Regional Comparison of Home Visiting Care Service Satisfaction among Elder Beneficiaries of the Long Term Care Insurance

Chanyeong Kwak

doi:10.12799/jkachn.2016.27.2.114

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Original Article
Regional Comparison of Home Visiting Care Service Satisfaction among Elder Beneficiaries of the Long Term Care Insurance: Chanyeong Kwak; Journal of Korean Academy of Community Health Nursing 2016;27(2):114-123.
DOI: https://doi.org/10.12799/jkachn.2016.27.2.114
Published online: June 30, 2016

Division of Nursing, Hallym University, Chuncheon, Korea.

• Received: March 5, 2016 • Revised: May 3, 2016 • Accepted: May 16, 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Abstract

Abstract

Purpose
This study aims at comparing levels of service satisfaction with and needs for visiting nurse(VN) services among their beneficiaries in order to make a plan for extending VN services.
Methods
The number of the subjects of this study is 270 in total. They were selected in random sampling in which 30 VN service recipients were randomly selected from each of 7 regions based on their grades and region types.
Results
The highest total score for satisfaction with the VN services was 46.30, which the rural residents gave to their received VN services, then the metropolitan residents gave 44.57, and the small and middle size cities' residents 43.64. On the other hand, the highest total score for needs for VN services was 33.03, which the small and middle size cities' residents gave to their received VN services, then the rural residents gave 31.68, and the metropolitan residents 30.88.
Conclusion
As the small and middle size cities' residents showed low satisfaction with and high needs for local VN services, policies need to be made to promote service providers' expertise and accessibility.
Key Words: Nursing service; Consumer satisfaction; Health policy; Needs

Table 1

Characteristics of Visiting Nurse Users (N=2,297)

Level	Metropolitan	Providence	Rural	Total
Level I	168	212	39	419
Level II	197	234	50	481
Level III	572	675	150	1,397
Total	937	1,121	239	2,297

Table 2

Characteristics Classified by Types of Service (N=270)

Characteristics	Categories	Metropolitan (n=90)	Providence (n=90)	Rural (n=90)	Total (n=270)	χ² or F (p)
Characteristics	Categories	n (%) or M±SD	n (%) or M±SD	n (%) or M±SD	n (%) or M±SD	χ² or F (p)
Gender	Male	38 (42.2)	46 (51.1)	38 (42.2)	122 (45.2)	1.91 (.384)
Gender	Female	52 (57.8)	44 (48.9)	52 (57.8)	148 (54.8)	1.91 (.384)
Age (year)	65~69	18 (20.0)	21 (23.3)	14 (15.6)	53 (19.6)	8.70 (.368)
	70~74	16 (17.8)	17 (18.9)	11 (12.2)	44 (16.3)
	75~79	23 (25.6)	14 (15.6)	28 (31.1)	65 (24.1)
	80~84	17 (18.9)	18 (20.0)	15 (16.7)	50 (18.5)
	≥85	16 (17.8)	20 (22.2)	22 (24.4)	58 (21.5)
		75.37±10.81	75.66±12.72	77.44±9.45	76.13±11.07	0.92 (.401)
Care-giver	Daughter	21 (23.3)	11 (12.2)	7 (7.8)	39 (14.4)	13.93 (.176)
	Son	15 (16.7)	15 (16.7)	18 (20.0)	48 (17.8)
	Spouse	39 (43.3)	40 (44.4)	32 (35.6)	111 (41.1)
	Others	11 (12.2)	11 (12.2)	16 (17.8)	38 (14.1)
Disease	Dementia	33 (36.7)	38 (42.2)	40 (44.4)	111 (41.1)	4.56 (.336)
	Stroke	34 (37.8)	25 (27.8)	33 (36.7)	92 (34.1)
	Dementia+stroke	23 (25.6)	27 (30.0)	17 (18.9)	67 (24.8)
Duration of visiting nursing service (year)	<1	32 (35.6)	37 (41.1)	34 (37.8)	103 (38.1)	12.18 (.432)
	1~<2	19 (21.1)	18 (20.0)	14 (15.6)	51 (18.9)
	≥2	39 (43.3)	35 (38.9)	42 (46.7)	116 (43.0)
Frequency of visiting nursing use (week)		1.71±2.23	2.30±2.51	1.93±2.34	1.98±2.36	0.46 (.635)
Service provider	Nurse	78 (86.7)	80 (88.9)	74 (82.2)	232 (85.9)	3.87 (.423)
	Certified nurse aid	4 (4.4)	3 (3.3)	2 (2.2)	9 (3.3)
	Unknown	8 (8.9)	7 (7.8)	14 (15.6)	29 (10.7)
Use of medical services	Yes	69 (76.7)	68 (75.6)	61 (67.8)	198 (73.3)	2.16 (.340)
Use of medical services	No	21 (23.3)	22 (24.4)	29 (32.2)	72 (26.7)	2.16 (.340)

