• Title, Summary, Keyword: home visit

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The Relationship between Home-Visit Nursing Services and Health Care Utilization among Nursing Service Recommended Beneficiaries of the Public Long-Term Care Insurance (노인장기요양보험 방문간호 권고군의 방문간호 이용과 의료 이용의 관계)

  • Kang, Sae Bom;Kim, Hongsoo
    • Health Policy and Management
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    • v.24 no.3
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    • pp.283-290
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    • 2014
  • Background: This study aimed to examine the relationship between home-visit nursing services and health care utilization under the public long-term care insurance program in Korea. Methods: We analyzed the long-term care need assessment database and the long-term care and the health insurance claim databases of National Health Insurance Service between July 2011 and June 2012. The sample includes a total of 20,065 home-visit nursing recommended-older beneficiaries who use home-visit nursing and/or home-visit care, based on a standard benefit model developed by the Health Insurance Policy Institute of National Health Insurance Service. The beneficiaries were categorized into home-visit nursing use and non-use groups, and the home-visit nursing use group was again divided into high-use and low-use groups home-visit nursing, based on their total annual home-visit nursing expenditure. Two-part models and negative-binomial regression models were used for the statistical analysis. Results: The home-visit nursing use was negatively associated with the number of outpatient visit and cost, while adjusting for all covariates. The home-visit nursing use was also negatively associated with the inpatient cost among the high home-visit nursing use group. Conclusion: The findings implies home-visit nursing use prevents health care utilization. Further studies and policy strategies that can promote and strengthen home-visit nursing services under the public long-term care insurance are necessary in Korea.

Trends in Home-visit Nursing Care by Agencies' Characteristics under the National Long-term Care Insurance System (노인장기요양보험의 방문간호 제공기관 특성별 서비스 제공 추이)

  • Lee, Jung Suk;Hwang, Rah Il;Han, Eun Jeong
    • Journal of Korean Academy of Community Health Nursing
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    • v.23 no.4
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    • pp.415-426
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    • 2012
  • Purpose: This study aimed to investigate trends in home-visit nursing care by agencies' characteristics under the national long-term care insurance system. Methods: Cochran-Mantel-Haenzel tests were conducted, using data drawn from the nationwide long-term care insurance claim database of the Korean National Health Insurance Corporation from 2009 to 2011. Results: The number of home-visit nursing care agencies has decreased continuously since 2009. There were also similar trends in the total amount of service provided by home-visit nursing care agencies, the number of recipients, the number of employees, and payments. This study showed that there were statistically significant differences in the trends in home-visit nursing care by agencies' characteristics. Despite the overall downward trend, there were some increases in the percentage of home-visit nursing care provided by agencies which were established by individuals, located in large cities, and which combined home-visit care with home-visit bathing. Conclusion: Home-visit nursing care agencies are responsible for providing community-based healthcare services. For past three years, however, they have not been utilized to their full potential. Understanding the trends in home-visit nursing care by agencies' characteristics is important to develop utilization strategies for home-visit nursing care.

A Study of Hospital-based Home-Visit Nutrition Education Needs of Patients at Discharge (퇴원환자의 병원중심 방문영양지도 요구도 조사)

  • Ahn, Su Mi
    • Korean Journal of Community Nutrition
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    • v.19 no.4
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    • pp.386-400
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    • 2014
  • Objectives: The purpose of this study was to provide a basic data of nutrition services in home health care by analyzing hospital-based home-visit nutrition education needs of patients at discharge. Methods: Data was collected from September 11 to October 12, 2012 by administering questionnaires to 289 chronic disease patients to be discharged from a university hospital in Pusan. The home-visit nutrition education instruments used for collecting data were developed by the researcher. Results: Regarding the demands of home-visit nutrition education, 62.3% of subjects were willing to use home-visit nutrition education and 37.7% weren't. The main reason for using the home-visit nutrition education was "the effective nutrient management in consultation with an individual's doctor", 38.9% and 31.2% of patients who did not wish to use the service gave the reason for their decision as, "Just by managing the nutritional requirements of a family's diet and, the patient will be able to fully recover", respectively. As for the demand, classified with the areas of home-visit nutrition education, the demand for the area of basic nutrition (3.75/5.00) was the highest followed by, the area of educational nutrition (3.74/5.00), therapeutic nutrition (3.67/5.00), and dietary nutrition (3.55/5.00). The demand for the area of educational nutrition was high "Considering the state of dietary management, such as disease status and drugs", 73.7%. As for the relation between the characteristics of the study subjects and analysis of demand home-visit nutrition education, the characteristic of subjects, that is, "regular home-visit nutrition education", "practice of diet therapy after discharge" had a significant difference statistically (p < 0.01). As for the relation between the needs for fundamental home-visit nutrition education and the demand of home-visit nutrition education, basic nutrition, educational nutrition, therapeutic nutrition, and dietary nutrition had a significant difference statistically (p < 0.01).

