Figure 1

Flow chart for selection of study participants.

Table 1

Baseline Characteristics according to Service or Non-service (N=5,041)

Characteristics	Categories	Non-service	Service	x2 or t (p)
		n (%) or M±SD	n (%) or M±SD
Gender	Male	1,724 (39.4)	190 (28.5)	29.04 (<.001)
	Female	2,651 (60.6)	476 (71.5)
Age (year)	65~69	1,132 (25.9)	133 (20.0)	13.36 (.010)
	70~74	879 (20.1)	139 (20.9)
	75~79	894 (20.4)	136 (20.4)
	80~84	781 (17.9)	144 (21.6)
	≥85	689 (15.7)	114 (17.1)
		74.31±9.22	75.31±8.93	-2.52 (.145)
Economic sates	Medicaid	2,182 (49.9)	344 (51.7)	10.87 (.368)
	1~2	206 (4.7)	45 (6.8)
	3~4	173 (4.0)	26 (3.9)
	5~6	251 (5.7)	25 (3.8)
	7~8	421 (9.6)	67 (10.1)
	9~10	1,142 (26.1)	159 (23.9)
Care-giver	Alone	429 (9.8)	73 (11.0)	7.29 (.063)
	Couple	1,486 (34.0)	220 (33.0)
	Son or daughter	1,352 (30.9)	231 (34.7)
	Ect	1,108 (25.3)	142 (21.3)
Dementia	No	3,447 (78.8)	494 (74.2)	6.42 (.007)
	Yes	928 (21.2)	172 (25.8)
Stroke	No	2,723 (62.2)	383 (57.5)	4.50 (.019)
	Yes	1,652 (37.8)	283 (42.5)
Hypertension	No	1,973 (45.1)	271 (40.7)	3.37 (.036)
	Yes	2,402 (54.9)	395 (59.3)
Diabetes mellitus	No	2,980 (68.1)	487 (73.1)	7.82 (.003)
	Yes	1,395 (31.9)	179 (26.9)
Arthritis	No	3,026 (69.2)	395 (59.3)	23.89 (<.001)
	Yes	1,349 (30.8)	271 (40.7)
Cancer	No	3,868 (88.4)	643 (96.5)	41.69 (<.001)
	Yes	507 (11.6)	23 (3.5)
Disease number		1.94±1.11	2.02±1.03	-1.81 (.071)

Table 2

Baseline Health Status according to Service or Non-service (N=5,041)

Variables	Categories		Non-service	Service	x2 or t (p)
			n (%) or M±SD	n (%) or M±SD
Care need	Tracheostomy	No	4,260 (97.4)	658 (98.8)	4.95 (.013)
		Yes	115 (2.6)	8 (1.2)
	Suction	No	4,227 (96.6)	646 (97.0)	0.26 (.356)
		Yes	148 (3.4)	20 (3.0)
	O2 therapy	No	4,203 (96.1)	635 (95.3)	0.78 (.215)
		Yes	172 (3.9)	13 (2.0)
	Wound care	No	2,274 (52.0)	384 (57.7)	7.48 (.003)
		Yes	2,101 (48.0)	282 (42.3)
	Tube feeding	No	4,113 (94.0)	610 (91.6)	5.73 (.013)
		Yes	262 (6.0)	56 (8.4)
	Pain (cancer)	No	4,034 (92.2)	618 (92.8)	0.28 (.597)
		Yes	341 (7.8)	48 (7.2)
	Foley care	No	3,456 (79.0)	468 (70.3)	25.50 (<.001)
		Yes	919 (21.0)	198 (29.7)
	Colostomy care	No	4,142 (94.7)	639 (95.9)	1.91 (.167)
		Yes	233 (5.3)	27 (4.1)
	Hemodialysis care	No	3,732 (85.3)	583 (87.5)	2.34 (.126)
		Yes	643 (14.7)	83 (12.5)
	Diabetic foot care	No	4,174 (95.4)	648 (97.3)	4.98 (.026)
		Yes	201 (4.6)	18 (2.7)
	Number		1.17±0.55	1.16±0.44	-1.81 (.071)
Activities of daily living			26.77±6.30	25.20±6.10	2.75 (.097)
Cognitive function			4.57±2.47	4.84±2.41	2.32 (.128)
Rehabilitation function			15.12±3.88	14.37±3.43	15.03 (<.001)

Table 3

Medical Cost according to Service or Non-service

Variables	Year	Non-service		Service		t (p)
		Mean	SD	Mean	SD
Total medical cost (won)	2009	9,737,171	11,842,018	5,766,340	7,843,330	8.38 (<.001)
	2010	10,401,643	12,340,262	5,001,793	6,317,000	11.07 (<.001)
	2011	9,728,544	11,986,919	4,175,214	5,913,082	21.74 (<.001)
	2009~2011	8,628	9,472,588	1,591,126	8,421,830	-4.07 (<.001)
Total inpatient day (day)	2009	35.76	74.82	29.13	67.72	2.16 (.031)
	2010	42.32	94.58	20.38	46.88	5.88 (<.001)
	2011	39.84	94.59	16.74	56.71	6.14 (<.001)
	2009~2011	-4.07	87.40	12.38	82.51	-4.56 (<.001)
Total outpatient day (day)	2009	55.67	58.72	43.76	44.24	5.02 (<.001)
	2010	53.96	60.37	41.27	44.10	5.21 (<.001)
	2011	50.91	60.19	35.32	38.95	6.48 (<.001)
	2009~2011	4.76	42.03	8.45	36.80	-2.14 (<.001)