Table 3

Types of Service (N=270)

Characteristics	Metropolitan (n=90)	Providence (n=90)	Rural (n=90)	Total (n=270)	χ² (p)
Characteristics	n (%)	n (%)	n (%)	n (%)	χ² (p)
Physical assessment & monitoring	80 (88.9)	82 (91.1)	88 (97.8)	250 (92.6)	5.62 (.060)
Medication	31 (34.4)	23 (25.6)	41 (45.6)	95 (35.2)	7.93 (.019)
Respiratory care	18 (20.0)	16 (17.8)	10 (11.1)	44 (16.3)	2.82 (.244)
Skilled nursing	26 (28.9)	14 (15.6)	21 (23.3)	61 (22.6)	4.62 (.099)
Care for elimination	35 (38.9)	29 (32.2)	35 (38.9)	99 (36.7)	1.15 (.563)
Care for pressure ulcer	44 (48.9)	48 (53.3)	33 (36.7)	125 (46.3)	5.39 (.067)
Nutritional care	13 (14.4)	12 (13.3)	11 (12.2)	36 (13.3)	0.19 (.908)
Health education & consulting	59 (65.6)	48 (53.3)	63 (70.0)	170 (63.0)	5.75 (.056)
Massage & excercise	53 (58.9)	57 (63.3)	59 (65.6)	169 (62.6)	0.89 (.642)

Table 4

Service Satisfaction (N=270)

Variables	Categories	M±SD	F	p	Post hoc
Explanation about receiving services	Metropolitan^a	4.26±0.61	4.35	.014	a, c>b
	Providence^b	4.01±0.88
	Rural^c	4.34±0.84
	Subtotal	4.20±0.79
Trust on service provider	Metropolitan^a	4.32±0.61	0.82	.441
	Providence^b	4.24±0.72
	Rural^c	4.38±0.76
	Subtotal	4.31±0.70
Professional knowledge about client's disease	Metropolitan^a	4.20±0.67	1.74	.177
	Providence^b	4.10±0.82
	Rural^c	4.31±0.77
	Subtotal	4.20±0.76
Level of professional skills	Metropolitan^a	4.26±0.59	2.55	.080	a, c>b
	Providence^b	4.08±0.88
	Rural^c	4.33±0.83
	Subtotal	4.22±0.78
Physical assessment skill	Metropolitan^a	3.77±0.87	5.79	.003	c>a, b
	Providence^b	3.79±0.87
	Rural^c	4.17±0.91
	Subtotal	3.91±0.90
Appropriateness of provided service	Metropolitan^a	4.12±0.73	3.89	.022	c>b
	Providence^b	3.99±0.80
	Rural^c	4.31±0.80
	Subtotal	4.14±0.79
Management of urgent medical condition	Metropolitan^a	3.80±0.82	2.72	.068	c>a
	Providence^b	3.92±0.81
	Rural^c	4.10±0.96
	Subtotal	3.94±0.87
Frequency of service	Metropolitan^a	3.88±0.87	0.02	.982
	Providence^b	3.88±0.85
	Rural^c	3.86±1.01
	Subtotal	3.87±0.91
Desire to service use continuously	Metropolitan^a	4.36±0.57	8.23	<.001	c>a, b
	Providence^b	4.21±0.71
	Rural^c	4.58±0.54
	Subtotal	4.38±0.63
Overall satisfaction	Metropolitan^a	4.28±0.60	5.30	.006	c>b
	Providence^b	4.12±0.73
	Rural^c	4.46±0.72
	Subtotal	4.29±0.70
Improvement of health condition after the use of service	Metropolitan^a	3.34±1.14	0.60	.549
	Providence^b	3.30±1.01
	Rural^c	3.47±1.01
	Subtotal	3.37±1.05
Total	Metropolitan^a	44.57±5.20	4.05	.018	c>b
	Providence^b	43.64±7.03
	Rural^c	46.30±6.65
	Subtotal	44.84±6.41

