PURPOSE: This is a comparative study using secondary data from the Korean national long term care (LTC) insurance. METHODS: Visiting nursing (VN) service users (n=666) and non-users (n=4,375) were extracted and compared in terms of medical expenditures, length of hospitalization, and annual number of ambulatory care visits to investigate effects of VN services in LTC. RESULTS: Total health care expenditures were compared between the two groups and it was found that VN service users spent about $ 1700 than non-users for their medical costs between 2009 and 2011. The average length of in-hospital stay for VN service users was 19.4 days shorter than that of non-users. However, using VN services did not significantly influence the annual number of ambulatory care visits. CONCLUSION: The study has found that VN services are effective ways of providing community-based LTC services. We recommend LTC policy makers to further utilize VN services to deliver cost effective health care services.
Administrative Personnel ; Ambulatory Care ; Delivery of Health Care* ; Health Care Costs ; Health Expenditures ; Hospitalization ; Humans ; Inpatients ; Insurance ; Insurance, Long-Term Care* ; Long-Term Care* ; Nursing Services* ; Nursing* ; Outpatients

PURPOSE: The purpose of this study was to estimate nursing costs and to establish appropriate nursing fees for long-term care services for community elders. METHODS: Seven nurses participated in data collection related to visiting time by nurses for 1,100 elders. Data on material costs and management costs were collected from 5 visiting nursing agencies. The nursing costs were classified into 3 groups based on the nurse's visit time under the current reimbursement system of long-term care insurance. RESULTS: The average nursing cost per minute was 246 won. The material costs were 3,214 won, management costs, 10,707 won, transportation costs, 7,605 won, and capital costs, 5,635 won per visit. As a result, the average cost of nursing services per visit by classification of nursing time were 41,036 won (care time <30 min), 46,005 won (care time 30-59 min), and 57,321 won (care time over 60 min). CONCLUSION: The results of the study indicate that the fees for nurse visits currently being charged for long-term care insurance should be increased. Also these results will contribute to baseline data for establishing appropriate nursing fees for long-term care services to maintain quality nursing and management in visiting nursing agencies.
Costs and Cost Analysis ; Humans ; Insurance, Health, Reimbursement/economics ; Insurance, Long-Term Care/economics ; Long-Term Care/*economics ; Nursing Services/*economics ; Time Factors

BACKGROUND: South Korea is rapidly being an aging-society and the demand of long-term care insurance services for elderly patients is rising. In addition, because the elderly taking multiple medicines, the adherence is lowered and the adverse events are easily occurred. Therefore, many are interested in introducing the geriatric pharmacy specialist to manage this situation. PURPOSE: By applying a similar program such as the geriatric pharmacy specialist working in nursing home, we conducted this study to evaluate the potential contribution to both the health insurance services and financial savings for the elderly patients. METHODS: We conducted a trial in an elderly nursing home to collaborate between doctor and pharmacist making a checklist for improving medication adherence and establish a consultation system. Also we applied a smart phone application in the pharmaceutical care processes. RESULTS: Thereby completing the drug therapy related checklist apply to nursing facilities in South Korea. And we got a performance that improves medication adherence when used in the clinical practice settings. CONCLUSION: By introducing a training program of pharmacy care managers and geriatric professionals such as the United States and Japan, we revealed the elderly nursing home residents and vulnerable elderly people living alone were improved the medication adherence and it will contributed to the health and quality of life of the patients.
Aged* ; Checklist ; Drug Therapy ; Education ; Humans ; Income ; Insurance, Health ; Insurance, Long-Term Care ; Japan ; Korea ; Long-Term Care ; Medication Adherence* ; Nursing Homes* ; Nursing* ; Pharmaceutical Services ; Pharmacists ; Pharmacy ; Quality of Life ; Specialization ; United States ; Smartphone

PURPOSE: This study aims at comparing levels of service satisfaction with and needs for visiting nurse(VN) services among their beneficiaries in order to make a plan for extending VN services. METHODS: The number of the subjects of this study is 270 in total. They were selected in random sampling in which 30 VN service recipients were randomly selected from each of 7 regions based on their grades and region types. RESULTS: The highest total score for satisfaction with the VN services was 46.30, which the rural residents gave to their received VN services, then the metropolitan residents gave 44.57, and the small and middle size cities' residents 43.64. On the other hand, the highest total score for needs for VN services was 33.03, which the small and middle size cities' residents gave to their received VN services, then the rural residents gave 31.68, and the metropolitan residents 30.88. CONCLUSION: As the small and middle size cities' residents showed low satisfaction with and high needs for local VN services, policies need to be made to promote service providers' expertise and accessibility.
Consumer Behavior ; Hand ; Health Policy ; House Calls* ; Insurance, Long-Term Care* ; Long-Term Care* ; Nursing Services

Insurance, Major Medical; Insurance; Insurance, Health; Costs and Cost Analysis A cross sectional study on 170 outpatients and 170 inpatients with health insurance card, was conducted at Saint Paul Hospital - Ha Noi. A half of outpatients had had to pay an extracost of 1.2 times in comparing with the insurant cost. Most of inpatients had had an extracost to pay by themselves of 1.1 times in comparing with those payed by the insurance system. The quality of care services, the waiting time, the quality of medications and redimdant official protocols made the patient offensive
Insurance, Major Medical ; Insurance ; Insurance, Health ; Costs and Cost Analysis

