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Delivery of institutional long-term care under two social insurances: Lessons from the Korean experience

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  • Kim, Hongsoo
  • Jung, Young-Il
  • Kwon, Soonman

Abstract

Little is known about health and social care provision for people with long-term care (LTC) needs under multiple insurances. The aim of this study is to compare the profile, case-mix, and service provision to older people at long-term care hospitals (LTCHs) covered by the national health insurance (NHI) with those of older people at long-term care facilities (LTCFs) covered by the public long-term care insurance (LTCI) in Korea. A national LTC survey using common functional measures and a case-mix classification system was conducted with a nationally representative sample of older people at LTCFs and LTCHs in 2013. The majority of older people in both settings were female and frail, with complex chronic diseases. About one fourth were a low-income population with Medical-Aid. The key functional status was similar between the two groups. As for case-mix, more than half of the LTCH population were categorized as having lower medical care needs, while more than one fourth of the LTCF residents had moderate or higher medical care needs. Those with high medical care needs at LTCFs were significantly more likely to be admitted to acute-care hospitals than their counterparts at LTCHs. The current delivery of institutional LTC under the two insurances in Korea is not coordinated well. It is necessary to redefine the roles of LTCHs and strengthen health care in LTCFs. A systems approach is critical to establish person-centered, integrated LTC delivery across different financial sources.

Suggested Citation

  • Kim, Hongsoo & Jung, Young-Il & Kwon, Soonman, 2015. "Delivery of institutional long-term care under two social insurances: Lessons from the Korean experience," Health Policy, Elsevier, vol. 119(10), pages 1330-1337.
    • Handle: RePEc:eee:hepoli:v:119:y:2015:i:10:p:1330-1337
    DOI: 10.1016/j.healthpol.2015.07.009
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    Cited by:

    1. Kim, Hongsoo & Kwon, Soonman, 2021. "A decade of public long-term care insurance in South Korea: Policy lessons for aging countries," Health Policy, Elsevier, vol. 125(1), pages 22-26.
    2. Sunjoo Boo & Jungah Lee & Hyunjin Oh, 2020. "Cost of Care and Pattern of Medical Care Use in the Last Year of Life among Long-Term Care Insurance Beneficiaries in South Korea: Using National Claims Data," IJERPH, MDPI, vol. 17(23), pages 1-10, December.
    3. Rainer Kotschy & David E. Bloom, 2022. "A Comparative Perspective on Long-Term Care Systems," NBER Working Papers 29951, National Bureau of Economic Research, Inc.
    4. Jo, Wonkwang & You, Myoungsoon, 2019. "News media’s framing of health policy and its implications for government communication: A text mining analysis of news coverage on a policy to expand health insurance coverage in South Korea," Health Policy, Elsevier, vol. 123(11), pages 1116-1124.

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