Table 5

Types of Needs for Visiting Nurse Service (N=270)

Variables	Categories	M±SD	F	p	Post hoc
Ability of request for service needed freely	Metropolitan^a	3.98±0.97	4.56	.011	b>a, c
	Providence^b	4.36±0.66
	Rural^c	4.03±1.04
	Subtotal	4.12±0.92
Service to be provided based on client's request	Metropolitan^a	4.18±0.87	0.87	.422
	Providence^b	4.27±0.76
	Rural^c	4.10±0.91
	Subtotal	4.18±0.85
Increased frequency of service	Metropolitan^a	3.31±1.14	4.26	.015	b>a, c
	Providence^b	3.78±1.03
	Rural^c	3.56±1.05
	Subtotal	3.55±1.09
Service provider's knowledge level	Metropolitan^a	4.46±0.52	0.14	.871
	Providence^b	4.47±0.60
	Rural^c	4.50±0.64
	Subtotal	4.47±0.59
Expanded service fields	Metropolitan^a	3.93±0.92	1.91	.150
	Providence^b	4.20±0.85
	Rural^c	4.08±0.97
	Subtotal	4.07±0.92
Information about visiting nursing	Metropolitan^a	3.86±0.91	3.50	.032	b>a
	Providence^b	4.18±0.79
	Rural^c	4.10±0.86
	Subtotal	4.04±0.86
Improvement of the administrative procedure	Metropolitan^a	3.31±0.94	4.10	.018	b>a, c
	Providence^b	3.73±1.04
	Rural^c	3.43±1.07
	Subtotal	3.49±1.03
Supervision of service providers	Metropolitan^a	3.87±0.84	1.14	.320
	Providence^b	4.06±0.87
	Rural^c	3.89±1.03
	Subtotal	3.94±0.92
Total	Metropolitan^a	30.88±4.18	5.05	.007	b>a, c
	Providence^b	33.03±4.80
	Rural^c	31.68±4.70
	Subtotal	31.87±4.64

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Regional Comparison of Home Visiting Care Service Satisfaction among Elder Beneficiaries of the Long Term Care Insurance

Level	Metropolitan	Providence	Rural	Total
Level I	168	212	39	419
Level II	197	234	50	481
Level III	572	675	150	1,397
Total	937	1,121	239	2,297

