• 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.42 no.2
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• pp.236-247
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• 2012

Purpose: Purposes of this study were: evaluation of family burden of caring for elders who receive long term care services, and examination of differences in burden before and after the introduction of long term care service in Korea. Methods: Data were collected by questionnaires from 416 caregivers of elders who were registered with the Long Term Care Insurance Corporation in six cities. Data were collected in September, 2010 and analyzed using descriptive statistics, paired t-test, and ANOVA with the Scheffe test, and stepwise multiple regression. Results: Family burden decreased significantly after longterm care service was initiated. Subjective burden decreased from 2.93 to 2.69 (t=11.78, $p$<.001), and objective burden, from 3.40 to 3.10 (t=12.73, $p$<.001). Stepwise multiple regression analysis revealed that factors affecting subjective burden were family relations (F=13.60, $p$=.003), age (F=5.47, $p$=.019), job (F=6.98, $p$=.008), and education (F=4.59, $p$=.032), and that factors affecting objective burden were living together (F=17.66, $p$<.001), job (F=13.34, $p$=.003), monthly income (F=6.61, $p$=.010), and type of service (F=6.62, $p$=.010). Conclusion: The results of this first study to investigate caregiver burden after the Korean Long-term Care Insurance System was begun provide positive information for the development of strategies to decrease family burden in long term care.

• Health Policy and Management
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• v.29 no.4
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• pp.496-501
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• 2019

Background: In this study, wage status and wage determinants of care workers were analyzed. Methods: The analysis used database (DB) of long-term care institutions, DB of long-term care institutions, DB of long-term care workers, DB of health insurance qualification, and contribution possessed by National Health Insurance Services. We analyzed the wage status of the care workers from 2009 to 2016 through basic analysis and estimated the factors affecting the wage of the long-term care facilities' care workers using pooled ordinary least squares. Results: The monthly average wage of care workers was raised from Korean won (KRW) 1.37 million in 2009 to KRW 1.52 million in 2016, and the working hours were shortened by 20 hours from 207 hours to 187 hours. Hourly wages increased by KRW 1,329 from KRW 6,831 in 2009 to KRW 8,160 in 2016. The average monthly wage of care workers was affected by gender, age, years of employment, monthly working hours, establishment type, city size, institutional size, the grade of the institution, and management status. In particular, the wage level of the care workers was high when the larger the size of the institution, the better the management status (fill rate), the establishment type is "government and local government" and "corporation," the institutional rating is high, and the facility manager has the first grade of the social worker license. Conclusion: The government should consider aggressive policies to improve the treatment of care workers as well as the quality of long-term care services so that there will be more long-term care facilities that are guaranteed social publicity above a certain level.

• Journal of Preventive Medicine and Public Health
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• v.37 no.3
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• pp.282-291
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• 2004

Objectives : The aim of this study was to investigate the functional status variables related to the care time of health professionals for patients in long-term care facilities. Methods : The functional stati of 1001 patients in 8 long-term care hospitals were examined by the Resident Assessment Instrument for Long-term Care Facility Version 2.0. The care time of health professionals for patients was calculated using data from a self-reported task survey by nurses, auxiliary nurses, private aides, doctors, physiotherapists and social workers. Results : The average care time per diem was 240.6 minutes. The care time by doctors, nurses and private aides were 11.0, 71.0 and 139.5 minutes, respectively. The lower the function of activities of daily living (ADL) and the greater the symptoms of extensive services, special care and clinical complexity, the more care time was served. On the contrary, the greater the symptoms of nursing rehabilitation, depression, cognitive disorder, behavior problem and psychiatry/mood disorder, the less care time was served. Age and gender were not significantly related to the care time. Conclusions : Developing a case mix classification system for elderly long term care patients may be helpful for both of patients and health care providers. The ADL, extensive services, special care and clinical complexity of variables should be considered in the development of a case mix system for the long term care of patients in Korea.