A Study on the Recognition of Client Home Visit Nursing Care Services in Public Health Centers (방문간호사업에 대한 대상자의 인식에 관한 연구)

  • Min, Young-Sun;Chung, Yeoun-Kang;Han, Seung-Eui
    • Journal of Korean Academy of Community Health Nursing
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    • v.11 no.2
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    • pp.399-410
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    • 2000
  • In this, analyzing the type of subjectivity in which people would have about home visit nursing services originating from public health care centers. I tried to research more effective ways to improve home visit nursing care services. and later. for the development of home visit nursing care. to supply basic data. The method for this study was the Q-method. created by William Stephenson. and was adequate for the study of subjectivity. For this study. through the deep interview. literature inquiry, and the discussion course. 206 Q-statement sentences were abstracted. and based on them, after Q-sample-selection. I then collected the Q-categorized-result from 32 subjects from Mar. 10. 2000 to Mar. 25. 2000. Through the statistic a analysis of PC-Qunal program. the subjectivity species were categorized and analyzed. The study results show that there are 3 sorts of recognition types. and they are analyzed in the following; The first type: the positively receiving type shows that they feel thankful and a trusting feeling about home visit nursing. The second type: the negatively mistrusting type shows that they had doubtful attitudes about the specialty of home visit nursing: they wanted medicine or nutrition remedies rather than health education and concerning the their own health care, they prefered the hospitals or clinics. The third type: the conditional receiving type shows that even though they had a positive receiving attitude about home visit nursing wanting to consult with the home visit nurses about the difficult problem which could not easily be settled, hoping that the home visit nurses could visit them more often, in their actual lives. they strongly indicated their attitudes concerning money as more important than home visits. The subjects in these 3 types commonly had a good feeling about the kindness of the home visit nurses: the first and third types also had a positive recognition about home visit nursing; however. in aspects of the evaluation and receiving attitudes, they showed a big difference. When all the above results are integrated. in the case of the first type the home visit nursing service, which satisfied the demand for health care of the medically weak people. should be continuously supplied. Additionally in case of the second type (negatively mistrust). continuous education and support should be supplied with enough interest to lead their concerns about their own health care as well as lead medical spending in a productive and effective direction in order to change their impressions. Through this study. I learned that the recognition of the objectives of home visit nursing services can be categorized in to 3 types and could be analyzed. Thus I wish that this study helps to present basic data which contributes to the development of the home visit nursing field.

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Measuring Workload of Home Visit Care Activities Using Relative Values (방문요양 행위 업무량의 상대적 가치 측정)

  • Han, Seong-Ok;Park, Eun-Cheol;Kang, Dae-Ryong;Kang, Im-Ok
    • Journal of Preventive Medicine and Public Health
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    • v.41 no.5
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    • pp.331-338
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    • 2008
  • Objectives : The purpose of this study was to measure the workload of home visit care activities and their relative values. This study examined also factors that affect the workload of home visit care activities. Methods : The participants of this study were 126 home-helpers of 50 home visit care agencies at the 2nd Long-term Care Insurance Demonstration Project. The workload of home visit care activities was divided into total work and four dimensions ; physical efforts, mental efforts, stress and time. Home visit care activities consisted of four categories with 24 items. We used magnitude estimation method to measure their relative values of the four dimensions. The participants answered the relative values of each activities based on the reference service. We used the activity for supporting their elderly's evacuation as the reference service. Results : Most of the respondents were over 40 years old female. They consumed most their time supporting elderly's going out. They consumed their highest physical, mental efforts, and stress for activities of coping with emergency situation. The Pearson correlation coefficients showed significant relationships between workload and each dimensions. This study showed that all four dimensions are statistically significant predictors of workload of home visit care activities. Also, we found that the home-helper's career affects the workload of home visit care activities. Conclusions : The workload of home visit care activities could be explained by physical efforts, mental efforts, stress and time.

