• Title/Summary/Keyword: Long-term elderly care insurance

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Development of Eligibility Criteria for Comprehensive Medication Management Programs in Long-term Care Facilities Using RAND/UCLA Appropriateness Method (RAND/UCLA Appropriateness Method를 이용한 요양시설의 포괄적 약물관리 프로그램의 대상자 기준 개발)

  • Jang, Suhyun;Kang, Cinoo;Ah, Youngmi;Lee, Ju-Yeun;Kim, Jung-Ha;Jang, Sunmee
    • Korean Journal of Clinical Pharmacy
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    • v.32 no.3
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    • pp.260-269
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    • 2022
  • Background: Comprehensive medication management is essential to achieve safe and optimal drug use for the elderly in long-term care facilities (LTCF). This study aimed to develop eligibility criteria for "Comprehensive medication management program in LTCF" using the RAND/UCLA Appropriateness Method (RAM). Furthermore, we attempted to estimate the number of beneficiaries who met the criteria by analyzing the National Health Insurance claims data. Methods: Twelve criteria were selected initially. We composed a panel of 14 experts with expertise in long-term care. We conducted two survey rounds to reach a consensus. Rating for appropriateness and decision regarding agreement were applied per RAM. We analyzed the National Health Insurance data to estimate the number of LTCF residents who met each eligibility criterion. Results: Of the 11 items agreed upon, ten items were determined to be appropriate. In 2018, 83.6% of 165,994 residents of LTCF met one or more eligibility criteria. The largest number of subjects met the "New residents of LTCF" criterion, followed by "Take high-alert drugs" and "Chronic excessive polypharmacy." Since the items evaluated as most appropriate by the expert panel and those with a large number of subjects were similar, we confirmed the external validity of our criteria. Conclusion: It is worth noting that this is the first attempt to establish the eligibility criteria for medication management in LTCF. Further preliminary research is needed to identify the selected subjects' drug-related problems and revise the criteria according to the results.

A Study on Improvement of Laws regarding Welfare for the Aged (노인복지 관련법제의 발전방향)

  • Park, Ji-Soon
    • Journal of Legislation Research
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    • no.41
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    • pp.87-123
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    • 2011
  • Korea is expected to become an 'aged society' with more than 14 percent of the public aged 65 years or more by 2018. The rapid aging is giving rise to various problems within the society along with falling birthrate in a short period of time. In this context, the role and function of laws on welfare for the aged must be particularly emphasized. Also the Senior Citizens Welfare Act is of great importance as it provides social welfare service on the basis of functional connection with social insurance and public assistance. First, this paper looks into the history of laws related to welfare for the elderly such as the Senior Welfare Act, the Act on Long-term Care Insurance for Senior Citizens and the Basic Old Age Pension Act as well as the findings of earlier studies. In the second place, it will break down such laws by main components aiming to examine details of the laws and questions raised regarding them and to seek ways to achieve improvement with an emphasis on health care, old age income security, housing welfare(assisted living facilities), job security for the aged. The Senior Welfare Act offers substance of social welfare service for the elderly. Income security, health and medical care, welfare measures through long-term care and assisted living facilities, social participation by working are the key elements and all of them should be closely associated to ensure citizens get sufficient public support in their old age. For this purpose, the Senior Welfare Act is under a normative network with laws such as Act on Long-term Care Insurance for Senior Citizens and Basic Old Age Pension Act. Current laws on welfare for the aged including Senior Welfare Act are not sufficiently responsive to the aged society of the 21st century. Income security combined with decent social participation, health and medical care closely connected with long-term care system, efficient expense sharing between government and local government, enhancement of effectiveness of welfare measures can be considered as means to improve current welfare system so that the elderly can enjoy their old age with dignity and respect.

