Level of Resident Care Need and Staffing by Size of Nursing Home under the Public Long-term Care Insurance in South Korea

Purpose: Formal long-term care in nursing homes became a popular means of caring for frail elders in South Korea. This universal long-term care (LTC) insurance for elders was introduced in 2008. The aim of this study was to provide information on the extent of and variations in residents’ care needs and nursing staffing characteristics across nursing homes. Methods: This was a population-based secondary analysis of a large national survey study involving 1,472 older residents in 92 nursing homes in South Korea in 2013. Characteristics of residents and nursing homes were collected by functional assessment and an examination of administrator surveys for nursing home size was done using descriptive analysis. Results: Small and small-medium nursing homes were more likely to provide care to non-Medical-aid beneficiaries and older people with lower care need level. These smaller homes also better met the minimum nursing staffing standard. However, they were less likely to hire registered nurses (RNs), as it is not yet a staffing requirement for nursing homes in Korea. Conclusion: South Korea has a policy agenda to increase nursing staffing level, especially by adding RNs, and decrease variations in staffing levels by nursing home size. Further evidence on care-need level, proper resource allocation, and policies designed to strengthen the LTC workforce is essential to advance the LTC system in Korea.