An Analysis of Home Health Care Travel Cost (가정간호 수가 중 교통비 분석)

  • Baek, Hee-Chong;Song, Chong-Rye;Kim, Hae-Young
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.10 no.1
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    • pp.52-57
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    • 2003
  • The purpose of this study was to evaluate appropriateness of home health care travel cost. For the evaluation, investigated the operating costs of vehicles used by home care nurses and then were components of home care nurses's annual salaries. Travel costs were then calculated based on actual travel expenses of home health care service. Actual data of 23 hospital-based home care agencies between July, 2002 to December, 2002 were collected for the analysis of the travel costs. The results of this study are : 1) For home visit, 65% of home care agencies turned out to be using only hospital owned cars, and 17.1% be depending purely on home care nurses' cars. On average, 1.9 cars used for home visit. 2) Out of 89 agencies, 23 agencies responded to the travel cost survey. Total maintenance cost of a car per month was 381,457 won. 3) Average per visit personal expenses of home care nurses during travel time turned out to be 7,124won assuming 8 working hours per day, 4 visits per day, and 30 minuets of travel time for each visit. 4) Total home health care travel cost per visit was 12,069 won, which was the sum of actually paid travel cost of 4,945 won and personal expenses during travel time of 7,124. In conclusion. we reckon that current compensation price of home care nurses' travel is inappropriate because total home health care travel costs of 12,069 won per visit turned out to be 2.1 times of currently prevailing standard compensation price of 5,830 per visit.

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Estimation of Home Care Nursing Cost to the Patient with Cerebrovascular Disease based on a Bundle of Home Care Nursing Service (뇌혈관질환 환자군의 가정간호 행위묶음 수가연구)

  • Hong, Jin-Ui;Yun, Soon-Nyoung
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.7 no.1
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    • pp.26-38
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    • 2000
  • The purpose of this study was to estimate home care nursing cost for the patient with Cerebrovascular Disease based on a bundle of home care nursing services This study was conducted through four steps. The first step was to investigate home care nursing activities that were offered to the patient with Cerebrovascular Disease(CD) by home care nurse. The second step was to investigate the time spent on home care nursing service and to calculate labor and manufacturing cost. The third step was to calculate home care nursing cost per minute. And at the fourth step, home care nursing cost for a patient with Cerebrovascular Disease based on a bundle of home care nursing service was calculated. The results of the study were as follows: 1) The number of direct home care nursing activities for the patient with CD was 108, and the time of each activity was spent from 1 to 10 minutes. 2) Average time per visit was 51 minute, and the firs visit time were spent 1.6 times higher than 2nd visit time. 3) Nursing cost per minute(cost per visit ${\\}\;22,565\;\div\;$ average time per visit 51 minutes) was ${\\}\;442$. The cost per visit was calculated on Basic visiting cost(nurse's labor cost ${\\}\;15,760$ + management cost ${\\}\;6,805$) divided by average time per visit(51 minutes). 4) Home care nursing cost to the patient with CD based on bundle of home care nursing service was consisted of basic home care nursing cost, the cost of a bundle of service practiced on visit. and transportation fee. Basic home nursing cost(the time spent on basic home nursing service 20 minutes ${\times}$ nursing cost per minute ${\\}\;442$) was ${\\}\;8,840$. The cost of the bundle of home care nursing services to the patient with CD was calculated as self care ${\\}\;2.898$, Tracheostomy care ${\\}\;10,166$, immobility care ${\\}\;6,188$, sore care ${\\}\;6,188$. Foley care ${\\}\;6,630$, and Levin tube or Gastrostomy care ${\\}\;7.514$. Transportation fee which was composed of the labor cost for transportation(${\\}\;5,122$) and the car management cost(${\\}\;3.876$) was ${\\}\;8,998$. Home care nursing cost to the patient with CD based on bundle of home care nursing services consisted of basic home care nursing cost, the cost of a bundle of service practiced on visit, and transportation fee. It will contribute to improve quality of home care service, because of giving appreciate incentives to home care nurses. And it will be more efficient than current cost of hospital based home care. But it need to management than calculation of the current fee-for-services of home care.

