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요양병원 퇴원 후 시설입소 영향요인 - 장기요양 재가급여 이용자를 중심으로 -
윤민희 ( Minhee Youn ),이용주 ( Yongjoo Rhee ) 한국보건경제정책학회(구 한국보건경제학회) 2021 보건경제와 정책연구 Vol.27 No.2
노인의 요양병원 이용률이 지속해서 증가하고 병원이나 장기요양 시설에 입원하게 되는 경우가 많아지면서 퇴원 후 지역사회 내의 정착을 위한 관리의 필요성이 높아지고 있다 본 연구는 요양병원을 퇴원한 후 노인장기요양보험 재가급여를 이용한 노인이 지역사회에 정착하지 못하고 시설에 입소하는 데 영향을 미치는 요인을 파악하는 데 목적이 있다 국민건강보험공단의 노인 코호트DB 자료를 활용하여 요양병원을 퇴원한 노인 중에서 노인장기요양보험 인정자를 연구대상으로 설정하고 이를 재가급여 이용군과 재가급여 미 이용군으로 구분하여 각각 분석하였다 연구대상의 노인요양시설 입소에 영향을 미치는 요인을 파악하고자 로지스틱 회귀분석을 실시하였다 연구결과 재가급여 미 이용군에 비해 재가급여 이용군에서 두드러지게 나타난 시설입소 영향요인은 인지기능 영역과 재활 영역이었다 인지기능과 관련된 증상이 많을수록 재활과 관련된 운동 장애나 관절 제한 정도가 심할수록 재가급여 이용군의 시설입소 확률이 높아졌다 본 연구는 요양병원 퇴원환자가 지역사회로 정착하는 과정에서 재가급여 이용률을 높이고 불필요한 시설입소를 예방하는 방안에 대한 기초자료로 활용될 수 있을 것이다 As the elderly increase to admit long-term care hospital and long-term care facilitates and then re-admit hospitals, it is necessary to provide appropriate care for the discharged elderly to keep them living in community. This study aims to examine the factors associated with nursing home admission among the elderly who received the home care services supported by long-term care insurance system after long-term care hospital discharge. The study used the extracted data of the Korean National Health Insurance Service Elderly Cohort Database. The study data was selected for those who are the eligible older beneficiaries for level of long-term care needs after long-term care hospital discharge. Then data were divided into two groups for analysis; long-term home care service users and non-long-term home care service users. Logistic regressions were used to identify factors associated with nursing home admission in each group. The results showed that loss of cognitive function and rehabilitation were most significant factors associated with admitting to nursing home among long-term home care services users compared to those did not used long-term home care services. The elderly who reported more cognitive function impairment, or those who had severe motor disturbance and joint movement restriction, are more likely to be relocated to nursing homes among long-term home care services users. These findings could be useful for increasing home care service use in long-term care insurance and preventing unnecessary admission to nursing home among the community-living elderly after long-term care hospital discharge.
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지역사회 중독관리서비스 현황 : 중독관리통합지원센터를 중심으로
전교연(KyoYeon Jun),이루리(Luri Lee),박우리(Woori Park),황우석(Wooseok Hwang),이용주(YongJoo Rhee),오홍석(Hong Seok Oh),김용진(Yong Jin Kim),이해국(Hae Kook Lee),노성원(Sungwon Roh) 한국중독정신의학회 2017 중독정신의학 Vol.21 No.2
Objectives : The number of patients withsubstanceuse disorders, gambling disorder, and Internet gaming disorder is estimated atabout 5 million. However, only 1-8 percent of them receive treatment. This study identified the current situation of the Community Addiction Management Centers (CAMC) in Korea, and suggested a way to improve addiction management. Methods : The research investigated the current status of CAMC and individual tasks. It reviewed the addiction management system of the Substance Abuse and Mental Health Administration (SAMHSA) in the United States. Results : The subjects consisted of 255 employees. In most centers, more than 95 % of registered subjects were patients with alcohol use disorder, whereas patients with drug use disorders were 16.9% in Gwangju/Jeonnam. Patientswith gambling disorder were 10.9% in Jeonbuk, and 12.7% in Jeju. Large-scale centers with 8 or higher full time equivalent deal with addictions other than alcohol and have higher work efficiency. Conclusion : In order to improve the standard of addictionmanagement, a large-scale center is advantageous, and each center should set its task goal considering the size and regional characteristics of the center. It is necessary to establish a systematic liaison with local agencies and secure funds for preventing the breakaway of experienced workforce.
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