This article aims to extract some lessons from the last five years' experience of Japan in its implementation of Long-term Care Insurance scheme(LTCI). Although both Korea and Japan are facing the most rapid ageing of the population among the OECD countries, the Japan precedes Korea in many aspects by about thirty years. Long-term care(LTC) services had been provided through two schemes in Japan before the introduction of LTCI in April 2000: Welfare Service Programs and the Health Service System for the Elderly(HSSE). LTCI incorporated both the previous social or welfare services and the long-term care services under the HSSE. Japanese LTCI started with the aims of introducing improved insurance coverage for home care, extending such coverage for the first time to nursing homes and further reducing the dependency of the elderly on beds in hospitals. In Korea, due to the lack of infrastructure to support the LTC services in Korea as well as the yet immature ageing of population, it would be quite risky to make haste in introducing LTCI in Korea. Rather the main focus of the Korean LTC policy should be put on establishing and enlarging both facilities and human resources to support the LTC services.
Aged ; Asian Continental Ancestry Group* ; Health Services ; Home Care Services ; Humans ; Insurance Coverage ; Insurance, Long-Term Care* ; Japan ; Korea ; Long-Term Care* ; Nursing Homes

PURPOSE: The purpose of this study was to demonstrate the effects of visiting nursing services in long-term care (LTC) insurance on changes in health status and physical functions among the elderly. METHODS: We analyzed survey data on the living status and welfare needs of the elderly from 2008 and 2011 using the difference-in-difference method with propensity score matching. RESULTS: The subjects were 76 elders including 38 visiting nursing service users(intervention group) and 38 home-based LTC service users (control group). Results from DID analysis confirmed that the subjective health status level of the intervention group was 2.2 points higher (p=.044) and the depression level was 0.3 point lower (p=.039) than the control group. In addition, the intervention group's ADL score was 1.9 (p=.027) and IADL 3.9 (p=.030), showing that their health was deteriorated less. CONCLUSION: Visiting nursing service in LTC insurance was associated with delayed deterioration of subjective health status, depression, ADL and IADL. These findings suggest the need of rebuilding visiting nursing service programs focusing on prevention services, which will be more contributive to elderly health care and the reduction of social costs.
Activities of Daily Living ; Aged ; Delivery of Health Care ; Depression ; Humans ; Insurance ; Insurance, Long-Term Care* ; Long-Term Care ; Nursing Services* ; Propensity Score

The payment system such as national long term care insurance for the elderly and per diem rate for geriatric hospitals introduced in 2008 has greatly changed the Korean medical system for the elderly. Therefore, today it would be inevitable to discuss quality assessment of healthcare services provided by nursing facilities and geriatric hospitals in order to effectively establish and operate the introduced systems. Under these circumstances, in an effort to provide elderly people with high-quality medical services with limited resources, it is believed that the quality indicators need to include the following: (1) provision and management of medical services for major health problems; (2) assessment of quality of life for residents; (3) assessment of ADL and rehabilitation services so as to maintain and improve functions; (4) assessment of convenience of living facilities; and (5) assessment of rate of potential avoidable hospitalization in acute care hospitals. Moreover, along with an effort to define roles of nursing facilities and geriatric hospitals, it would be necessary to set up the feasible stepwise strategy through discussions with relevant institutions.
Activities of Daily Living ; Aged ; Delivery of Health Care ; Hospitalization ; Humans ; Insurance, Long-Term Care ; Quality Indicators, Health Care ; Quality of Life

PURPOSE: This study examined the characteristics and service utilization of home nursing care beneficiaries under the Korean Long-Term Care Insurance (LTCI). METHODS: We used assessment data and claim data of National Health Insurance Corporation from July to August 2008. Data were composed of subjects who were the beneficiaries of home nursing care. RESULTS: A total of 634 subjects were analyzed. Of the subjects, 57.1% were 75 years and over. The average score of nursing care need was only 0.71 and the percentage of those whose nursing care need score was zero was 58.0%. More than half of the subjects had partially dependent musculoskeletal conditions, and 75.5% had two or more comorbidities. A third of them usedonly home nursing care, and another third used both home nursing care and general home care at the same time. Those who needed sore care used the largest home nursing care benefits. CONCLUSION: Home nursing care of LTCI performs community-based healthcare services under LTCI. Throughout the past two years, however, it has not been active. Understanding the characteristics of its users is important in order to develop effective strategies for activating home nursing care.
Comorbidity ; Delivery of Health Care ; Home Care Services ; Home Nursing* ; Insurance, Long-Term Care* ; Long-Term Care* ; National Health Programs ; Nursing Care

PURPOSE: This study was attempted to provide quality improvement and revitalization of visiting nurse services by Importance-Performance Analysis of persons being provided with the services. METHODS: The subjects were 350 people being provided with visiting nurse services from a long term home care institution in the kangwon Province during the period of data collection between Aug. 16 and Sep. 15, 2011. Data analysis was conducted through t-test, ANOVA, and IPA by using the SPSS/WIN 12.0 program. RESULTS: As a result of the Importance-Performance Analysis of visiting nurse services, it turned out that the strength on reliability, assurance, and empathy should be maintained with good work and the aspects of responsiveness appeared to be intensively improved, and the tangibility proved to be subject to improvement. CONCLUSION: For the activation of visiting nurse services, methods for improving the performance in the intensive care area and management strategy establishment which highlights the advantages of strength maintenance area are needed.
Community Health Nursing* ; Data Collection ; Empathy ; Home Care Services ; Humans ; Insurance, Long-Term Care* ; Critical Care ; Long-Term Care* ; Quality Improvement ; Statistics as Topic