• 보건행정학회지
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• 제19권4호
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• pp.78-97
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• 2009

This study examined the factors related to family caregiver satisfaction with institutional care services for beneficiaries under the Public Long-Term Care Insurance(PLTCI) system. Determining what contributes to family caregiver satisfaction is a critical step toward implementing effective quality improvement strategies. A national cross-sectional descriptive survey was conducted from November to December 2008, using proportionate quota sampling based on the location and level of Long-Term Care of the beneficiaries. Total 1,745 family caregivers wrote informed consents and 733 (response rate 42%) completed questionnaires, which included caregiver characteristics, organizational resources, primary objective and subjective stressors, perceived quality of services, and family caregiver satisfaction. Family caregivers were satisfied overall with institutional care. In multiple regression analysis, there was a statistically significant difference in degree of family caregiver satisfaction according to caregiver characteristics(relationship to beneficiary), primary objective stressors (insurance type of beneficiary), perceived quality of services(respect to family caregivers' idea, ADL support, expertness of staff, careful concern of staff, fulfillment of client's requests, and safety of institution's environment). In public long-term care, satisfaction efforts are in an early stage of development. This study is meaningful as the first attempt to measure family caregiver satisfaction with institutional care for beneficiaries under the PLTCI system, and to identify factors affecting the satisfaction. Among the identified factors, the policy makers, the insurer, and the providers need to pay attention to perceived quality of services, in particular, to improve customer satisfaction. Our findings can provide quality care improvement initiatives in the public long-term care setting.

• 재활간호학회지
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• 제12권2호
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• pp.92-101
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• 2009

Purpose: This study was conducted to explore the functional status and long-term care services for the community-dwelling low-income elderly. Method: A descriptive research design was used in this study. The functional status of the participants was obtained using Minimum Data Set-Home Care Version 2.0 and the long-term care services were identified via Michigan's choice. Total of 154 persons aged 65 years or older completed Korean Minimum Data Set-Home Care Version 2.0 on the community dwelling low-income elderly. Results: The average of Activities of Daily Living was 4.19, and the range was 0-55, while the average of Instrument of Activities of Daily Living was 4.85 and the range was 0-56. Among the subjects, 46.1% belonged to the Information and Referral group and 1.3% to the Nursing Home group. Severe daily pain was reported by 14.9%, and 76.6% of the participants had impaired vision. The Activities of Daily Living was difference according to living with, education, vision, and depression. The long-term care services differed according to gender, pain, vision, hearing, and depression. Conclusion: The support policy for the elderly needed to focus on impaired visual and depression to enhance the activities of daily living. Moreover, there is a need for the Information and Referral group to arrange and develop nursing intervention resources.

• Journal of Preventive Medicine and Public Health
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• 제38권1호
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• pp.16-24
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• 2005

Objectives : To help develop strategies to cope with the changes arising from the rapid aging process by predicting the determining factors of intention to actual use of the charged long-term care services for elderly as perceived by the middle aged who play the major role of supports. Methods : Subjects were the parents (men 177, women 507) in their 40s of the students selected from a university of Busan city. A questionnaire survey was conducted for 4 weeks in October 2003 about the knowledge for long-term care service, the intention of actual use, and the preferences about the type of service suppliers. Data analysis was performed with frequency, chi-square test, and t-test using SPSS program (ver 10.0K), along with data mining using decision tree of Enterprise Miner V8.2 by SAS. Results : About half of the subjects (53.7%) had the actual experiences of elderly supports. Intentions to use the charged services were relatively high in home visiting nursing care service (40.1%) and long-term care facilities service (40.4%), and were influenced by previous knowledge about the services. The intentions were stronger in women, those with higher education, and those with greater income levels. Actual elderly supports were mostly (80%) done by women, and the perceived burdens for the supports were bigger in women and those of lower socioeconomic level. Desired charges were about 10,000 won for the bath service, 20,000 won for the rests services per day, and about 500,000 won for the long-term care facilities service per month. From the result of decision tree analysis, the job professionalism was the most important determining factor of intention to actual use of the services with validation as $63{\sim}71%$. Health and welfare mixed type facilities were preferred, and the most important consideration was the level of professionalism. Conclusions : Intention to actual use of the charged services was largely determined by the aspects of time and cost. Polices to increase the number of service suppliers and to decrease the burdens perceived by actual supporters were strongly recommended.