Health Status and Social Support among the Elderly Living Alone with Restricted Daily Functions (홀로 사는 일상생활 기능제한 노인의 건강 상태 및 사회적 지지 현황)

  • Park, Young-Hee
    • The Korean Journal of Health Service Management
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    • v.12 no.1
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    • pp.95-107
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    • 2018
  • Objectives : This study was performed to investigate the health status and social support among elderly living alone with restricted daily functions using the data of the "2014 the Korean Elderly Survey". Methods : Data on 2,407 elderly living alone were drawn and statistically examined using a t-test, an ANOVA, and a multiple regression analysis. Results : The study found that first, the elderly living alone with restricted daily functions comprised 22.1% of the total elderly living alone, and those who were older elderly, illiterate, with low-income, having poor nutrition management, and with a poor health status. Second, among the elderly living alone with restricted daily functions, there was a group with very little support from the family and only 14.0% were covered by long-term care insurance. Third, the life satisfaction of the elderly with restricted functions was lower than that of the non-restricted elderly, and was affected by income, health conditions, depression, access to senior welfare centers, and communication with others. Conclusions : The elderly living alone with restricted daily functions have serious health risks and social support, and hence they should be provided with more proactive support for life, health care and social care to live independently within their communities.

Physical Function(ADL, IADL) and Related Factors in the Elderly People Institutionalized in Long-term Care Facilities (장기요양시설 노인들의 신체적 기능(ADL, IADL) 수준 및 관련요인)

  • Ahn, Kwon-Suk;Park, Sung-Kyeong;Cho, Young-Chae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.3
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    • pp.480-488
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    • 2016
  • This study examined the levels of ADL and IADL among elderly people who were institutionalized in long-term care facilities and determined their association with socio-demographic characteristics, health status, and health related behaviors. Interviews were performed, during the period from June 1 to July 31, 2015, to 205 elderlies received from long-term care service. As a results, the total mean score was $16.67{\pm}2.11$ for ADL (range: 6~8) and $15.13{\pm}3.79$ for IADL (range: 7~21). The selected factors associated with ADL were with or without a spouse, frequency of going out, subjective health status, and mastication ability. The factors associated with ADL were selected, such as gender, with or without a spouse, frequency of going out, subjective health status, disability of body, and amnesia. In conclusion, the level of ADL and IADL in the elderly people selected from long-term care insurance were influenced by the socio-demographic characteristics, health status and health-related behaviors.

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.

Differences of Cancer Patient's Health Care Utilizations between Medical Aid Program and National Health Insurance in the Elderly (노인 암환자의 건강보험과 의료급여 이용차이 분석)

  • Lee, Yong-Jae
    • The Journal of the Korea Contents Association
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    • v.11 no.5
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    • pp.270-279
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    • 2011
  • This study to analyze differences of cancer patient's health utilizations in medical aid program and national health insurance by analysing health insurance claims data, and identify effects of health care systems. The majors results of the research were as follows. First, cancer patients in medical aid program more used total medical expenditures than in national health insurance mostly by many outpatient visits and long term hospitalization. Second, results of multiple regression, cancer patients in medical aid program more used total expenditures and inpatient expenditures. But, outpatient expenditures weren't different, cancer patients in medical aid program more visited medical institutions and hospitalized long term periods than in national health insurance. Therefore, it is too early to conclude that moral hazard is in health utilizations of medical aid program, because cancer patients in medical aid program many use in benefits for many nonbenefit burdens.

A Study on the Determinants of Private Long-Term Care Insurance and First Home Care Use in the United States: Using Discrete Time Model (미국의 민간장기요양보험 가입과 재가요양서비스 이용의 결정요인에 관한 연구: 이산시간모델을 사용하여)

  • Kim, So-Yun;Hong, Gong-Soog;Montalto, Catherine P.
    • Survey Research
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    • v.11 no.2
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    • pp.97-121
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    • 2010
  • Using the 1998-2004 Health and Retirement Study(HRS), this study explored the determinants of private long-term care insurance(LTCI) ownership and the first home care use. To account for the interaction between LTCI purchase and home care use, this study used two-period utility model as theoretical framework. Discrete time model was used as an empirical model to incorporate the time-dependent feature of LTCI ownership. And this study accounted for the endogeneity of LTCI ownership and home care use by employing full information maximum likelihood estimation. This study indicated insignificant effects of private LTCI ownership and Medicaid eligibility on the home care use. Also, the effects of income and assets on home care utilization were negligible. Those who have poor health condition and who do not have potential informal caregivers were more likely to use home care. For private LTCI ownership, income and assets have positive relationship with LTCI purchase, and poor health status and age were negatively related to LTCI purchase. The elderly living with children and those who have more siblings were less likely to have private LTCI, and those who lived with spouses with no children were more likely to buy private LTCI. Based on the findings, this study provides implications to design long-term care(LTC) policies in the U.S. and to develop LTC planning education programs.

