건강보험 청구자료분석을 통한 요양시설과 요양병원 노인의 급성기병원 입원 및 사망의 관련 요인

• 영문명: Factors Associated with Acute Hospitalizations and Mortality of Older Adults in Long-Term Care Facilities and Long-Term Care Hospitals: A Population-Based, Pubic-Insurance Big-Data Analysis
• 발행기관: 한국노인간호학회
• 간행물 정보: 『노인간호학회지』제24권 제2호, 162~173쪽, 전체 12쪽
• 주제분류: 의약학 > 의학일반
• 파일형태: PDF
• 발행일자: 2022.05.31

영문 초록

Purpose: This study examined individual, institutional, and regional factors associated with 90-day acute hospital- izations and 1-year mortality among older people admitted to long-term care facilities (LTCFs) and long-term care hospitals (LTCH) in Korea. Methods: We analyzed the National Health Insurance Services (NHIS) Elderly Cohort Database linked with regional statistics. The sample included 13,839 LTCF residents and 23,962 LTCH patients. Multi-level logistic regression analyses were conducted. Results: The risk for 90-day acute hospital admission was positively associated with being male and having comorbidities among both LTCF residents and LTCH patients. Being 80+ years old and having a severe case-mix (LTCF grade 1/LTCH groups A1 & 2) were positively associated with acute hospitalizations among LTCF residents, but the relationships were negative among LTCH patients. People in urban LTCFs and/or those in facilities located in regions with a higher physician supply had lower acute hospitalizations. The risk for 1-year mortality after LTCF or LTCH admission was positively associated with being an old male, having a severe case-mix, and comorbidities. Among institutional factors, public ownership for LTCFs and being a larger size for LTCHs were negatively associated with mortality. Conclusion: This health and long-term care big data analysis showed various factors influenced adverse health outcomes among older Koreans receiving institutionalized long-term care, and the patterns of the relationships were different for LTCFs and LTCHs. Further investigations are needed into the mechanisms underlying the complex dynamics among the multi-level determinants of acute care utilization and mortality by institution type.

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장기요양, 보건의료 이용, 다수준 분석, 빅데이터, Long-term care, Patient acceptance of health care, Big data, Multilevel analysis