• 보건행정학회지
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• 제22권3호
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• pp.403-426
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• 2012

The purpose of this study is to compare the standards and guidelines of long-term care facilities based on the physical environments and human resources in Korea, Japan, USA, and Australia. Ultimately, this study suggests the directions for amendments of long-term care service or running of the facilities in Korea. For achieving this purpose, we reviewed the homepage of national health departments, reports and articles of long-term care service, and acts related with long-term care in each country. This comparisons were carried in terms of physical environments, human resources by long-term care related acts and legal sanctions as means of quality control. This study implies that long-term care service guidelines or standards should be revised for developing the quality of our long-term care services.

• 보건행정학회지
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• 제17권2호
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• pp.52-67
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• 2007

Korean government is preparing the long-term care financing and delivery system in order to cope with rapid population aging. The system should be designed to provide demented patients with an appropriate services that the patients want to take, and considered to be necessary for them. In this regard, this study aims to analyse empirically a relationship between the types of long-term care services that demented patients wanted to take and they actually received during 2004. The caregivers of 609 dementia patients, who were randomly selected in a manner of proportional allocation from a nationwide claim database of the Korean National Health Insurance Corporation, were interviewed in September, 2005. Independent variables include socio-demographic characteristics, Activities of Daily Living(ADL) and Instrumental Activities of Daily Living(IADL). To explore the correspondence of the types of long-term care services that demented patients wanted to take and that they actually received, and its affecting factors, we conducted chi-square test and logistic regression analysis. Main findings are as follows. First, while only 20% of study subjects wanted home services as a long-term care services, those who wanted to use the long-term care facilities and general hospital were 37%, 43% respectively. Second, the correspondence rate was just 38% on average, and extremely low in the demented patients who wanted to use long-term care facilities. Third, the demented patients who resided in urban areas and received relatively high level of education showed high correspondence rate. Fourth, the high ADL score was closely related to low correspondence rate.

• 한국지역사회생활과학회지
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• 제22권1호
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• pp.35-51
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• 2011

This study examined how caregiving experiences of spouses and adult children were different to each other in terms of caregiver characteristics, the impairment level of the elderly, caregiving time, caregiver burden, the effects of long-term care services, etc. Data were collected from 321 spouses and 324 adult children who cared for the functionally and/or cognitively impaired elderly using long-term care services. The main results are as follows. (1) Caregiver characteristics differed significantly between spouses and adult children. (2) Adult children cared for the more severely impaired elderly in terms of IADL, cognitive impairment, and behavior problems while spouses spent more time helping in ADL activities. (3) Spouse caregivers experienced greater overall burden, worry and strain, and financial burden compared to adult child caregivers. (4) Long-term care services were effective in reducing caregiver burden and improving family relations. Additionally, relations between adult child caregivers and the elderly was more improved than relations between spouse caregivers and the elderly after using long-term care services. Based on these findings, the differential experiences between spouse caregivers and adult child caregivers were discussed.

• 대한치위생과학회지
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• 제6권1호
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• pp.13-25
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• 2023

