PURPOSE: This study is designed to identify major factors that affect morale among staff of long-term care insurance in National Health Insurance Corporation. METHODS: In order to collect the data, a survey was conducted by using the structured questionnaire based on 161 staff members of long-term care insurance of 50 long-term care operation centers, which were randomly selected by the table of random numbers in the whole centers of National Health Insurance Corporation from September 1 to 30, 2011. As for the data analysis, SPSS 18.0 was used to conduct the descriptive statistics, t-test, ANOVA, Pearson correlation coefficient, mutiple regression, and path analysis. RESULTS: The average point of morale was 3.37, and had a negative correlation with the job stress, while it had a positive correlation with the social support, professional identity, and self-efficacy. Job stress, social support, and professional identity have a significant effect on morale among the independent variables. These variables have significant effects on morale, and also have a positive effect on self-efficacy. The findings show that self-efficacy mediates the process of morale. CONCLUSION: In this study, the factor which influences the morale was identified. It turned out that the morale could be improved by reinforcing the professional identity, managing the health status as well as rotating the working place. As such, it expects both the improvement of long-term care insurance services outcome and its quality through the morale management.
Hypogonadism ; Insurance, Long-Term Care ; Long-Term Care ; Mitochondrial Diseases ; Morale ; National Health Programs ; Ophthalmoplegia ; Surveys and Questionnaires ; Statistics as Topic

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

PURPOSE: The purpose of this study was to examine the association between utilization of home care services under the national long-term care insurance system and family caregiver distress. METHODS: A secondary data analysis was conducted in this study using data collected in 2011 and 2012 from the Korean version of International Resident Assessment Instrument (interRAI) Home Care assessment system. The study sample included 228 clients receiving community based home care and their family caregivers in Korea. Descriptive statistics, χ² test, t-test, and Heckman selection model analysis were conducted using SAS 9.3. RESULTS: Presence of family caregiver distress was significantly associated with days of nurse visits (β=-.89, p=<.001) and home helper visits (β=-.53, p=.014). Level of caregiver distress was also significantly associated with days of nurse visits (β=-.66, p=.028). Other factors which were significantly associated with caregiver distress were depression, cognitive function, inadequate pain control, social support for older adult, and caregiver relationship to the older adult. CONCLUSION: The results of this study show that visiting nurse service and appropriate support programs for Older Adults and family caregivers experiencing caregiver distress should be developed and provided to families based on the health care needs of older adults and their family caregivers for effective and sustainable home care.
Adult* ; Caregivers* ; Cognition ; Delivery of Health Care ; Depression ; Home Care Services* ; Humans ; Insurance, Long-Term Care ; Korea ; Long-Term Care ; Nurses, Community Health ; Social Control, Formal ; Statistics as Topic

OBJECTIVES: This study was performed to determine the levels of quality of life (QOL) according to the grade of long-term care service for the elderly people who were admitted from long-term care insurance, and to reveal its association with the physical and mental functioning such as the Activity of Daily Living (ADL), the Instrumental Activity of Daily Living (IADL), the Center for Epidemiologic Studies Depression Scale (CES-D), and the Mini-Mental State Examination-Korean version (MMSE-K). METHODS: The interviews were performed during the period from March 1 to May 31, 2009, for 958 elderly people in urban and rural areas. The questionnaire items included various indices such as the ADL, IADL, CES-D, and MMSE-K, as independent variables and the index of QOL, as the dependent ones. For statistical analysis, t-tests were used for the mean scores of QOL according to gender and the grade of long-term care services, and Spearman's correlation was used for each variable. The effects of physical and mental functioning for QOL were assessed by covariance structure analysis. The statistical significance was set at p<0.05. RESULTS: The mean scores of QOL among all the subjects was 55.4 +/- 15.62 (Grade I: 49.7 +/- 14.17, Grade II: 56.8 +/- 14.62, Grade III: 59.4+/-16.36), and it was lower according to the higher grade of long-term care insurance. In terms of the correlation matrix of the QOL and the physical and mental function factors, the QOL showed positive correlation with the ADL, IADL and MMSE-K, while it had negative correlation with depression. On the analysis of covariance, mental functioning (depression and the MMSE-K) had a greater influence on the level of QOL than the physical functioning (ADL and IADL). CONCLUSIONS: The level of the QOL in the elderly people who were admitted from long-term care insurance was lower according to higher the grade of long-term care insurance. Also, the mental functioning (depression and MMSE-K) was more influential on the level of the QOL than the physical functioning (ADL and IADL).
Activities of Daily Living/psychology ; Aged ; Depression/psychology ; Female ; *Health Status ; Humans ; Insurance, Long-Term Care/*statistics & numerical data ; Long-Term Care/*psychology/*statistics & numerical data ; Male ; *Mental Health ; Quality of Life/*psychology ; Residence Characteristics ; Socioeconomic Factors

OBJECTIVETo evaluate long-term cost effectiveness of telbivudine and lamivudine for the treatment of CHB.

METHODSCost effectiveness was conducted from social health insurance perspective. A Markov model was established based on disease progression pattern and the data from the 2 years GLOBE clinical trial. The information of annual medical expenditure and quality-of-life assessment for different CHB-related diseases was obtained from literature. Incremental cost per life year or quality-adjusted life year gained was measured.

RESULTSCompared with lamivudine, the incremental cost for 1 additional QALY gained with telbivudine in treating HBeAg-positive and -negative CHB were 5403 yuan and 28239 yuan in Beijing, as well 4916 yuan and 29618 yuan in Guangzhou, respectively. According to national economic burden of CHB-related diseases, the ICER with telbivudine vs lamivudine were 1282 yuan and 31565 yuan for HBeAg-positive and -negative CHB.

CONCLUSIONAccording to WHO recommendation for ICER threshold, telbivudine is cost effective in treating HBeAg-positive and -negative CHB, as compared to lamivudine.

Adult ; Antifungal Agents ; economics ; therapeutic use ; China ; epidemiology ; Cost-Benefit Analysis ; DNA, Viral ; blood ; Drug Costs ; statistics & numerical data ; Economics, Pharmaceutical ; Female ; Hepatitis B e Antigens ; blood ; Hepatitis B, Chronic ; complications ; drug therapy ; economics ; epidemiology ; Humans ; Insurance, Long-Term Care ; Lamivudine ; economics ; therapeutic use ; Liver Cirrhosis ; etiology ; prevention & control ; Male ; Markov Chains ; Middle Aged ; Models, Economic ; Nucleosides ; economics ; therapeutic use ; Prescription Drugs ; economics ; Pyrimidinones ; economics ; therapeutic use ; Quality-Adjusted Life Years ; Thymidine ; analogs & derivatives