• 한국융합학회논문지
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• 제8권11호
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• pp.193-201
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• 2017

본 연구는 보건복지계열 예비졸업생들의 노인장기요양보험에 대한 전반적 인식도를 파악하기 위해 시도하였다. 일개 4년제 대학의 보건복지계열 예비졸업생 총 207명의 설문조사에 대해 SPSS ver 22.0을 이용하여 분석하였다. 연구결과 보건복지계열 예비졸업생의 노인장기요양보험에 대한 관심도와 지식 수준은 낮았으나, 태도는 긍정적인 것으로 나타났다. 또한, 노인장기요양보험에 대한 지식과 태도는 대상자의 노인시설 봉사 경험에 따라 차이가 있는 것으로 나타났다. 향후 보건복지계열 대학생의 노인장기요양보험에 대한 인식과 관심도를 증진시킬 수 있는 교육과정 개선과 함께 능동적 봉사활동 프로그램 개발이 필요할 것이다.

• 보건의료산업학회지
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• 제5권3호
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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.

• Communications for Statistical Applications and Methods
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• 제28권4호
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• pp.393-410
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• 2021

The Korean Long-Term Care Insurance (K-LTCI) provides financial support for long-term care service to people who need various types of assistance with daily activities. As the number of elderly people in Korea is expected to increase in the future, the demand for long-term care insurance would also increase over time. Projection of future expenditure on K-LTCI depends on the number of beneficiaries within the grading system of K-LTCI based on the test scores of applicants. This study investigated the suitability of mixture distributions to the model K-LTCI score distribution using recent empirical data on K-LTCI, provided by the National Health Insurance Service (NHIS). Based on the developed mixture models, the number of beneficiaries in each grade and its variability under the current grading system were estimated by simulation. It was observed that a mixture model is suitable for K-LTCI score distribution and may prove useful in devising a funding plan for K-LTCI benefit payment and investigating the effects of any possible revision in the K-LTCI grading system.

• 한국산학기술학회논문지
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• 제15권11호
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• pp.6746-6755
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• 2014

본 논문은 기초생활보장수급자를 대상으로 장기요양서비스 이용 여부가 의료 이용에 미치는 영향을 파악하기 위한 서술적 연구이다. 연구 대상은 장기요양 1등급 판정을 받은 기초생활보장수급자 5,834명을 대상으로 하였다. 기초생활보장수급자의 의료 이용에 미치는 영향을 다중회귀분석으로 분석한 결과 2007-2009년 총 진료비 변화량을 설명하는 $R^2$은 22.6%이었으며, 장기요양 서비스 이용자에 비해 미이용자는 8,297,329원 증가하였다(${\beta}=.29$, p< .001). 입원일 변화량의 $R^2$은 22.4%이었으며, 서비스 이용자에 비해 미이용자는 119.013일 증가하였다(${\beta}=.33$, p< .001). 총 진료비와 입원일 변화량에 영향을 미치는 요인은 장기요양서비스 이용 여부, 수발자 여부, 2009년 일상생활수행능력, 간호처치, 재활기능이 유의한 영향을 미치는 것으로 나타났다. 따라서 장기요양 서비스 미이용자의 의료 이용이 높게 나타남에 따라 미이용자에 대한 적정 의료와 요양서비스 이용을 지원할 수 있는 정책 마련이 필요로 된다.

• 사물인터넷융복합논문지
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• 제8권2호
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• pp.13-24
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• 2022

본 연구는 우리나라에서 매년 증가하고 있는 노인장기요양기관의 부당청구 맥락과 부당청구 예방을 위한 대책들이 어떠한지를 탐색하기 위해서 언론기사를 활용한 텍스트 마이닝 분석을 실시하였다. 기사는 뉴스 빅테이터 분석 시스템인 빅카인즈에서 수집하였고, 수집기간은 노인장기요양보험이 시행된 2008년 7월부터 2022년 2월 28일까지로 약 15년간이다. 이 기간 동안 '노인요양+부당청구', '장기요양+부당청구', 등의 키워드로 총 2,627개의 기사가 수집되었고, 이중 중복된 기사를 제외한 총 946개가 선정되었다. 본 연구의 텍스트마이닝 분석결과로 첫째, 모든 구간(2008.7.1-2022.2.28)에서 가장 높은 빈도로 언급된 상위 10위 키워드는 노인장기요양기관, 부당청구, 국민건강보험공단, 노인장기요양보험, 장기요양급여(비용), 노인요양시설, 보건복지부, 노인, 신고, 포상금(지급)의 순으로 나타났다. 둘째, N-gram 분석결과 장기요양급여(비용)과 부당청구, 부당청구와 노인장기요양기관, 허위와 부당청구, 신고와 포상금(지급), 노인장기요양기관과 신고 등의 순으로 나타났다. 셋째, TF-IDF 분석은 빈도분석의 결과와 유사하게 나타났지만, 신고, 포상금(지급), 증가 등은 순위가 상승하였다. 상기 분석결과를 바탕으로 노인장기요양기관 부당청구 예방을 위한 방향성을 제시하였다.

