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Incidence of Pressure Ulcers During Home and Institutional Care Among Long-Term Care Insurance Beneficiaries With Dementia Using the Korean Elderly Cohort

Authors
 Juyeong Kim  ;  Young Choi  ;  Jaeyong Shin  ;  Suk-Yong Jang  ;  Kyeong Hee Cho  ;  Jin Young Nam  ;  Eun-Cheol Park 
Citation
 Journal of the American Medical Directors Association, Vol.18(7) : 638.e1-638.e5, 2017 
Journal Title
 Journal of the American Medical Directors Association 
ISSN
 1525-8610 
Issue Date
2017
MeSH
Aged ; Cohort Studies ; Dementia/epidemiology* ; Dementia/therapy ; Female ; Health Services for the Aged/economics ; Health Services for the Aged/organization & administration* ; Home Care Services/economics ; Home Care Services/organization & administration* ; Humans ; Insurance, Long-Term Care/statistics & numerical data* ; Long-Term Care/economics ; Long-Term Care/organization & administration* ; Male ; Middle Aged ; Pressure Ulcer/epidemiology* ; Republic of Korea
Keywords
Long-term care insurance ; home care ; institutional care ; pressure ulcer ; quality of care
Abstract
OBJECTIVE: To assess whether type of long-term care service is a risk factor of the incidence of pressure ulcers among older adults with dementia who are receiving long-term care insurance (LTCI). METHODS: Data from LTCI beneficiaries (benefit level 1 or 2) with dementia, aged 60 and older (n = 7841), in the Korean Elderly Cohort data set from 2008 to 2013 were used. Type of long-term care service was categorized into home or institutional care using the LTCI Claims Database. The National Health Insurance Claims Database was used to identify the incidence of pressure ulcers as the outcome variable in a survival analysis using the time-dependent Cox proportional hazard model. RESULTS: Of the 7841 participants, 98 (1.2%) exhibited pressure ulcers. Compared with beneficiaries receiving home care, those receiving institutional care had a higher adjusted hazard ratio for pressure ulcers (hazard ratio 6.48, 95% confidence interval 3.48-10.86). These associations were particularly strong among beneficiaries without pressure ulcers during the mandatory assessment for benefit eligibility and who were partially ambulatory. DISCUSSION: Beneficiaries receiving institutional care were more likely to have pressure ulcers than were those receiving home care. The government must monitor the quality of institutional long-term care services and encourage service providers to improve such care.
Full Text
https://www.sciencedirect.com/science/article/pii/S1525861017302360
DOI
10.1016/j.jamda.2017.04.013
Appears in Collections:
4. Graduate School of Public Health (보건대학원) > Graduate School of Public Health (보건대학원) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
Yonsei Authors
남진영(Nam, Jin Young)
박은철(Park, Eun-Cheol) ORCID logo https://orcid.org/0000-0002-2306-5398
신재용(Shin, Jae Yong)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/160265
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