간호행정학회지 (Journal of Korean Academy of Nursing Administration)

  • 제19권4호
  • /
  • Pages.437-448
  • /
  • 2013
  • /
  • 1225-9330(pISSN)
  • /
  • 2288-4955(eISSN)
한국간호행정학회 (Korean Academy of Nursing Administration)
권호 표지
DOI QR코드

DOI QR Code

당뇨병성 족부질환자에 대한 가정간호서비스의 비용-효과분석

Cost-effectiveness Analysis of Home Care Services for Patients with Diabetic Foot

  • 투고 : 2013.03.11
  • 심사 : 2013.06.09
  • 발행 : 2013.09.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: This study was a retrospective survey to examine economic feasibility of home care services for patients with diabetic foot. Methods: The participants were 33 patients in the home care services (HC) group and 27 in the non-home care services (non-HC) group, all of whom were discharged early after inpatient treatment. Data were collected from medical records. Direct medical costs were calculated using medical fee payment data. Cost-effectiveness ratio was calculated using direct medical costs paid by the patient and the insurer until complete cure of the diabetic foot. Effectiveness was the time required for a complete cure. Direct medical costs included fees for hospitalization, emergency care, home care, ambulatory fees, and hospitalization or ambulatory fees at other medical institutions. Results: Mean for direct medical costs was 11,118,773 won per person in the HC group, and 16,005,883 won in the non-HC group. The difference between the groups was statistically significant (p=.042). Analysis of the results for cost-effectiveness ratio showed 91,891 won per day in the HC patients, and 109,629 won per day in the non-HC patients. Conclusion: Result shows that the cost-effectiveness ratio is lower HC patients than non-HC patients, that indicates home care services are economically feasible.