연구배경: 본 연구는 비정형 빅데이터를 활용하여 노인장기요양보험의 직접적 서비스 인력인 요양보호사의 서비스질 관리를 확인하고자 수행되었다. 연구방법: 요양보호사의 서비스질과 관련된 소셜 비정형 데이터를 텍스톰을 사용하여 수집·분석하였다. 데이터를 크롤링하여 수집된 상위 50개 키워드들 간의 빈도분석, TF-IDF, 중심성 분석, 의미연결망분석과 CONCOR 분석을 실시하였다. 연구결과: 빈도분석 결과 상위권에 속한 키워드는 '요양서비스' '요양보호사', '서비스질', '요양보호', '장기요양기관', '향상', '어르신', '처우', '개선', '필요' 였으며, 연결중심성과 위세중심성 분석결과도 거의 동일한 순위로 확인되었다. CONCOR 분석결과 4개의 그룹으로, 요양서비스질 개선, 요양서비스 운영, 요양서비스 제도, 요양보호사의 심리적인 부분에 대한 인식이 높은 것으로 나타났다. 결론: 본 연구는 요양보호사의 서비스질과 관련한 인식을 의미있는 그룹으로 제시하였으며 이는 요양보호사 서비스질 향상을 위한 다각적인 방향성 수립에 기여할 것으로 판단된다.

• 한국엔터테인먼트산업학회논문지
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• 제15권1호
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• pp.199-206
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• 2021

초고령 사회가 임박함에 따라 노인성 질환자 또한 증가하고 있으며 이로 인한 사회적 문제로 시설과 정책의 부족이 제기되고 있다. 의료보장의 현실적 대안으로 국민건강보험이 이야기되고 있으며, 요양병원은 급성기 병원과 장기요양시설 사이로 분류되며 의료비 절감의 대체재로 작용하고 있다. 그러나 유지기 재활의 핵심인 요양병원은 서비스의 질적 문제가 심각히 제기되고 있고, 현 의료체계의 문제로 재활 난민이 양산되는 문제가 있다. 특히 2015년 선행연구에서 전라북도의 요양병원 현황이 가장 열악하였으며 이에 공공데이터를 활용하여 전라북도 요양병원 일반현황, 다빈도 상병 현황, 재활서비스 관련 현황, 재활서비스 중 작업치료 관련 현황에 대하여 탐색하고자 한다.

• 한국보건간호학회지
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• 제30권3호
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• pp.512-525
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• 2016

Purpose: Ageing in place may improve the quality of life of frail elderly and decrease their costs of services. The purpose of this study was to examine the factors that influence the institutionalization of elderly using home care services in a Korean long-term care insurance system. Methods: This study used the data of '2009 Satisfaction survey of Korean long-term care system'. The survey proceeded to use a sampling data based on region, level of long-term care need, and insurance type among the beneficiaries between August and September 2009. The onset dates of institutionalization of 1,095 participants were ascertained from long-term care insurance claim data. This study calculated the hazard ratio through the Cox Proportional Hazard Model. Results: A total of 176 subjects who were institutionalized in nursing homes were included. There were higher risks in the group that included those who were 85 years and over, had dementia or fracture, used home-visit nursing service, and were not supported by direct family. Conclusion: The results of this study have policy implications to supplement the home care service system and postpone nursing home institutionalization of elderly.

• 동서간호학연구지
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• 제26권1호
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• pp.28-38
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• 2020

Purpose: The aim of this study was to provide information on the extent and variations of elderly residents' nursing care needs, and provision of nursing care across long term care facilities. Methods: A nationwide survey was conducted on nurse managers from 1,041 long term care facilities, by e-mail or fax, from August 16 to September 30 in 2017. A self-reported questionnaire consisting of 5 domains was used to collect data. Results: Facilities with more than 30 residents were more likely to need skilled nursing services and to obtain the nursing staff such as a registered nurse and a nurse's aide. Awareness and satisfaction of hospital-based home nursing care was high in all facilities. In addition, there are some differences in nurse managers' perceptions of the level of healthcare resources and required action by facility size. Nurse managers of senior congregate housings were more likely to have considerable difficulty in dealing with healthcare needs of residents and recognizing the healthcare resource shortage. A majority of nurse managers agreed on the need to employ a registered nurse. Conclusion: This study confirmed that it is essential to increase nurse staffing level and to reform the long term care insurance for enhancing the accessibility of healthcare services, especially for the residents in small long term care facilities. There is also a need to provide diverse education and training opportunities for nursing staff working in long term care facilities.