• The Korean Journal of Health Service Management
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• v.5 no.3
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• pp.13-23
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• 2011

This paper investigated the operating environment for the representative of each agency and the facility workers on the basis of analytical result of recognition changes of the operating environment changes under the operating the long-term care insurance. It was described plans to take positive effect on the operating as follows. The first, on the result of regression analysis, the service administrative range takes the biggest effect on the general recognition of executing the long-term care insurance off and on. The affirmative recognition of the service administrative range had the general recognition on the system be positive effect. But the operator of facility asserts that the care manager's professionalism related quality of service be strengthened. The second, on the result of regression analysis, in the financial accounting administrative it is revealed the more positive recognition it is, the more positive effects it has. From the difference verification of an operation size from operation subject, the small operation size and personal facility recognize the long term care insurance positively. On the other side the facilities where the operation size is big recognize the system negatively. The long-term care facility should rearrange a support program newly and the government needs to promote the donation activity, because it is needed to reduce the financial burden of facilities.

• Health Policy and Management
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• v.4 no.2
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• pp.27-57
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• 1994

The objective of running a long-term care institution is to provide services helpful for maintaining, supporting, and improving elderlies' optimum level of physical, mental, and psychosocial functioning. For the purpose of analyzing the current situations of institutional long term care facilities in Korea, 27 facilities were selected proportionately from each of the cities and provinces, out of the total 152 facilities. About 20% of those who were institutionalized during 25 August through 2 Qctober 1993, the 391 elderlies were chosen on a systematic random basis. The instrument of this study was developed by modifying the tools of CARE, MAI and PCTC. A multivariate approach of discriminant analysis and clustering technique were employed for this study. The Stiudy reveals that there is no clear differentiation of goals and functions among the longterm care institutions in Korea. Staffing patte군 of long-term care facilities shows a shortage of nurses, physical therapists, and dieticians. The linkage between acute care facilities and long-term care is weak, and administration of long-term care faciltiy is carried out by non-professionals. They are responsible for assessing health status before entering the facility, and evaluating elderlies' care. Therefore, it is not surprising to find that most of the facilities have accommodated agede regardless of their real needs and health status. Based upon findings of the analysis, this study has classified long-term care facilities into four types : Type I is to help elderlies maintain independence in daily living activities. Type II facilities have the objective of maintaining and improving the current level of elderlies' function. Type III is to maintain maximum independence of elderlies in activities of daily living. And Type IV is identified for the group of facilities designed to restore or improve functional abilities of elderlies. In conclusion, the following suggestions are made : the need for long-term care should be assessed by multidimensional measurement. Institutional long-term care facilities should be classified and developed in response to type of type of care and service need. Both acute and long-term care facilities should be linked together in order to support the evaluation of service operation and program development.

• Journal of the Korea Convergence Society
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• v.5 no.3
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• pp.7-16
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• 2014

The purpose of this study was to identify the factors influencing the level of nursing needs of a long-term care service user at home and the care giving burden of a primary caregiver. For this study, data were collected from 152 primary caregivers in J City with self-administered questionnaires and analyzed using multiple regression technique. Among the nursing needs of long-term care giving service users, the level of psychological and social requests was the highest. This study found that two characteristics variables(long-term care insurance benefit level and long-term care giving grade) had difference was statistically significant in physical nursing needs and psychological nursing needs. Out of care giving burden of primary caregivers, physical care giving burden was found to be the highest. Out of factors influencing care giving burden, daily care giving hours was the factor which had strongest influence. Basic living recipients and female primary caregivers showed higher care giving burden. The more care givers there were, the less care giving burden became.

• 한국노년학
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• v.34 no.2
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• pp.369-386
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• 2014

The purpose of this study was to develop the classification of home-based long-term care activities and to test its validity. In this study, the taxonomy of long-term care activities was structured according to the service domain and process. Two expert groups participated in making a draft of the taxonomy that was composed of 7 service domains, 22 care needs, 22 service objectives, and 114 activities. Reliability and validity of the taxonomy was tested in a sample of 152 elderly subjects who used the home-based long-term care services. Based on the factor analysis of 114 activities, 21 factors were extracted from 114 activities. Internal consistency of the factors was high. Content validity was confirmed by the CVI. Long-term care insurance grade was used to assess the criterion validity. Among 21 care needs, 12 cares needs were significantly different from their grade. The classification of home-based long-term care activities demonstrated reliability and validity. In conclusion, the use of this classification is recommended while communicating with the elderly subjects, service providers, and the 3rd party payers.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.27 no.3
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• pp.241-249
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• 2020