Table 4

Multiple Regression to Predict Change of Medical Cost by 2009~2011

Variables	Change of total medical cost
	Bu (won)	SE (won)	βs	t
(Constant)	2,896,003	1,544,822		1.88
Service (ref=non-service)	1,970,407	395,621	0.07	4.98**
Gender (ref=male)	-268,498	291,546	-0.01	-0.92
Age	-22,867	16,815	-0.02	-1.36
Economic state	-43,959	31,154	-0.02	-1.41
Care-giver (ref=no)	-153,260	143,389	-0.02	-1.07
Dementia (ref=no)	-638,187	343,497	-0.03	-1.86
Stroke (ref=no)	540,544	298,193	0.03	1.81
Hypertension (ref=no)	-48,746	281,173	-0.01	-0.17
Diabetes mellitus (ref=no)	-278,024	309,695	-0.01	-0.90
Arthritis (ref=no)	-377,027	303,485	-0.02	-1.24
Cancer (ref=no)	388,977	578,379	0.01	0.67
Tracheostomy (ref=no)	1,572,544	1,096,228	0.03	1.44
Suction (ref=no)	3,000,985	1,009,112	0.06	2.97*
O2 therapy (ref=no)	238,336	717,925	0.01	0.33
Wound care (ref=no)	-730,503	399,822	-0.04	-1.83
Tube feeding (ref=no)	-2,098,748	645,792	-0.06	-3.25*
Pain (ref=no)	496,103	675,284	0.01	0.74
Foley care (ref=no)	-1,145,415	411,036	-0.05	-2.79*
Colostomy care (ref=no)	1,137,829	671,662	0.03	1.70*
Hemodialysis care (ref=no)	-2,892,582	506,928	-0.11	-5.71**
Diabetic foot care (ref=no)	1,692,246	673,406	0.04	2.51*
ADL baseline score	88,064	28,812	0.06	3.06*
Cognitive function baseline score	-203,983	61,496	-0.06	-3.32*
Rehabilitation function baseline score	-44,968	43,951	-0.02	-1.02
	R2=.29, Adjusted R2=.29, F=101.87, p<.001

Bu=unstandardized regression coefficients: βs=standardized regression coefficients; ^*p<.05, ^** p<.001.

Table 5

Multiple Regression to Predict Change of Inpatient and Outpatient Day by 2009~2011

Variables	Change of total inpatient day				Change of total outpatient day
	Bu (day)	SE (day)	βs	t	Bu (day)	SE (day)	βs	t
(Constant)	61.93	14.49		4.28**	0.44	6.82		0.06
Service (ref=non-service)	19.44	3.71	0.08	5.24**	3.12	1.75	0.03	1.79
Gender (ref=male)	-4.33	2.73	-0.02	-1.58	-0.56	1.29	-0.01	-0.44
Age	-0.47	0.16	-0.05	-2.98*	0.09	0.07	0.02	1.26
Economic state	-0.32	0.29	-0.02	-1.1	-0.03	0.14	0.00	-0.20
Care-giver (ref=no)	-2.75	1.35	-0.03	-2.04*	0.38	0.63	0.01	0.6
Dementia (ref=no)	-9.97	3.22	-0.05	-3.10*	0.35	1.52	0.00	0.23
Stroke (ref=no)	4.53	2.80	0.03	1.62	0.39	1.32	0.01	0.30
Hypertension (ref=no)	-0.46	2.64	0.00	-0.18	-0.25	1.24	0.00	-0.20
Diabetes mellitus (ref=no)	0.12	2.90	0.00	0.04	2.61	1.37	0.03	1.91
Arthritis (ref=no)	-0.38	2.85	0.00	-0.13	1.21	1.34	0.01	0.91
Cancer (ref=no)	-5.30	5.42	-0.02	-0.98	-2.76	2.55	-0.02	-1.08
Tracheostomy (ref=no)	-0.55	10.28	0.00	-0.05	-0.89	4.84	0.00	-0.18
Suction (ref=no)	19.32	9.46	0.04	2.04*	2.65	4.45	0.01	0.60
O2 therapy (ref=no)	2.29	6.73	0.01	0.34	-2.34	3.17	-0.01	-0.74
Wound care (ref=no)	-11.95	3.75	-0.07	-3.19*	1.17	1.77	0.01	0.66
Tube feeding (ref=no)	-35.00	6.06	-0.10	-5.78**	-2.01	2.85	-0.01	-0.77
Pain (ref=no)	-0.88	6.33	0.00	-0.14	1.41	2.98	0.01	0.47
Foley care (ref=no)	-17.76	3.85	-0.09	-4.61**	-1.18	1.81	-0.01	-0.65
Colostomy care (ref=no)	0.49	6.30	0.00	0.08	-4.26	2.96	-0.02	-1.44
Hemodialysis care (ref=no)	-6.21	4.75	-0.03	-1.31	-24.28	2.24	-0.21	-10.85**
Diabetic foot care (ref=no)	8.63	6.32	0.02	1.37	-1.21	2.97	-0.01	-0.41
ADL baseline score	0.31	0.27	0.02	1.15	0.24	0.13	0.04	1.92
Cognitive function baseline score	-1.50	0.58	-0.04	-2.60*	-0.17	0.27	-0.01	-0.63
Rehabilitation function baseline score	-0.29	0.41	-0.01	-0.69	-0.37	0.19	-0.03	-1.90
	R2=.39, Adjusted R2=.38, F=122.65, p<.001 R2=.05, Adjusted R2=.04, F=10.08, p<.001

Bu=unstandardized regression coefficients: βs=standardized regression coefficients; ^*p<.05, ^** p<.001.

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