v.25 no.1
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• pp.19-28
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• 2016

Purpose: This study was a descriptive research to identify the effects of communication skills, compassion satisfaction, compassion fatigue on burnout among staff of long term care insurance for the elderly in National Health Insurance Services in Korea. Methods: A descriptive cross-sectional design was used. The participants were 191 staffs of long-term care insurance in National Health Insurance Services. Data were collected via mail from the 24 branch offices which were randomly selected among the total of 226 centers of National Health Insurance Corporation. Stamm's professional quality of life (ProQOL) and Communication Skills Test tool were included in questionnaire to detect. SPSS/WIN 20.0 was used to conduct the descriptive statistics, t-test, ANOVA, correlation analysis, and multiple regression. Results: Compassion fatigue had a significant positive effect on burnout, while Compassion satisfaction had a negative effect on burnout. The explained variance for burnout was 69% and compassion fatigue was the most significant factor in burnout among staff of long term care insurance services. Conclusion: The results indicate that the factors influencing staffs' burnout are compassion fatigue, compassion satisfaction, and education level. Therefore, strategies to decrease compassion fatigue and improve compassion satisfaction are needed to decrease burnout for staffs of long-term care insurance in National Health Insurance Services.