Health Policy Manag.  2019 Jun;29(2):195-205. 10.4332/KJHPA.2019.29.2.195.

Determinant Factors in Cost to Feed for Long-Term Care Facilities Residents

Affiliations
  • 1Health Insurance Policy Research Institute, National Health Insurance Service, Wonju, Korea. 07007@nhis.or.kr

Abstract

BACKGROUND
The food and food service influence the quality of life and the general health condition of older persons living in long-term care (LTC) facilities. Purchasing good food materials is a ground of good food service. In Korea, the residents in LTC facilities should pay for the cost of food materials and ingredients out of their pocket because it is not covered by LTC insurance. This study explored what factors affect the cost of food materials paid by LTC facility residents and which factor affects most.
METHODS
We used data from the study on out-of-pocket payment on national LTC insurance, which surveyed 1,552 family caregivers of older residents in LTC facilities. We applied conditional multi-level model, of which the first level represents the characteristics of care receivers and caregivers and its second level reflects those of LTC facilities.
RESULTS
We found that the facility residents with college-graduated family caregivers paid 11,545 Korean won more than those with less than elementary-graduated ones. However, the income level of family caregivers did not significantly affect the amount of the food material cost of the residents. The residents in privately owned, large, metropolitan-located facilities were likely to pay more than those in other types of facilities. The amount of the food material cost of the residents was mainly decided by the facility level factors rather than the characteristics of care recipients and their family caregivers (intra-class correlation=82%).
CONCLUSION
These findings suggest that it might be effective to design a policy targeting facilities rather than residents in order to manage the cost of food materials of residents in LTC facilities. Setting a standard price for food materials in LTC facilities, like Japan, could be suggested as a feasible policy option. It needs to inform the choice of LTC users by providing comparable food material cost information. The staffing requirement of nutritionist also needs to be reviewed.

Keyword

Food cost; Long-term care insurance; Health expenditures; Long-term care facilities; Multi-level analysis

MeSH Terms

Caregivers
Food Services
Health Expenditures
Humans
Insurance
Insurance, Long-Term Care
Japan
Korea
Long-Term Care*
Nutritionists
Quality of Life
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