Ownership of Long-Term Care Facility and Incidence of Pressure Ulcers among Republic of Korea
10.4332/KJHPA.2020.30.4.522
- Author:
Sung-Youn CHUN
1
;
Hyeki PARK
;
Woorim KIM
;
Yeong-Jun JOO
;
Tae-Hoon LEE
;
Eun-Cheol PARK
Author Information
1. Department of Public Health, Yonsei University Graduate School, Korea
- Publication Type:ORIGINAL ARTICLE
- From:Health Policy and Management
2020;30(4):522-530
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:In 2008, Korea implemented a new type of social insurance known as “long-term care insurance”. We examined the association between ownership of long-term care facilities and the incidence of pressure ulcers after the implementation of “long-term care insurance”. This study is a population-based retrospective cohort study from 2006 to 2013.
Methods:We used medical claims data from the Korean National Health Insurance Corporate Elderly Cohort Database from 2006 to 2013. These data comprise a nationally representative sample. To avoid confounders, only patients admitted to one long-term care facility and who stayed for >70% of the follow-up time were included; as a result, 3,107 individuals were enrolled. The main independent variable was the operating entity of the long-term care facility (local government, corporate bodies, and private for-profit owners), and the dependent variable was the 1-year incidence of pressure-ulcers. Survival analysis (Cox proportional hazard model) was used as an analysis method.
Results:Compared to patients admitted to local government long-term care facilities, patients admitted to private long-term care facilities had a significantly higher 1-year risk of pressure ulcers (hazard ratio [HR], 1.94; 95% confidence interval [CI], 1.29–2.91); the risk was especially high among patients who were cognitively dependent (HR, 2.34; 95% CI, 1.25–4.37).
Conclusion:Patients admitted to private for-profit long-term care facilities were more likely to have pressure ulcers compared to those in local government and corporate body long-term care facilities. Appropriate assessment tools and publicly available information, as well as more restricted legal requirements, are needed to improve the care quality and outcomes of patients in long-term care facilities.
