title: Cognitive function, behavioral problems, and physical function in long-term care insurance beneficiaries with dementia in South Korea: comparison of home care and institutional care services.
abstract: OBJECTIVE
  To examine, in beneficiaries with long-term care (LTC) insurance (LTCI) with dementia in Korea, changes in cognitive function, behavioral symptoms, and physical function over time in relation to LTCI service type and to determine the 2-year effects of service type on those health outcomes.
  
  
  METHODS
  Secondary analyses of the existing LTCI data set from 2008 to 2010.
  
  
  METHODS
  South Korea.
  
  
  METHODS
  LTCI beneficiaries with dementia aged 65 and older (N=31,319). Participants were divided according to the service type that they were receiving home care (HC), institutional care (IC), and combined care (CC).
  
  
  METHODS
  A LTC approval checklist was used to determine the level of LTCI coverage of each participant and to assess cognitive function, behavioral symptoms, and physical function. Linear mixed models and multiple regression models were used.
  
  
  RESULTS
  There were significant differences in cognitive function, behavioral symptoms, and physical function at baseline between individuals receiving the three service types (P<.001) and overall improvements in those outcomes over 2 years in the three groups (P<.001). After limiting the sample to those who had received LTCI services for the full 2 years (2008-2010) and adjusting for baseline characteristics, individuals receiving HC were more likely to have better cognitive and physical function than those receiving IC or CC but were likely to have more behavioral symptoms 2 years after the LTCI enrollment (P<.001).
  
  
  CONCLUSIONS
  LTCI service type (HC, IC, CC) predicted cognitive function, behavioral symptoms, and physical function at 2-year follow-up in beneficiaries with dementia. Further research is necessary to examine the effect of LTC services on health outcomes in a longer observational cohort.
authors.affiliation: Department of Nursing Environments and Systems, College of Nursing, Seoul, South Korea; Nursing Policy Research Institute, Yonsei University, Seoul, South Korea.
authors.forename: Tae Wha
authors.initials: TW
authors.lastname: Lee
authors.forename: Eunsil
authors.initials: E
authors.lastname: Yim
authors.forename: Eunhee
authors.initials: E
authors.lastname: Cho
authors.forename: Jane
authors.initials: J
authors.lastname: Chung
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000453:epidemiology / Q000451:nursing* / Q000503:physiopathology; D003704:Dementia / Q000453:epidemiology / Q000451:nursing* / Q000503:physiopathology; D005260:Female; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D007326:Institutionalization / Q000458:organization & administration*; D007353:Insurance, Long-Term Care; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000451:nursing* / Q000503:physiopathology; D056910:Republic of Korea / Q000453:epidemiology
keywords: behavioral symptoms; cognition; dementia; long-term care system; physical function