Purpose: This study aimed to investigate possible ways to expand the services of home-visit nursing through a review of the progress, achievements, and obstacles of home-visit nursing; a pilot project of an integrated home-service; the application of the Omaha System; as well as a case analysis of providing home-visit nursing services. Method: An integrated review was conducted using various source materials, including laws, previous studies, and a case analysis. Results: In case analysis of providing visiting nursing service, rehabilitation nursing, end-of-life nursing, and dementia care showed high nursing needs. It was necessary that the various home visit nursing services in the intervention area of the Omaha System, administrative services, case management, and center operation activities were all included in the payment systems of long-term care insurance. Conclusion: In the future, home visit nursing services of long-term care insurance should be reborn in the form of a center for integrated case management in the community, which would set long-term goals until the time of a client's death and encompass the realm of human rights for health, quality of daily life, and a dignity of life.

• Journal of Korean Public Health Nursing
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• v.24 no.2
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• pp.211-225
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• 2010

Purpose: This comparative study analyzed information systems including manpower, contents of service, clients, and costs among four nations. Methods: A literature review of relevant publications from Korea, United States, Japan, and Germany supported the use of several plans to activate home nursing care services under the long-term care insurance system in Korea. Results: Korean home nursing care services require quality improvements. The results indicated that a rule is necessary that rations simple visiting service and home nursing care services under the long-term care insurance system, that an integrated management system for elderly care is required, and that the revised delivery of services needs to establish and reflect on various factors to estimate the value in a home visiting nursing care cost system. Conclusion: The data should be valuable in establishment of home nursing care services under the long-term insurance system in Korea.

• Health Policy and Management
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• v.33 no.3
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• pp.295-310
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• 2023

Background: The long-term care (LTC) group has higher rates of chronic disease and disability registration compared to the general older people population. There is a need to provide integrated medical services and care for LTC group. Consequently, this study aimed to identify medical usage patterns based on the ratings of LTC and the characteristics of benefits usage in the LTC group. Methods: This study employed the National Health Insurance Service Database to analyze the effects of demographic and LTC-related characteristics on medical usage from 2015 to 2019 using a repeated measures analysis. A longitudinal logit model was applied to binary data, while a linear mixed model was utilized for continuous data. Results: In the case of LTC ratings, a positive correlation was observed with overall medical usage. In terms of LTC benefit usage characteristics, a higher overall level of medical usage was found in the group using home care benefits. Detailed analysis by medical institution classification revealed a maintained correlation between care ratings and the volume of medical usage. However, medical usage by classification varied based on the characteristics of LTC benefit usage. Conclusion: This study identified a complex interaction between LTC characteristics and medical usage. Predicting the requisite medical services based on the LTC rating presented a challenge. Consequently, it becomes essential for the LTC group to continuously monitor medical and care needs, even after admission into the LTC system. To facilitate this, it is crucial to devise an LTC rating system that accurately reflects medical needs and to broaden the implementation of integrated medical-care policies.

• Journal of Digital Convergence
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• v.14 no.10
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• pp.71-81
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• 2016

The objective of this study is to suggest methods to improve in-home service quality through service evaluation by long-term care workers. To achieve this objective, general characteristics of 223 long-term care workers, evaluation of service and agency, and retraining needs have been surveyed. An assessment of the survey results have resulted in the following conclusions. Though long-term care workers are not uneducated, the majority face unstable employment. And the content of supervision hoped for in producing improved long-term care services has been found to be based on the service-user's relationships. Moreover, among topics needing to be addressed for retraining, much attention has been shown for understanding of the elderly and their families, health care knowledge about geriatric diseases, and counseling techniques directed towards the affected person and their family. Findings from the research are as follow: enhancing the quality of long-term care requires a structural reassessment; upgrading the quality of care agencies requires the improvement of methods used to raise awareness of users and their guardians and the expansion of opportunities for education programs for professionalism.

• Journal of Korean Public Health Nursing
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• v.30 no.2
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• pp.259-273
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• 2016

Purpose: The purpose of this study was to explore the barriers and solution of providing long-term care (LTC) services at home for the beneficiaries with mild dementia. Methods: The data were collected by interviewing three focus groups consisting of 10 home-visit nurses and analyzed through the analytic process by Morgan and Krueger. Results: The barriers of providing LTC services for clients were identified as follows: inadequateness of the current LTC model for elderly individuals with mild dementia and inappropriateness of the personal environment for home care. The solutions for these barriers were suggested as follows: building up a safe environment for home care and maintaining an appropriate standard utilization plan of LTC service. Conclusion: The current service model for the beneficiaries with mild dementia should be modified in order to provide comprehensive long-term care services based on their complex needs.

• 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.