Cost-benefit Analysis of Home Visiting Care for Vulnerable Populations with Hypertension

취약계층 고혈압 대상자를 위한 방문건강관리사업의 비용편익분석

  • Ko, Young (College of Nursing, Eulji University) ;
  • Lee, In-Sook (College of Nursing, Seoul National University)
  • 고영 (을지대학교 간호대학) ;
  • 이인숙 (서울대학교 간호대학)
  • Received : 2011.09.24
  • Accepted : 2011.12.15
  • Published : 2011.12.31


Purpose: This study was to investigate the effect of home visiting care service and to evaluate the effect from the cost-benefit perspective. Methods: Target participants were enrolled in 2007~2008 for home visiting care and provided with a home visiting nursing service for more than 18 months in J Ward of S City. Of 391 participants, 244 who satisfied the inclusion criteria were used in the final analysis. Cost-benefit analysis was done using the net benefit and benefit/cost ratio. Results: After providing the home care nursing service, the blood pressure control rate increased from 50.8% to 75.4%. Of the subjects, 39.8% maintained their blood pressure level within the target range. As a whole, the net benefit of home visiting care per person ranged from 434,964.86 to 447,112.43 won and the benefit/cost ratio ranged from 2.82 to 2.84. Conclusion: Home visiting care for vulnerable populations with hypertension was effective in both maintaining blood pressure and reducing blood pressure to the target range. Therefore these results are especially useful for establishing the value of home visiting services for policy makers as well as for prioritizing vulnerable populations.


  1. Ahn, Y. O., Kim, D. H., Bae, J. M., Lee, M. S., Shin, M. H., & Lee, S. I. (1995). A study on effective implementation of health examination. Seoul: National Health Insurance Corporation.
  2. Alcocer, L., & Cueto, L. (2008). Review: Hypertension, a health economics perspective. Therapeutic Advanced in Cardiovascular Disease, 2, 147-155. doi: 10.1177/17539447080 90572
  3. Bae, S. I., Kim, J. S., & Park, I. S. (2005). The cost-benefit analysis for high blood pressure in health examination. The Korean Journal of Health Economics and Policy, 11, 39-61.
  4. Bae, S. S., Kim, J., Min, K. B., Kwon, S. H., & Han, D. S. (1999). Patient compliance and associated factors in the community- based hypertension control program. Journal of Preventive Medicine and Public Health, 32, 215-227.
  5. Cantor, J. C., Morisky, D. E., Green, L. W., Levine, D. M., & Salkever, D. S. (1985). Cost-effectiveness of educational interventions to improve patient outcomes in blood pressure control. Preventive Medicine, 14, 782-800. doi:10. 1016/0091-7435 (85)90071-4
  6. Collins, R., Peto, R., MacMahon, S., Hebert, P., Fiebach, N. H., Eberlein, K. A. et al. (1990). Blood pressure, stroke, and coronary heart disease. part 2, short-term reductions in blood pressure: overview of randomised drug trials in their epidemiological context. Lancet, 335, 827-838. doi: 10.1016/0140-6736 (90)90944-Z
  7. Earp, J. A., Ory, M. G., & Strogatz, D. S. (1982). The effects of family involvement and practitioner home visits on the control of hypertension. American Journal of Public Health, 72, 1146-1154.
  8. Grover, S. A., Coupal, L., Kaouache, M., & Lowensteyn, I. (2007). Preventing cardiovascular disease among canadians: What are the potential benefits of treating hypertension or dyslipidemia? Canadian Journal of Cardiology, 23, 467- 473. doi:10.1016/S0828-282X(07) 70786-9
  9. Jung, Y. H., & Ko, S. J. (2004). Estimating socioeconomic costs of five major disease. The Korean Journal of Public Finance, 18, 77-104.
  10. Kang, Y. S., Lee, S. J., Yang, B. M., & Hur, J. (1988). Costbenefit analysis of nursing intervention program for the aged. Journal of Korea Gerontological Society, 8, 120-144.
  11. Kaplan, G. A., & Keil, J. E. (1993). Socioeconomic factors and cardiovascular disease: A review of the literature. Circulation, 88, 1973-1998.
  12. Kim, J. H., Lee, H. Y., & Jung, H. J. (2008). 2007 National health insurance statistical yearbook. Seoul: Health Insurance Review & Assessment Service, National Health Insurance Corporation.
  13. Ko, I. S., Kim, G. S., Lim, M. H., Lee, K. J., Lee, T. W., Park, H. S. et al. (2007). Effects of health education on the knowledge and self-care of hypertension for visiting nursing clients. Journal of Korean Academy of Public Health Nursing, 21 , 134-145.
  14. Korea Center for Disease Control and Prevention. (2008, December). 2007 National health statistics: the first year (2007) of the 4th the national health and nutrition examination survey. Retrieved October 5, 2009, from http://
  15. Lee, J. Y., Kim, H. L., & Kim, Y. H. (2006). Difference of selfcare behavior implementation in clients with hypertension by visiting nursing service. Journal of Chungnam University Academy of Nursing, 9, 53-62.
  16. Lee, T. W., & Ko, I. S. (2002). Cost-benefit analysis on community health practitioner. Journal of Korean Academy of Nursing, 32, 435-446.
  17. Liljas, B. (1998). How to calculate indirect costs in economic evaluations. Pharmacoeconomics, 13(1), 1-7.
  18. Management Center For Health Promotion. (2009-a, March). Estimation of optimal workload for the visiting nurse of customizing health care through the job analysis. Seoul: Ajou University, Management Center For Health Promotion.
  19. Management Center For Health Promotion. (2009-b, December). 2007 Customized home visiting care project yearbook. Seoul: Management Center For Health Promotion, Ministry of Health, Welfare and Family Affairs.
  20. Ministry of Health and Welfare. (2007, November). Result report of customized home visiting care project in 2007. Seoul: Author.
  21. Ministry of Labor. (2008, May). Survey report on wage structure. Seoul: Author.
  22. Ministry of Public Administration and Security. (2008, June). Civil service pay. guidance. Retrieved December 15, 2009, from
  23. Park, J. G., & Choi, M. J. (2004). Automobile insurance. Incheon: SunHak Press.
  24. Park, K. O. (2008, November). Nurse! Why do they leave small and medium hospitals? Korean Nurses Association Policy Forum, Seoul, Korea. Retrieved November 20, 2009, from
  25. Shin, H. S., Lee, T. J., & Yang, B. M. (1993). The economic analysis on visiting nurse program. Journal of Institute of Health and Environmental Science, 3 , 9-17.
  26. Statistics Korea. (2009). Economic activity participation rate and consumer price index. Retrieved October 24, 2009, from
  27. The Korean Society of Hypertension. (2004, December). 2004 Korean hypertension treatment guidelines. Seoul: Committee on Guidelines of Hypertension Treatment, The Korean Society of Hypertension.
  28. World Health Organization. (2002, October). The world health report 2002-reducing risks, promoting healthy life. Geneva: World Health Organization.
  29. Yang, B. M., Kim, J. H., & Lee, S. Y. (1992). The economic analysis of industrial health promotion program: A costbenefit analysis of preventing occupational disease program in Korea. Seoul: Ministry of Labor.
  30. Yonsei University Health Promotion Project Support Group. (2007). Cost-effectiveness analysis of national prevention programs for cardiovascular disease. Seoul: Management Center for Health Promotion, The Korea Institute for Health and Social Affairs.