이중차이분석을 활용한 노인장기요양보험제도의 방문간호서비스 효과 = The Effects of Visiting Nursing Services in Long-term Care Insurance: A Difference-in-Difference Analysis

다국어 초록 (Multilingual Abstract)

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.

참고문헌 (Reference)

1 박창제, "장기요양보호서비스의 비용․효과분석: 시설보호 대 재가보호" 한국노인복지학회 50 (50): 145-172, 2010

2 이정석, "장기요양방문간호 이용자의 특성 및 이용실태" 한국지역사회간호학회 22 (22): 33-44, 2011

3 성명숙, "방문간호의 국내외 현황분석- 한국, 미국, 일본, 독일의 사례를 중심으로 -" 한국보건간호학회 24 (24): 211-225, 2010

4 김명희, "노인장기요양보험제도에 의한 방문간호사의 역할·업무분석" 한국보건간호학회 23 (23): 232-250, 2009

5 김명희, "노인장기요양보험제도에 의한 방문간호 표준개발" 한국보건간호학회 24 (24): 285-301, 2010

6 권현정, "노인장기요양보험제도가 대상노인 및 부양가족의 삶의 질과 가족관계 만족도에 미치는 영향 - 성향점수매칭(PSM)과 이중차이(DD) 결합모형을 이용한 분석 -" 한국사회복지학회 63 (63): 301-326, 2011

7 강새봄, "노인장기요양보험 방문간호 권고군의 방문간호 이용과 의료이용의 관계" 한국보건행정학회 24 (24): 283-290, 2014

8 현경래, "노인장기요양보험 급여이용이 기능상태 변화에 미치는 영향" 한국노년학회 32 (32): 593-609, 2012

9 이미진, "노인 장기요양서비스의 질 측정상의 쟁점에 대한 고찰" 한국사회복지정책학회 38 (38): 141-165, 2011

10 Elkan R, "What is the effectiveness of home visiting or home-based support for older people?" World Health Organization Regional Office for Europe's Health Evidence Network (HEN) 19-, 2004

11 Cynthia M. Boyd, "The Effects of Guided Care on the Perceived Quality of Health Care for Multi-morbid Older Persons: 18-Month Outcomes from a Cluster-Randomized Controlled Trial" Springer Nature 25 (25): 235-242, 2010

12 Ronald M. Andersen, "Revisiting the Behavioral Model and Access to Medical Care: Does it Matter?" SAGE Publications 36 (36): 1-, 1995

13 김경희, "RAI-MDS-HC 2.0으로 평가한 방문보건 대상자의 건강요구" 한국생활환경학회 15 (15): 102-111, 2008

14 Patorno E, "Propensity score methodology for confounding control in health care utilization databases" 10 (10): 8941-8916, 2013

15 Lee AJ, "Performed the first anniversary of long-term care insurance visiting nursing service policy debate for the activation" National Health Insurance Corporation 2009

16 Lee TH, "Performance evaluation about operation the LTC insurance system: 3rd. clinical effects of LTC insurance and development of clinical indicato" Ministry for Health Welfare and Family Affairs 181-, 2011

17 Huber M, "Long-term care for older people" OECD Publishing 138-, 2005

18 Sun WD, "Latest elderly long-term care insurance" Elderly Information Center of Korea 290-, 2012

19 Long-term Care Insurance Corporation, "Introduction of policy" National Health Insurance Corporation

20 Lee KE, "Health outcomes for older adults with stroke in nursing home and home care" Yonsei University 2013

21 Lee YK, "Evaluation of the elderly long-term care insurance : User’s perspective" 168 : 25-33, 2010

22 Park JY, "Development of Integrated care model for LTC and medical service" National Health Insurance Corporation 2010

23 Moon KJ, "Current status and problems of home visit nursing service within long term care insurance" Sungshin Women's University 2011

24 Lee JS, "Correlation analysis between standard LTC utilization plan and expenditures for long term care" National Health Insurance Corporation 188-, 2008

25 Jung YS, "A study on home visiting nursing care and medical care utilization in the elderly patients with long-term care" Inje University 2012

26 Hyun KR, "A study on factors and improvement related to physical function change of LTC applicants" National Health Insurance Corporation 2010

27 Statistics Korea., "2013 elderly statistics" Statistics Korea

28 Park MH, "008the living status and welfare needs survey based analysis report" Ministry for Health Welfare and Family Affairs 2009