키워드

참고문헌

  1. Apelqvist, J., & Larsson, J. (2000). What is the most effective way to reduce incidence of amputation in the diabetic foot?. Diabetes Metabolism Research and Reviews, 16, s75-s83. https://doi.org/10.1002/1520-7560(200009/10)16:1+<::AID-DMRR139>3.0.CO;2-8
  2. Basic statistics diabetes Task Force Team. (2007). Basic statistics on diabetes Task Force Team report: Diabetes in Korea 2007. Seoul: Korean Diabetes Association & Health Insurance Review & Assessment Service.
  3. Bryant, R. A., & Nix, D. P. (Eds.). (2007). Acute & chronic wounds current management concepts (3rd ed.). St. Louis: Mosby Elsevier.
  4. Carter, M. J. (2010). Cost-effectiveness research in wound care: Definitions, approaches, and limitations. Ostomy Wound Management, 56, 48-59.
  5. Choi, G. C., Lee, H. Y., & Lee, S. M. (2009). A survey of medical costs for health insurance patients in 2008. Seoul: National Health Insurance Corporation.
  6. Chung, C. H., Kim, D. J., Kim, J. Y., Kim, H. Y., Kim, H. Y., Min, K. Y., et al. (2006). Current status of diabetic foot in Korean patients using national health insurance database. Journal of Korea Diabetes Association, 30, 372-376. http://dx.doi.org/10.4093/jkda.2006.30.5.372
  7. Drummond, M. F., Sculpher, M. J., Torrance, G. W., O'Brien, B. J., & Stoddart, G. L. (2005). Methods for the economic evaluation of health care programmes (3rd ed.). New York: Oxford university press.
  8. Frykberg, R. G., Zgonis, T., Armstrong, D. G., Driver, V. R., Giurini, J. M., Landsman, A. S., et al. (2006). Diabetic foot disorders: A clinical practice guideline (2006 revision). Journal of Foot and Ankle Surgery, 45, s1-66. http://dx.doi.org/10.1016/S1067-2516 (07)60001-5
  9. Harris, C., & Shannon, R. (2008). An innovative enterostomal therapy nurse model of community wound care delivery. Journal of Wound Ostomy Contience Nursing, 35, 169-183. http://dx.doi.org/10.1097/01.WON.0000313639.37247.c0
  10. Health Insurance Review & Assessment Service. (2010). Diseases of frequent home care visiting by year in national health insurance claim database. Home Care Nurses Association, Unpublished internal data.
  11. Holzer, S. E., Camerota, A., Martens, L., Cuerdon, T., Crystal-Peters, J., & Zagari, M. (1998). Costs and duration of care for lower extremity ulcers in patients with diabetes. Clinical Therapeutics, 20, 169-181. https://doi.org/10.1016/S0149-2918(98)80044-1
  12. Hwang, N. M. (2000). Cost-benefit analysis of the hospital-based home health care program for terminal cancer patients. Unpublished doctoral dissertation, Seoul National University, Seoul, Korea.
  13. Kang, S. W., Kwon, Y. D., Ko, S. K., & Ji, N. J. (2005). Effects of home health care on social cost containment: Evidence from the patients undergone by knee arthroplasty in Korea. The Korean Journal of Health Economics and Policy, 11, 85-99.
  14. Kim, D. I., Kim, H. C., Ko, Y. J., Sung, I. H., Shin, B. S., Oh, W. S., et al. (2006). Diabetic foot: Diagnosis & treatment. Seoul: Euihakmunhwa.
  15. Kim, E. Y., & Yang, B. M. (2002). Economic evaluation of longterm care service. Korean Health Economic Review, 18, 1-17.
  16. Kim, J. H. (2005). A cost-effectiveness analysis of long-term home oxygen therapy for patients with chronic obstruction pulmonary diseases (COPD) and policy implication in Korea. The Korean Journal of Health Economics and Policy, 11, 1-38.
  17. Ku, B. J., Choi, D. E., Joeng, J. O., Rha, S. Y., Lee, H. J., Hong, W. J., et al. (2002). The clinical observation in diabetic patients with foot ulcer. Clinical Diabetes, 3, 244-252.
  18. Lavery, L. A., Armstrong, D. G., & Harkless, L. B. (1996). Classification of diabetic foot wounds. Journal of Foot and Ankle Surgery, 35, 528-531. http://dx.doi.org/10.1016/S1067-2516(96)80125-6
  19. Lee, T. W. (1998). The costs of long-term care alternatives for the elderly. Journal of Korean Academy of Nursing Administration, 4, 351-361.
  20. Lee, T. W. (2001). Methodological issues in nursing research on cost-effectiveness analysis. Journal of Korean Academy of Nursing, 31, 1202-1209.
  21. Lim, J. Y. (2001). Cost-effectiveness analysis of home care service for cerebrovascular disease patients. Unpublished doctoral dissertation, Korea University, Seoul.
  22. Ministry of Health and Welfare. (2010). Guide on the medical institute base home health agency management. Seoul: Yimungieob.
  23. Nathwani, D., & Zambrowski, J. J. (2000). Advisory group on home based and outpatient care (AdHOC): An international consensus statement on non-inpatient parental therapy. Clinical Microbiology and Infection, 6, 464-476. http://dx.doi.org/10.1046/j.1469-0691.2000.00113.x
  24. Park, J. Y., & Ko, S. K. (2000). Cost-benefit analysis of the community-based home health care program. Korean Health Economic Review, 6, 203-245.
  25. Paul, I. M., Phillips, T. A., Widome, M. D., & Hollenbeak, C. S. (2004). Cost-effectiveness of postnatal home nursing visits for prevention of hospital care for jaundice and dehydration. Pediatrics, 114, 1015-1022. http://dx.doi.org/10.1542/peds.2003-0766-L
  26. Song, C. R., Han, S. H., Lee, Y. A., Kim, M. Y., & Chae, S. M. (2011). An analysis of treatment types and home care services referral for patients with diabetic foot. Journal of Korean Academic Society of Home Health Care Nursing, 18, 32-39.
  27. Stockl, K., Tafesse, E., Vanderplas, A., & Chang, E. (2004). Cost of lower-extremity ulcers among patients with diabetes. Diabetes Care, 27, 2129-2134. http://dx.doi.org/10.2337/diacare.27.9.2129
  28. Sung, Y. H., Hwang, M. S., Ru, S. S., & Kim, S. J. (2005). The effects of hospital based home care nursing on antibiotic treatment for patients with CMV infection following kidney transplant. Clinical Nursing Research, 10, 129-44. https://doi.org/10.1177/174498710501000210
  29. Tennvall, G. R., & Apelqvist, J. (2004). Health-economic consequences of diabetic foot lesions. Clinical Infection Diseases, 39, s132-139. http://dx.doi.org/10.1086/383275
  30. Yang, B. M. (2009). Health economics (2nd ed.). Seoul: Nanam Press.

피인용 문헌

  1. 건강보험 자료를 이용한 전국 의료기관 가정간호 실시 및 이용 현황 분석: 2008년-2017년 vol.26, pp.1, 2013, https://doi.org/10.22705/jkashcn.2019.26.1.36
  2. 농어촌 지역의 대상자 중심 통합방문형 간호서비스 모형 개발 vol.35, pp.1, 2013, https://doi.org/10.5932/jkphn.2021.35.1.5