Characteristics	Categories	Metropolitan (n=90)	Providence (n=90)	Rural (n=90)	Total (n=270)	χ² or F (p)
Characteristics	Categories	n (%) or M±SD	n (%) or M±SD	n (%) or M±SD	n (%) or M±SD	χ² or F (p)
Gender	Male	38 (42.2)	46 (51.1)	38 (42.2)	122 (45.2)	1.91 (.384)
Gender	Female	52 (57.8)	44 (48.9)	52 (57.8)	148 (54.8)	1.91 (.384)
Age (year)	65~69	18 (20.0)	21 (23.3)	14 (15.6)	53 (19.6)	8.70 (.368)
	70~74	16 (17.8)	17 (18.9)	11 (12.2)	44 (16.3)
	75~79	23 (25.6)	14 (15.6)	28 (31.1)	65 (24.1)
	80~84	17 (18.9)	18 (20.0)	15 (16.7)	50 (18.5)
	≥85	16 (17.8)	20 (22.2)	22 (24.4)	58 (21.5)
		75.37±10.81	75.66±12.72	77.44±9.45	76.13±11.07	0.92 (.401)
Care-giver	Daughter	21 (23.3)	11 (12.2)	7 (7.8)	39 (14.4)	13.93 (.176)
	Son	15 (16.7)	15 (16.7)	18 (20.0)	48 (17.8)
	Spouse	39 (43.3)	40 (44.4)	32 (35.6)	111 (41.1)
	Others	11 (12.2)	11 (12.2)	16 (17.8)	38 (14.1)
Disease	Dementia	33 (36.7)	38 (42.2)	40 (44.4)	111 (41.1)	4.56 (.336)
	Stroke	34 (37.8)	25 (27.8)	33 (36.7)	92 (34.1)
	Dementia+stroke	23 (25.6)	27 (30.0)	17 (18.9)	67 (24.8)
Duration of visiting nursing service (year)	<1	32 (35.6)	37 (41.1)	34 (37.8)	103 (38.1)	12.18 (.432)
	1~<2	19 (21.1)	18 (20.0)	14 (15.6)	51 (18.9)
	≥2	39 (43.3)	35 (38.9)	42 (46.7)	116 (43.0)
Frequency of visiting nursing use (week)		1.71±2.23	2.30±2.51	1.93±2.34	1.98±2.36	0.46 (.635)
Service provider	Nurse	78 (86.7)	80 (88.9)	74 (82.2)	232 (85.9)	3.87 (.423)
	Certified nurse aid	4 (4.4)	3 (3.3)	2 (2.2)	9 (3.3)
	Unknown	8 (8.9)	7 (7.8)	14 (15.6)	29 (10.7)
Use of medical services	Yes	69 (76.7)	68 (75.6)	61 (67.8)	198 (73.3)	2.16 (.340)
Use of medical services	No	21 (23.3)	22 (24.4)	29 (32.2)	72 (26.7)	2.16 (.340)

Characteristics	Metropolitan (n=90)	Providence (n=90)	Rural (n=90)	Total (n=270)	χ² (p)
Characteristics	n (%)	n (%)	n (%)	n (%)	χ² (p)
Physical assessment & monitoring	80 (88.9)	82 (91.1)	88 (97.8)	250 (92.6)	5.62 (.060)
Medication	31 (34.4)	23 (25.6)	41 (45.6)	95 (35.2)	7.93 (.019)
Respiratory care	18 (20.0)	16 (17.8)	10 (11.1)	44 (16.3)	2.82 (.244)
Skilled nursing	26 (28.9)	14 (15.6)	21 (23.3)	61 (22.6)	4.62 (.099)
Care for elimination	35 (38.9)	29 (32.2)	35 (38.9)	99 (36.7)	1.15 (.563)
Care for pressure ulcer	44 (48.9)	48 (53.3)	33 (36.7)	125 (46.3)	5.39 (.067)
Nutritional care	13 (14.4)	12 (13.3)	11 (12.2)	36 (13.3)	0.19 (.908)
Health education & consulting	59 (65.6)	48 (53.3)	63 (70.0)	170 (63.0)	5.75 (.056)
Massage & excercise	53 (58.9)	57 (63.3)	59 (65.6)	169 (62.6)	0.89 (.642)

