Korea Social Policy Review 2023 KCI Impact Factor : 2.47
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pISSN : 1226-0525
- https://journal.kci.go.kr/kasp
KJCKorea
Journal Central
Utilization and Expenditure of Health Care and Long-term Care at the End of Life : Evidence from Korea
- Korea Social Policy Review
- Abbr : KSPR
- 2018, 25(1), pp.99-123
- DOI : 10.17000/kspr.25.1.201803.99
- Publisher : Korean Association of Social Policy
- Research Area : Social Science > Sociology > Medical / Welfare / Social policy
- Published : March 31, 2018
한은정
1,
Hwang rah-il
2,
Jungsuk Lee
3
1국민건강보험공단 건강보험정책연구원
2신한대학교
3국민건강보험공단
Accredited
ABSTRACT
Purpose: This study empirically investigates the utilization and expenditure of health care and long-term care at the last year of life for long-term care beneficiaries in Korea. Methods: This study used National Health Insurance and Long-term Care Insurance claims data of 271,474 LTCI beneficiaries, who died from July 2008 to December 2012. Their cause of death, place of death, health care costs, and the provision of aggressive care were analyzed. Results: Cardio-vascular disease(29.8%) and cancer(15.3%) were reported as their major cause of death, and hospital(64.4%), home(22.0%), social care facility(9.2%) were analyzed as the place of death. 99.3% of subjects used both health care and long-term care during the last 1 year of life. The average survival period were 516.2 days after they were LTCI beneficiaries. The health care expenditure gradually increased near the death, and the last month were three times more rather than the first month. Furthermore, 31.8% experienced some aggressive cares(CPR, blood transfusion, hemo-dialysis, etc.) at the last month of life. Conclusion: The results of this study suggest that it is important to develop the end of life care policies(for example, hospice, advanced care directives) for the LTCI beneficiaries. They might contribute to the improvement of quality of life and the reduction of health care expenditure of the elderly at the end-of-life.
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[report]
고숙자
/ 2014
/ 생애말기 관리의 사회적 가치 분석
/ 한국보건사회연구원
[report]
국민건강보험공단
/ 2016
/ 고령사회를 대비한 노인의료비 효율적 관리방안
/ 국민건강보험공단
[report]
국민건강보험공단
/ 2017
/ 2016년 건강보험통계연보
/ 국민건강보험공단･건강보험심사평가원
[report]
국민건강보험공단
/ 2017
/ 2016년 노인장기요양보험 통계연보
/ 국민건강보험공단
[journal]
김신미
/ 2003
/
Attributes Considered Important for a Good Death among Elderly and Adults
/ 한국노년학
/ 한국노년학회
23(3)
: 95~110
[book]
김진수
/ 2013
/ 요양병원과 요양시설의 역할정립방안 연구- 연계방안을 중심으로 -
/ 한국보건사회연구원
[journal]
신용석
/ 2013
/
Grounded Theory Approach on the Adaptation Process in Facility of Long-Term Care Elderly
/ 한국사회복지학
/ 한국사회복지학회
65(3)
: 155~182
[journal]
윤영호
/ 2004
/
Public Attitudes Toward Dying with Dignity and Hospice.Palliative Care
/ Journal of Hospice and Palliative Care
/ 한국호스피스완화의료학회
7(1)
: 17~28
[book]
이선미
/ 2011
/ 사망 전 의료이용의 합리적 관리를 위한 진료비 지출구조 분석
/ 국민건강보험공단
[book]
이정면
/ 2012
/ 노인요양시설 입소자의 의료적 요구 관리방안
/ 국민건강보험공단
[report]
정경희
/ 2014
/ 2014년도 노인실태조사
/ 보건복지부
[journal]
정형선
/ 2007
/
Aging and Health Care Expenditure
/ 보건경제와 정책연구
/ 한국보건경제정책학회
13(1)
: 95~116
[journal]
최용욱
/ 2016
/ 급속한 기대수명 증가의 함의
/ KDI FOCUS
69
: 1~7
[book]
최정수
/ 2015
/ 호스피스 완화의료 활성화 방안- 노인장기요양서비스 이용자를 중심으로
/ 한국보건사회연구원
[web]
통계청
/ 2015
/ 2016 고령자 통계
/ http://kostat.go.kr/portal/korea/kor_nw/2/6/5/index.board?bmode=read&aSeq=356426&pageNo=&rowNum=10&amSeq=&sTarget=&sTxt=
[web]
통계청
/ 2017
/ 2016년 출생･사망통계 잠정 결과
/ http://kostat.go.kr/portal/korea/kor_nw/2/1/index.board?bmode=read&bSeq=&aSeq=359243&pageNo=1&rowNum=10&navCount=10&currPg=&sTarget=title&sTxt
[web]
통계청
/ 2017
/ 2016년 사망원인 통계 결과
/ http://kostat.go.kr/portal/korea/kor_nw/2/6/2/index.board?bmode=read&aSeq=363268&pageNo=&rowNum=10&amSeq=&sTarget=&sTxt=
[report]
한은정
/ 2014
/ 노인장기요양보험 인정자의 사망 전 급여이용 실태 분석
/ 국민건강보험공단
[journal]
한은정
/ 2016
/
Long-Term Care Providers’ Views on Good Death for Their Care Recipients
/ 한국사회정책
/ 한국사회정책학회
23(4)
: 177~203
[report]
한은정
/ 2016
/ 장기요양 인정자의 급여이용 행태별 부양실태조사
/ 국민건강보험공단
[web]
ぎょせい
/ 2017
/ 平成24年度介護保険の手引き
/ http://www.city.osaka.lg.jp/contents/wdu020/fukushi/korean/kaigo/03_kaigohoken_seido.html
[journal]
Barnato, AE.