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The Influence of Self-esteem and Optimism on the Self-leadership of Multicultural Family Home-visit Instructors (다문화가족 방문교육지도사의 자존감 및 낙관성이 셀프리더십에 미치는 영향)

  • Kwon, Ki-Nam;Hwang, Hae Shin;Chae, Jin-Young;Kim, Hera;Kang, Bog-Jeong;Suh, Ju-Hyun
    • Journal of Korean Home Management Association
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    • v.35 no.2
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    • pp.63-75
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    • 2017
  • The purpose of this study was to investigate the differences in optimism, self-esteem and self-leadership according to age, monthly income, and teaching experiences of multicultural family home-visit instructors and the influence of optimism and self-esteem on self-leadership. 668 home-visit instructors participated in the online survey from 140 multicultural family support centers in Seoul, 6 metropolitan cities, 9 provinces, and other cities and counties. Data were analyzed through frequence, percentages, Pearson's correlations, One-way ANOVA, $Scheff{\acute{e}}$ post-hoc test, and stepwise multi-regression using SPSS 21.0. The main findings are as follows. First, there were significant differences in optimism and self-esteem according to age and monthly income. Second, there were significant differences in self-leadership according to age and home-visit teaching experiences. Third, the stepwise multiple regression model showed that optimism, self-esteem and the individual variables had an influence on the self-leadership of home-visit instructor's self-expectation. These results suggest that self-esteem and optimism are important precursors of self-leadership and self-leadership training based on self-esteem and optimism is necessary for self-leadership enhancement of home-visit instructors.

Test on the Cost and Development on the Payment System of Home Health Care Nursing (가정간호수가 적정성 검증 및 수가체계 개선 방안)

  • Ryu Ho-Sihn;Jung Key-Sun;Lim Ji-Young
    • Journal of Korean Academy of Nursing
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    • v.36 no.3
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    • pp.503-513
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    • 2006
  • Purpose: This study focused on analysing costs per home health care nursing visit based on home health care nursing activities in medical institutes. Method: The data was collected in three stages. First, the cost elements of home health care nursing services were collected and 31 home care nurses participated. Second, the workload and caseload of home care nursing activities were measured by the Easley-Storfjell Instrument(1997). Third, the opinions on improving the home health care nursing reimbursement system were collected by a nation-wide mailing survey from a total of 125 home care agencies. Result: The cost of home health care nursing per visit was calculated as 50,626\. This was composed of a basic visiting fee of $35,090{\\}({\fallingdotseq}355$)$ and travel fee of $15,536{\\}({\fallingdotseq}15$)$. The major problems of the home care nursing payment system were the low level of the cost per visit, no distinction between first visit and revisits, and the limitations in health insurance coverage for home health care nursing services. Conclusion: This study's results will contribute as a baseline for establishing policies for improvement of the home health care nursing cost and for applying a community-based visiting nursing service cost.

Analysis of Performance Requirement for Long-term Care Workers of Home Visit Care and Home Visit Bathing based on Korean Long-term Care Insurance System (방문요양.방문목욕 장기요양기관의 요양보호사 업무수행 요구도 분석)

  • Chang, Hyun-Sook
    • The Korean Journal of Health Service Management
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    • v.5 no.3
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    • pp.77-88
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    • 2011
  • As same time of starting on the Korean Long-term Care Insurance System, the government developed a program to train new qualification of long-term care workers. The number of enrolled long-term care workers are 950,000 persons in 2010. Mostly they are working in home based care work places such as home visit care centers and home visit bathing centers covered insurance. The purpose of this study is to understand the difference of task performance requirement according to long-term care workers' responsibilities which divided into home visiting care and home visiting bathing. The comparison analysis was conducted to task performance requirement in basic management, safety management, administration management, practical services. Key result was found that task performance requirement of long-term care workers whose responsibilities are home visiting care were more higher than the home visiting bathing. Finally, To improve quality of home visiting care and home visiting bathing, it is necessary to provide the fields based continuing education and reflect new reimburse system.