Effects of Visiting Nursing Services in Long-term Care Insurance on Utilization of Health Care

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.

Regional Comparison of Home Visiting Care Service Satisfaction among Elder Beneficiaries of the Long Term Care Insurance

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.

Influencing Factors for and Medical Expenditures of Metabolic Syndrome among Public Officials / 한국직업건강간호학회지

PURPOSE: This study examined the influencing factors for metabolic syndrome and the annual medical expenditures of metabolic syndrome among public officials. METHODS: The National Health Insurance data in 2009 were collected for 364,932 public officials and the heath examination results and annual medical expenditures were analyzed using PASW 18.0 program. RESULTS: The prevalence of metabolic syndrome is 17.6%, and it was higher in male officials than that of females in all age groups. In men, the influencing factors for metabolic syndrome were: age, family history of stroke, cardiovascular disease, hypertension, and diabetes mellitus, smoking, alcohol consumption, exercise, and obesity. However, in women, health-related behaviors such as smoking, alcohol consumption and exercise did not affect metabolic syndrome. People who had metabolic syndrome showed significantly higher medical expenditures than those without metabolic syndrome. The odds ratios of having the highest quartile in medical expenditures were 1.372 (95% CI 1.252~1.504, p<.001) in women with metabolic syndrome and 1.213 (95% CI: 1.184~1.243, p<.001) in men. CONCLUSION: The results implied that health-related behaviors were associated with metabolic syndrome, and resulted in higher medical expenditures. In order not only to decrease the risk of metabolic syndrome but also reduce medical expenditures, nurses should plan health promotion strategies to educate public officials about healthy life strategies.

Prevalence and Associated Risk Factors for Cardiovascular Disease: Findings from the 2005, 2007 Korea National Health and Nutrition Examination Survey

BACKGROUND: Socio-economic factors, culture, and the health care delivery system are all associated with increased risk of cardiovascular disease (CVD). However, their significance and prevalence in Korea have not been precisely determined. The purposes of this study were to identify factors related to increased CVD risk among Koreans, and compare the results with those of previous studies. METHODS: This study is an analysis of secondary data collected through the Korea National Health and Nutrition Examination Survey. For the purposes of this research, CVD is defined as medically diagnosed hypertension, stroke, angina, and myocardial infarction. Of the 38,746 survey participants, we analyzed 4,727 subjects who suffered from CVD. RESULTS: Before the age of 50, men have a greater risk of CVD than women while a woman's risk of CVD after 50 begins to rise with age. Socioeconomic factors such as education, income, single living pattern, chronic kidney disease (CKD), diabetes mellitus (DM), depression, rheumatic arthritis, chronic obstructive pulmonary disease, body mass index and waist circumference, lipids, physical activity, and diet are all associated with the prevalence of CVD. A multi-variate analysis demonstrated that CKD (odds ratio, OR=5.266, P<0.001) and DM (OR=2.872, P<0.001) are the strongest independent predictors of CVD among Koreans. CONCLUSIONS: The prevalence of CVD among Korean was about 12.2%. While most risk factors had similar influence on the development of CVD, depression, CKD, and DM showed stronger correlations than those seen in studies performed in other countries. Our results show that a greater importance should be placed on strict and early management of these diseases.