Health Policy Manag.
2020 Dec;30(4):522-530. 10.4332/KJHPA.2020.30.4.522.
Ownership of Long-Term Care Facility and Incidence of Pressure Ulcers among Republic of Korea
- Affiliations
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- 1Department of Public Health, Yonsei University Graduate School, Korea
- 2Institute of Health Services Research, Yonsei University, Seoul, Korea
- 3Research and Analysis Team, National Health Insurance Service Ilsan Hospital, Goyang, Korea
- 4International Cooperation Department, Health Insurance Review and Assessment Service, Wonju, Korea
- 5Division of Cancer Control & Policy, National Cancer Control Institute, National Cancer Center, Goyang, Korea
- 6Department of Preventive Medicine, Ajou University School of Medicine, Suwon, Korea
- 7Department Pharmaceutical Policy Research Division, Health Insurance Review and Assessment Service, Wonju, Korea
- 8Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
- KMID: 2510244
- DOI: http://doi.org/10.4332/KJHPA.2020.30.4.522
Abstract
- Background
In 2008, Korea implemented a new type of social insurance known as “long-term care insurance”. We examined the association between ownership of long-term care facilities and the incidence of pressure ulcers after the implementation of “long-term care insurance”. This study is a population-based retrospective cohort study from 2006 to 2013.
Methods
We used medical claims data from the Korean National Health Insurance Corporate Elderly Cohort Database from 2006 to 2013. These data comprise a nationally representative sample. To avoid confounders, only patients admitted to one long-term care facility and who stayed for >70% of the follow-up time were included; as a result, 3,107 individuals were enrolled. The main independent variable was the operating entity of the long-term care facility (local government, corporate bodies, and private for-profit owners), and the dependent variable was the 1-year incidence of pressure-ulcers. Survival analysis (Cox proportional hazard model) was used as an analysis method.
Results
Compared to patients admitted to local government long-term care facilities, patients admitted to private long-term care facilities had a significantly higher 1-year risk of pressure ulcers (hazard ratio [HR], 1.94; 95% confidence interval [CI], 1.29–2.91); the risk was especially high among patients who were cognitively dependent (HR, 2.34; 95% CI, 1.25–4.37).
Conclusion
Patients admitted to private for-profit long-term care facilities were more likely to have pressure ulcers compared to those in local government and corporate body long-term care facilities. Appropriate assessment tools and publicly available information, as well as more restricted legal requirements, are needed to improve the care quality and outcomes of patients in long-term care facilities.
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