Variables	Categories	M±SD	F	p	Post hoc
Explanation about receiving services	Metropolitan^a	4.26±0.61	4.35	.014	a, c>b
	Providence^b	4.01±0.88
	Rural^c	4.34±0.84
	Subtotal	4.20±0.79
Trust on service provider	Metropolitan^a	4.32±0.61	0.82	.441
	Providence^b	4.24±0.72
	Rural^c	4.38±0.76
	Subtotal	4.31±0.70
Professional knowledge about client's disease	Metropolitan^a	4.20±0.67	1.74	.177
	Providence^b	4.10±0.82
	Rural^c	4.31±0.77
	Subtotal	4.20±0.76
Level of professional skills	Metropolitan^a	4.26±0.59	2.55	.080	a, c>b
	Providence^b	4.08±0.88
	Rural^c	4.33±0.83
	Subtotal	4.22±0.78
Physical assessment skill	Metropolitan^a	3.77±0.87	5.79	.003	c>a, b
	Providence^b	3.79±0.87
	Rural^c	4.17±0.91
	Subtotal	3.91±0.90
Appropriateness of provided service	Metropolitan^a	4.12±0.73	3.89	.022	c>b
	Providence^b	3.99±0.80
	Rural^c	4.31±0.80
	Subtotal	4.14±0.79
Management of urgent medical condition	Metropolitan^a	3.80±0.82	2.72	.068	c>a
	Providence^b	3.92±0.81
	Rural^c	4.10±0.96
	Subtotal	3.94±0.87
Frequency of service	Metropolitan^a	3.88±0.87	0.02	.982
	Providence^b	3.88±0.85
	Rural^c	3.86±1.01
	Subtotal	3.87±0.91
Desire to service use continuously	Metropolitan^a	4.36±0.57	8.23	<.001	c>a, b
	Providence^b	4.21±0.71
	Rural^c	4.58±0.54
	Subtotal	4.38±0.63
Overall satisfaction	Metropolitan^a	4.28±0.60	5.30	.006	c>b
	Providence^b	4.12±0.73
	Rural^c	4.46±0.72
	Subtotal	4.29±0.70
Improvement of health condition after the use of service	Metropolitan^a	3.34±1.14	0.60	.549
	Providence^b	3.30±1.01
	Rural^c	3.47±1.01
	Subtotal	3.37±1.05
Total	Metropolitan^a	44.57±5.20	4.05	.018	c>b
	Providence^b	43.64±7.03
	Rural^c	46.30±6.65
	Subtotal	44.84±6.41

Variables	Categories	M±SD	F	p	Post hoc
Ability of request for service needed freely	Metropolitan^a	3.98±0.97	4.56	.011	b>a, c
	Providence^b	4.36±0.66
	Rural^c	4.03±1.04
	Subtotal	4.12±0.92
Service to be provided based on client's request	Metropolitan^a	4.18±0.87	0.87	.422
	Providence^b	4.27±0.76
	Rural^c	4.10±0.91
	Subtotal	4.18±0.85
Increased frequency of service	Metropolitan^a	3.31±1.14	4.26	.015	b>a, c
	Providence^b	3.78±1.03
	Rural^c	3.56±1.05
	Subtotal	3.55±1.09
Service provider's knowledge level	Metropolitan^a	4.46±0.52	0.14	.871
	Providence^b	4.47±0.60
	Rural^c	4.50±0.64
	Subtotal	4.47±0.59
Expanded service fields	Metropolitan^a	3.93±0.92	1.91	.150
	Providence^b	4.20±0.85
	Rural^c	4.08±0.97
	Subtotal	4.07±0.92
Information about visiting nursing	Metropolitan^a	3.86±0.91	3.50	.032	b>a
	Providence^b	4.18±0.79
	Rural^c	4.10±0.86
	Subtotal	4.04±0.86
Improvement of the administrative procedure	Metropolitan^a	3.31±0.94	4.10	.018	b>a, c
	Providence^b	3.73±1.04
	Rural^c	3.43±1.07
	Subtotal	3.49±1.03
Supervision of service providers	Metropolitan^a	3.87±0.84	1.14	.320
	Providence^b	4.06±0.87
	Rural^c	3.89±1.03
	Subtotal	3.94±0.92
Total	Metropolitan^a	30.88±4.18	5.05	.007	b>a, c
	Providence^b	33.03±4.80
	Rural^c	31.68±4.70
	Subtotal	31.87±4.64

Table 1 Characteristics of Visiting Nurse Users (N=2,297)

Table 2 Characteristics Classified by Types of Service (N=270)

Table 3 Types of Service (N=270)

Table 4 Service Satisfaction (N=270)

Table 5 Types of Needs for Visiting Nurse Service (N=270)