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The Effects of Cranio-Sacral Therapy on Brain Function Quotient of Elderly with Long-term Care Insurance Service (두개천골요법이 장기요양시설노인의 뇌기능지수에 미치는 효과)

  • Lee, Jung-eun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.1
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    • pp.474-484
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    • 2016
  • This study was performed to identify the effects of the improvement of brain function by CST on the elderly with the 2nd or 3rd grade of long-term care insurance service. A quasi-experimental design using a nonequivalent control group, pre-post test was used. A total of 12 elders (6 in the experimental group and 6 in the control group) were recruited. Upledger CST(10-Step Protocol) was performed on each subject for 50 minutes per session, once a week, for a total of 8 treatments over an 8 week period from Jan to Feb 2015. The brain function quotient was measured before the 1st CST and after the last CST by portable EEG measurement device using a 2 Channel neuro-feedback system. The data was analyzed by SPSS (Ver. 18.0) program. After CST intervention, the attention quotient (AQ), level of tension, anti-stress quotient (ASQ), emotion quotient (EQ) and brain quotient (BQ) of the experimental group was significantly better than that of the control group. These results showed that the CST was effective in reducing the level of fatigue by the AQ, increasing the physical and psychological stress relief by the ASQ, emotional balance by the EQ, and improving the total brain function by the BQ. Therefore, CST can be used as an effective intervention for improving the health and brain function of the elderly in health facilities.

A Study on the Emergence of Family-Care worker: Why Families choose to be Care Worker in Korea? (가족요양보호사의 발생에 대한 탐색적 연구: 한국의 노인장기요양보험제도에서 가족은 왜 요양보호사가 되었나?)

  • Yang, Nan Joo
    • 한국사회정책
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    • v.20 no.2
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    • pp.97-129
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    • 2013
  • This study aims to investigate causes of the emergence of so-called 'family-care workers' in the Long-term Care Insurance system in Korea. The LTCI system introduced in 2008 financially support the utilization of formal care services for the eligible elderly with care needs by paying for services of their care workers. Interestingly, 38.4 percent of payments for the in-home services were claimed by family members registered as qualified long-term care workers in 2012. We interviewed ten family care workers in depth and analyzed the needs of the aged and their families to explain the emergence of family care workers. The emergence of family-care workers is an inevitable result of choice by family members who face a dual burden of living and caring; be the additional choice following discharge the duty to support the elderly; be the alternative choice to fulfill unaccepted needs for services. These results suggest the needs for a comprehensive public provision of both income and social service support for the aged and an introduction of financial support for family care complementing the formal care support in the LTCI in Korea.

A Study of Factors That Influence the Promotion of Healthy Behavior in the Elderly According to Types of Residency (노인의 거주유형별 건강증진 행위 영향요인 비교)

  • Jeon Eun-Young;Kim Kwuy-Bun
    • Journal of Korean Academy of Nursing
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    • v.36 no.3
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    • pp.475-483
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    • 2006
  • Purpose: The goal of this study was to investigate the factors influencing health promoting behaviors in elderly individuals according to types of residency. Method: This was a descriptive study. The subjects were comprised of 243 elderly aged 65 years or over living in 3 large cities. The instruments used for this study were a health promoting lifestyle, perceived health status, geriatric depression short form scale-Korea, social support scale, and self-efficacy. The data was analyzed using SPSS Win 12.0. Result: Powerful predictors of a health promoting lifestyle were depression, self-efficacy, and perceived health status for the elderly living at home. In the cases of the elderly living in institutions, a powerful predictor of a health promoting lifestyle was identified as social support. Conclusion: For the operation of long-term care insurance, a service for home care programs is needed for the elderly living at home in order to reduce depression and to increase self-efficacy and perceived health status. In addition, social support provided by health-care professionals should be developed to promote a healthy lifestyle for the elderly living in institutional environments.