통합돌봄 체계 마련을 위한 중증 노인의 요양 및 의료필요도 평가와 정책과제

Abstract

Objectives: This study aimed to develop policy recommendations for clarifying the roles of long-term care hospitals (LTCHs) and long-term care facilities (LTCFs). The analysis was based on an evaluation of older adults’ medical and care needs and family caregivers’ perspectives using data from a 2021 pilot of an integrated assessment system. Methods: A mixed-methods design was employed. The quantitative analysis included 650 users of LTCHs and LTCFs, while the qualitative research explored family caregivers’ experiences and perceptions. Results: Although LTCHs cared for patients with relatively severe medical needs, more than 40% had very low needs, indicating a mismatch between institutional functions and patient characteristics. In LTCFs, about 30% of residents had moderate or severe needs, indicating an overlap in roles and possible service mismatch. Caregivers chose LTCHs for their perceived medical security but expressed dissatisfaction with the quality of caregiving. LTCFs were chosen due to their lower costs and limited home care, with caregivers showing high satisfaction with their affordability and supportive programs. Conclusion: Policy measures should discourage long-term hospitalization solely for care needs, strengthen linkages to facilitate timely transitions from hospitals to LTCFs, and adopt an integrated assessment system to better align services with the complex needs of older adults.