Purpose: The purpose of this study was to examine the association between utilization of home care services under the national long-term care insurance system and family caregiver distress. Methods: A secondary data analysis was conducted in this study using data collected in 2011 and 2012 from the Korean version of International Resident Assessment Instrument (interRAI) Home Care assessment system. The study sample included 228 clients receiving community based home care and their family caregivers in Korea. Descriptive statistics, χ 2 test, t-test, and Heckman selection model analysis were conducted using SAS 9.3. Results: Presence of family caregiver distress was significantly associated with days of nurse visits (ß=-.89, p =qqqlt;.001) and home helper visits (ß=-.53, p =.014). Level of caregiver distress was also significantly associated with days of nurse visits (ß=-.66, p =.028). Other factors which were significantly associated with caregiver distress were depression, cognitive function, inadequate pain control, social support for older adult, and caregiver relationship to the older adult. Conclusion:The results of this study show that visiting nurse service and appropriate support programs for Older Adults and family caregivers experiencing caregiver distress should be developed and provided to families based on the health care needs of older adults and their family caregivers for effective and sustainable home care.