• 대한물리치료과학회지
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• 제15권2호
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• pp.61-69
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• 2008

Background: This article reviewed the current status of home-based physical therapy infrastructure in long term care insurance and then solved the problem. Method: We used two forms of data that were acquired from ⅰ) the Ministry of Health & Welfare and the Family and National Health Insurance Corporation, ⅱ) a home-visiting health care program, and ⅲ) evaluation data from the Korea Health Industry Development Institute. The home-based physical therapy program was then analyzed. Results: The role and concept of home-based physical therapy was not clearly established. There were few home-based physical therapy programs in the community. The manpower of home-based physical therapists in the home-visiting health care program was very low. The role between home-visiting nurses (caregivers) and home-based physical therapists was mixed. Research and promotion regarding home-based physical therapy was poor. Conclusion: To establish a system of legal, long-term care insurance, we must increase the manpower of home-based physical therapists and the amount of research pertaining to the demand for home-based physical therapy.

• 보건행정학회지
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• 제21권3호
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• pp.381-396
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• 2011

This study is to investigate the factors affecting the regional rate of certification for long-term care insurance benefits. Analyzed data were the 253,935 certified beneficiaries (equivalent to 4.9% of total elderly population) as long-term care degree (LTC degree) 1~3 extracted from the applicants for long-term care in the beginning stage of the system from April 15 2008 to July 1 2009. Although the data were collected from individuals, after restructured into regional data and then analysed in the unit of 225 administrative regions for the Korean Long-term Care Insurance. The rate of certification was operated as the percentage of people of LTC degree 1~3 to the elderly population in each region. The average rate of certification among regions was 4.91%, and ranged from 2.20% to 8.32%. In the analysing regression models, most socio-demographic variables, applicants' disease characteristics, regional service infrastructure, and the certification interviewer's characteristics were included. The most influencing variables were the disease factors of applicants, especially dementia or cerebrovascular disease rather than arthritis, osteoporosis, or fracture patients were strong factors for the regional rate of certification. However, advanced studies adding more explainable factors on the regional variance of certification rate would be necessary to provide political agenda and measures for evidence-based certification process with high reliability and validity for a sustainable LTC system in Korea.

• 간호행정학회지
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• 제14권3호
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• pp.229-240
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• 2008

Purpose: To develop the patient classification system based on the resource utilization for reimbursement of long-term care hospitals in Korea. Method: Health Insurance Review & Assessment Service (HIRA) conducted a survey in July 2006 that included 2,899 patients from 35 long-term care hospitals. To calculate resource utilization, we measured care time of direct care staff (physicians, nursing personnel, physical and occupational therapists, social workers). The survey of patient characteristics included ADL, cognitive and behavioral status, diseases and treatments. Major category criteria was developed by modified delphi method from 9 experts. Each category was divided into 2-3 groups by ADL using tree regression. Relative resource use was expressed as a case mix index (CMI) calculated as a proportion of mean resource use. Result: This patient classification system composed of 6 major categories (ultra high medical care, high medical care, medium medical care, behavioral problem, impaired cognition and reduced physical function) and 11 subgroups by ADL score. The differences of CMI between groups were statistically significant (p<.0001). Homogeneity of groups was examined by total coefficient of variation (CV) of CMI. The range of CV was 29.68-40.77%. Conclusions: This patient classification system is feasible for reimbursement of long-term care hospitals.

• 한국산학기술학회논문지
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• 제20권10호
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• pp.395-405
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• 2019

우리나라는 경제발전, 출산율 저하, 보건의료의 발달로 65세 이상 노인 인구의 비율이 2018년 14% 고령사회, 2026년 20% 초고령사회로 예상되어 빠른 인구구조의 변화를 겪고 있다. 고령화에 따라 치매, 중풍 등 일상생활이 어려운 노인들의 수는 날로 증가하고, 핵가족화, 여성의 사회참여 증가 등으로 장기요양이 필요한 노인들을 가정에서 돌보는 것이 어려워졌다. 이에 정부는 이러한 사회적 구조 및 노인문제를 해결하기 위해 장기요양대상 노인의 삶의 질 향상과 가족부양 부담의 완화 등을 목적으로 노인장기요양보험법을 제정하여 시행하고 있다. 따라서 본 연구는 시설의 민영화와 난립으로 서비스의 공적 책임과 시설의 질 제고에 대한 요청이 확산되고 있는 부분을 살펴보고자 한다. 이 밖에도 저임금 요양인력의 양산, 재원조달 방식에 관한 문제 등의 대비가 다각도로 부족한 부분을 도출하고자 하였다. 본 연구를 통하여 노인장기요양보험제도가 초고령화 사회를 대비하여 장기 지속적으로 유지 발전하기 위해서는 법 제도적 측면의 개선방안의 모색과 더불어 노인복지서비스가 신체적 건강 뿐만 아니라 노후 생활의 안정을 위한 정신적 심리적 조치를 강구하는 방안을 검토하고자 한다.

• 가정간호학회지
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• 제14권2호
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• pp.98-105
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• 2007

Home health care system in Korea has been classified into three types of home care programs based on different laws and regulations; for example, home health care nursing(HHCN) is based on medical laws, visiting health care nursing (VHCN) is based on long-term health care insurance, and visiting health care(VHC) is based on the regional health care act. HHCN in Korea has taken on an important role under the mandate of the national health care system since 2000. VHCN will commence its role under the long term health care insurance system in 2008. The strengthening of VHC commanded health promotion and prevention for vulnerable families in the community in 2007. This is an important turning point for increasing quality management for home health care program; it suggests certain possibilities for building a foundation for further changes in the service delivery structure. Accordingly, the home health care policy makers in Korea have a major function and role that consists of developing an agenda and alternatives for policy making in a systematic manner and clearly presenting implementation strategies for elderly health care system.