• Asia-pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology
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• v.9 no.8
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• pp.569-576
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• 2019

The purpose of this study aimed to examine the effects of job stress on the turnover intention through mediation of vacational consciousness and to reduce turnover intention of long-term care workers based on the results. We used 447 long-term care workers working in Seoul and Gyeonggi area. For the research purpose, the mediation effect was verified after the technical analysis and verifying multicollinearity using on SPSS and sobel-test. The results of this study are as follows: First, the lower the age of care worker and the higher the monthly household income, the higher the turnover intention. Second, the higher the perceived job stress, the higher the turnover intention. Third, the higher the job consciousness of the long-term care workers, the lower the turnover intention. Fourth, job stress of long-term care workers showed statistically significant effect on turnover intention by partial mediation of job consciousness. Based on the above results, I suggested the clinical and policy practice to prevent the separation of long-term care workers and improve the quality of care service for the elderly.

• Health Policy and Management
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• v.32 no.2
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• pp.173-179
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• 2022

Background: This study aimed to identify patterns of elderly patients who transferred from long-term care hospitals to emergency rooms and provide the evidence of emergency medical systems to prepare for a super-aged society. Methods: The data source was the National Emergency Department Information System database from January 2014 to December 2019 in Korea. We performed a cross-sectional study among elderly patients (≥65 years) who transferred from a long-term care hospital to an emergency room. Trend analysis was conducted by year. Results: We identified 225,765 elderly patients who were transferred from long-term care hospitals to emergency rooms between January 1, 2014 and December 31, 2019. The proportion of the study population and their mean age were recently increased (p<0.001, respectively). The proportion of elderly patients being re-transferred (p=0.049) and the patients re-transferred to long-term care hospitals is significantly increased (p=0.005). Conclusion: The establishment of efficient emergency medical services for an aging society is important. It is necessary to develop a healthcare network with the government, long-term care hospitals, and medical institutions in the community suitable for preventing disease deterioration.

• Korea journal of population studies
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• v.9 no.1
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• pp.41-53
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• 1986

The purpose of this paper is two-fold. One is to investigate the determinants of the demand supply of labor, and another is to project long-term demand and supply of labor. The paper consists of three parts. In the first part, theoretical models and important hypotheses are discussed: for the case of a labor supply model, issues regarding discouraged worker model, permanent wage hypothesis, and relative wage hypothesis are examined and for the case of a demand model, issues regarding estimating an employment demand equation within the framework of an inverted short-run produc- tion function are inspected. Particularly, a theoretical justification for introducing a demographic cohort variable in a labor supply equation is also investigated. In the second part, empirical results of the estimated supply and demand equations are analyzed. Supply equations are specified differently between primary and secondary labor force. That is, for the case of primary labor force groups including males aged 25 and over, attempts are made to explain the variations in participation behavior within the framework of a neo-classical economics oriented permanent wage hypothesis. On the other hand, for the case of females and young male labor force, variations in participation rates are explained in terms of a relative wage hypothesis. In other words, the participation behavior of primary labor force is related to short-rum business fluctuations, while that of secondary labor force is associated with intermediate swings of business cycles and demographic changes in the age structure of population. Some major findings arc summarized as follows. (1) For the case of males aged 14~19 and 2O~24 groups and females aged 14∼19, the effect of schhool enrollment rate is dominant and thus it plays a key role in explaining the recent declining trend of participation rates of these groups. (2) Except for females aged 20∼24, a demographic cohort variable, which captures the impact of changes in the age structure on participation behavior, turns out to show positive and significant coefficients for secondary labor force groups. (3) A cyclical variable produce significant coefficients for prime-age males and females reflecting that as compared to other groups the labor supply behavior of these groups is more closely related to short-run cyclical variations (4) The wage variable, which represents a labor-leisure trade-off turns out to yield significant coefficients only for older age groups (6O and over) for both males and females. This result reveals that unlike the experiences of other higer-income nations, the participation decision of the labor force of our nation is not highly sensitive with respect to wage changes. (5)The estimated result of the employment demand equation displays that given that the level of GNP remains constant the ability of the economy to absord labor force has been declining;that is, the elasticity of GNP with respect to labor absorption decreasre over time. In the third part, the results of long-term projections (for the period of 1986 and 1995) for age-sex specific participation rates are discussed. The participation rate of total males is anticipated to increase slightly, which is contrary to the recent trend of declining participation rates of this group. For the groups aged 25 and below, the participation rates are forecast to decline although the magnitude of decrease is likely to shrink. On the other hand, the participation rate of prime- age males (25 to 59 years old) is predicted to increase slightly during 1985 and 1990. For the case of females, except for 20∼24 and 25∼34 age groups, the participation rates are projected to decrease: the participation rates of 25∼34 age group is likely to remain at its current level, while the participation rate of 20∼24 age group is expected to increase considerably in the future (specifi- cally, from 55% in 1985 to 61% in 1990 and to 69% in 1995). In conclusion, while the number of an excess supply of labor will increase in absolute magnitude, its size as a ratio of total labor force is not likely to increase. However, the age composition of labor force is predicted to change; that is, the proportion of prime-age male and female labor force is projected to increase.

