An Evaluation of Effects on Hypertension and Diabetes Mellitus Management of a Community-Based Nursing Care Center Using Cost-Benefit Analysis

비용편익분석을 이용한 일 재가노인간호센터의 고혈압 및 당뇨관리 효과평가

  • Received : 2010.07.15
  • Accepted : 2010.09.15
  • Published : 2010.09.30

Abstract

Purpose: This study was conducted to evaluate the economic efficiency of a community-based nursing care center to help policy makers determine whether or not to invest in similar facilities. Methods: The subjects were 101 elderly people over 65 years who participated in a health management program from February 1 to July 31, 2007. Direct cost was estimated with center operations cost, medical cost for out-patients and pharmacy cost. Indirect cost was measured by transportation cost. Direct benefit was calculated by saved medical cost for out-patients, saved pharmacy cost, saved transportation cost, and reducing hospital charges. Indirect benefit was estimated with prevention of severe complications. Economic efficiency was evaluated by cost-benefit ratio and net benefit. Results: Operating a community-based nursing care center was found to be cost-effective. Specifically, the cost of operating the center evaluated here was estimated at 135 million won while the benefit was estimated at 187 million won. Benefit-cost ratio was 1.38. Conclusion: The Community-based nursing care center that was described here could be a useful health care delivery system for reducing medical expenditures.

References

  1. Allred, C. A., Arford, P. H., Mauldin, P. D., & Goodwin, L. K. (1998). Cost-effectiveness analysis in the nursing literature, 1992-1996. Image J Nurs Sch, 30(3), 235-242. https://doi.org/10.1111/j.1547-5069.1998.tb01298.x
  2. Drummond, M. F., O'Brien, B. J., Stoddart, G. L., & Torrance, G. W. (1997). Methods for the economic evaluation of health care programmes, 2ed. Oxford: Oxford University Press.
  3. Kim, C. I., Lee, H. S., Jang, Y. O., Lee, Y. N., & Lee, H. J. (2005). Korea national health and nutrition examination survey. Seoul: Korea Institute for Health and Social Affaires.
  4. Kim, D. K. (1997). Cost-benefit analysis. Seoul: Parkyoungsa.
  5. Kim, H. J., Hue, J. H., Lee, M. H., Kang, H. Y., Jee, S. H., Nam, J. M., et al. (2007). Cost-effectiveness analysis of national prevention programs for cardiovascular diseases. Seoul: Management Center for Health Promotion.
  6. Lee, D. B. (1998). The epidemiologic study of chronic complications in non-insulin-dependent diabetes mellitus. Unpublished master's thesis, Chonnam National University, Gwangju.
  7. Lee, D. B. (1998). The epidemiologic study of chronic complications in non-insulin-dependent diabetes mellitus. Unpublished master's thesis, Chonnam National University, Gwangju.
  8. Lee, T. H., & Ko, I. S. (2002). Cost-benefit analysis on community health practitioner. J Korean Acad Nurs, 32(4), 435-446. https://doi.org/10.4040/jkan.2002.32.4.435
  9. Li, C., Engström, G., Hedblad, B., Berglund, G., & Janzon, L. (2005). Blood pressure control and risk of stroke: A population-based prospective cohort study. Stroke, 36(4), 725-730. https://doi.org/10.1161/01.STR.0000158925.12740.87
  10. Lim, J. Y. (2004). A cost-utility analysis of home care services by using the QALY. J Korean Acad Nurs, 34(3), 449-457. https://doi.org/10.4040/jkan.2004.34.3.449
  11. Min, S. H., Ko, S., & Lim, J. Y. (2008). Economic evaluation of Gemcitabine-cisplatin chemotherapy for non small-cell lung cancer patient in an outpatient setting. J Korean Acad Nurs, 38(3), 363-371. https://doi.org/10.4040/jkan.2008.38.3.363
  12. Ministry for Health, Welfare & Family Affairs. (2008a, April). The guideline of long term care insurance. Seoul: Author.
  13. Ministry for Health, Welfare & Family Affairs. (2008b, December). The manual of customized visiting health care program, Seoul.
  14. Park, C. G. (2006). Risk profiles for stroke and treatment modality in hypertensive patients. Korean Hypertens J, 12(2), 16-24.
  15. Rice, D. (1967). Estimating the cost of illness. Am J Public Health Nations Health, 57(3), 424-440. https://doi.org/10.2105/AJPH.57.3.424
  16. Son, H. Y., Kim, C. Y., Back, S. H., & Kim, J. Y. (2007). Diabetes in Korea 2007. Seoul: Health Insurance Review and Assessment Service.
  17. Song, M. S. (2006). Report on management and operations of intensive nursing care center for elderly at home in Gwang-Ju. Gwang-Ju:Community Health Center.
  18. Stone, P. W. (1998). Methods for conducting and reporting cost-effectiveness analysis in nursing. Image J Nurs Sch, 30(3), 229-234. https://doi.org/10.1111/j.1547-5069.1998.tb01297.x
  19. Yang, B. M. (1999). Health care economics. Seoul: Nanamsinseo.
  20. Yim, E. S. (2008). Cost-benefit analysis of the case management for the elderly patients with hypertension. Unpublished doctoral dissertation, Yonsei University, Seoul.
  21. Yusuf, S., Hawken, S., Ounpuu, S., Dans, T., Avezum, A., Lanas, F., et al. (2004). Effects of potentially modifiable risk factors associated with myocardial infartion in 52 countries (the INTERHEART study): Case-control study. Lancet, 364 (9438), 937-952. https://doi.org/10.1016/S0140-6736(04)17018-9