/ 2004
/ Trends in inpatient treatment intensity among Medicare beneficiaries at the end of life
/ Health Services. Reserch
39
: 363~375
[journal]
Buntin, MB
/ 2004
/ The costs of decedents in the Medicare program: implication for payments to medicare+choic plans
/ Health Services Research
39(1)
: 111~130
[web]
Cubanski, J..
/ 2016
/ Medicare Spending at the End of Life: A Snapshot of Beneficiaries Who Died in 2014 and the Cost of Their Care
/ https://www.kff.org/medicare/issue-brief/medicare-spending-at-the-end-of-life
[journal]
Gozalo, PL
/ 2008
/ Hospice effect on government expenditures among nursing home residents
/ Health services research
43(1)
: 134~153
[journal]
Huskamp, HA
/ 2012
/ The intersection of long-term care and end-of-life care
/ Medical Care Research and Review
69(1)
: 3~44
[book]
Institue of Medicine
/ 1997
/ Approaching death: improving care at the end of life
/ The National Academy Press
[journal]
Kane, RL
/ 1998
/ Variation in state spending for long-term care; factors associated with more balanced system
/ Journal of Health Politics, Policy and Law
23
: 364~390
[journal]
Kaufman, SR
/ 1998
/ Intensive care, old age, and the problems of death in America
/ Gerontologist
38
: 715~725
[journal]
Kitchener, M.
/ 2003
/ Medicaid community-based programs: a longitudinal analysis of state variation in expenditures and utilization
/ Inquiry
40
: 375~389
[journal]
Krishnan P.
/ 2017
/ Concept analysis of good death in long term care residents
/ International Journal of Palliative Nursing
23(1)
: 29~34
[journal]
Lacey D.
/ 2004
/ Tube feeding in advanced Alzheimer’s disease: when language misleads
/ American Journal of Alzheimer’s Disease and Other Dementias
19
: 125~127
[journal]
Lynn J.
/ 1997
/ Measuring quality of care at the end of life: a statement of principles
/ Journal of the American Geriatrics Society
45
: 526~527
[journal]
Lynn J.
/ 2001
/ Serving patients who may die soon and their families: the roll of hospice and other services
/ Journal of the American Medical Association
285
: 925~932
[journal]
Meerding, WJ
/ 1998
/ Health-care costs of ageing
/ Lancet
351(9096)
: 140~141
[journal]
Muramatsu, N.
/ 2008
/ Place of death among older americans
/ Medical Care
46(8)
: 829~838
[report]
National Hospice and Palliative Care Organization
/ 2014
/ NHPCO’s facts and figures: hospice care in America
/ NHPCO
[journal]
Perrels, AJ
/ 2014
/ Place of death and end-of-life transitions experienced by very old people with differing cognitive status: retrospective analysis of a prospective population-based cohort aged 85 and over
/ Palliative Medicine
28(3)
: 220~233
[journal]
Reynolds, K.
/ 2002
/ Needs of the dying in nursing homes
/ Journal of Palliative Medicine
5(6)
: 895~901
[journal]
Singer, PA
/ 1999
/ Quality end-of-life care
/ Journal of American medical association
281(2)
: 163~168
[journal]
Shipman, C.
/ 2008
/ Improving generalist end of life care: national consultation with practitioners, commissioners, academics, and service user groups
/ British Medical Journal
337
: 1720~
[journal]
Teno, JM
/ 2004
/ Family perspectives on end-of-life care at the last place of care
/ Journal of the American Medical Association
291(1)
: 88~93
[journal]
Zuckerman, RB
/ 2015
/ Hospice Use, Hospitalization, and Medicare Spending at the End of Life
/ Journals of Gerontology Series B: Psychological Sciences and Social Sciences
71(3)
: 569~580