Factors affecting regional rate of certification in Korean Long-term Care Insurance

This study is to investigate the factors affecting the regional rate of certification for long-term care insurance benefits. Analyzed data were the 253,935 certified beneficiaries (equivalent to 4.9% of total elderly population) as long-term care degree (LTC degree) 1~3 extracted from the applicants for long-term care in the beginning stage of the system from April 15 2008 to July 1 2009. Although the data were collected from individuals, after restructured into regional data and then analysed in the unit of 225 administrative regions for the Korean Long-term Care Insurance. The rate of certification was operated as the percentage of people of LTC degree 1~3 to the elderly population in each region. The average rate of certification among regions was 4.91%, and ranged from 2.20% to 8.32%. In the analysing regression models, most socio-demographic variables, applicants` disease characteristics, regional service infrastructure, and the certification interviewer`s characteristics were included. The most influencing variables were the disease factors of applicants, especially dementia or cerebrovascular disease rather than arthritis, osteoporosis, or fracture patients were strong factors for the regional rate of certification. However, advanced studies adding more explainable factors on the regional variance of certification rate would be necessary to provide political agenda and measures for evidence-based certification process with high reliability and validity for a sustainable LTC system in Korea.