• Nutrition Research and Practice
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• v.16 no.sup1
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• pp.1-10
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• 2022

BACKGROUND/OBJECTIVES: The Dietary Reference Intakes for Koreans (KDRIs) were revised in 2020. Due to the rapidly aging Korean population, special consideration was given to reclassify the KDRI age group categories of older adults. This article examines the evidence for modifying the current KDRI age group ranges of older adults (65-74 and ≥ 75 yrs). SUBJECTS/METHODS: We first reviewed the domestic and international data on the elderly, following which we received expert opinions on age classification from the KDRI Advisory Committee. Finally, the 6th and 7th (2013-2017) Korea National Health and Nutrition Examination Survey (KNHANES) data were used to analyze the nutritional intake statuses by considering the age of older adults. RESULTS: According to the review results of domestic and international data and the inputs received from the expert advisory committee, the minimum age considered for the elderly was maintained at 65 yrs. However, the KNHANES data was analyzed to review whether there was a need to subdivide the later periods. Examining the differences in nutrient intakes by age group through the interaction effect term of the piecewise linear regression model revealed the interaction effect was maximum in the groups divided by 65 yrs (50-64 and 65-80), as compared to the groups divided by 70 yrs (50-69 and 70-80) and 75 yrs (50-74 and 75-80). The mean adequacy ratio was calculated per 1 yr of age, and a 3-yr (age) moving average analysis was performed to examine the change in the trends of overall nutrient intake. However, it was challenging to secure a scientific basis for subdivision into age groups in older adults from the results obtained. CONCLUSIONS: This study could not find any scientific evidence for modifying the KDRI age groups for older adults.

• Journal of Oral Medicine and Pain
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• v.18 no.2
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• pp.81-96
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• 1993

In order to evaluate the prognosis of conservative treatment for Craniomandibular Disorders, 127 patients were subjected at the Dept. of Oral Medicine, Pusan National University Hospital from 1983 through 1991. All the changes of patients' symptoms and related factors were analyzed before treatment, after treatment and at follow-up examination by means of subjective and objective symptom indicies (Ai, AAI, SDS, Di, CDS, MCO). 1. All the indices were reduced and MCO became increased at follow-up examination (p<0.01). 2. As the duration after treatment became longer, all the indices became reduced and MCO became increased. 3. There were no significant differences in index scores according to sex and age. 4. Long-term patients showed higher index scores and lower MCO than short-term patients(p<0.01). 5. Chronic group showed higher index scores and lower MCO than acute group (p<0.05). 6. Macrotrauma group showed higher index scores and lower MCO than microtrauma group (p<0.05) 7. While muscle group showed the lowest MCO, muscle and joint group showed the highest index scores (p<0.01). 8. The long-term success rate of conservative treatment was more than 80% (p<0.01)

• Journal of Korean Academy of Nursing
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• v.39 no.3
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• pp.409-421
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• 2009

Purpose: In this research multi-level analysis was done to identify factors related to quality of services. Patient characteristics and organizational factors were considered. Methods: The data were collected from the Health Insurance Review and Assessment Service(HIRA) data base. The sample was selected from 17,234 patients who had been admitted between January 2007 and May 2008 to one of 253 long-term care hospitals located in Seoul, six other metropolitan cities or nine provinces The data were analyzed with SAS 9.1 using multi-level analysis. Results: The results indicated that individual level variables related to quality of service were age, cognitive ability, patient classification, and initial quality scores. The organizational level variables related to quality of service were ownership, number of beds, and turnover rate. The explanatory power of variables related to organizational level variances in quality of service was 23.72%. Conclusion: The results of this study indicate that differences in the quality of services were related to organizational factors. It is necessary to consider not only individual factors but also higher-level organizational factors such as nurse' welfare and facility standards if quality of service in long term care hospitals is to be improved.