Journal of muscle and joint health (근관절건강학회지)

Korean Society of Muscle and Joint Health (대한근관절건강학회)
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A Cost Benefit Analysis of Visiting Health Care for People 65 Years and Over Using Total Medical Expense from Health Insurance Claims Data

국민건강보험공단 진료비 자료를 활용한 65세 이상 방문건강관리사업 대상자의 비용-편익분석

  • Kim, Jinhyun (College of Nursing.The Research Institute of Nursing Science, Seoul National University) ;
  • Ko, Young (College of Nursing, Gachon University) ;
  • Kwon, Hyun-Jeong (College of Nursing, Seoul National University) ;
  • Yim, Eunshil (Department of Nursing, Daegu Health College)
  • 김진현 (서울대학교 간호대학.간호과학연구소) ;
  • 고영 (가천대학교 간호대학) ;
  • 권현정 (서울대학교 간호대학) ;
  • 임은실 (대구보건대학교 간호대학)
  • Received : 2020.12.03
  • Accepted : 2020.12.08
  • Published : 2020.12.31
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Abstract

Purpose: This study aimed to investigate the effect of home visiting care service and to evaluate the effect from the cost-benefit among older people. Methods: The target participants were enrolled in 2007 and they were classified into 1 year, 2 years, 3 years, and 4 years according to their service provision period. We analyzed health insurance claims data and entitlement data from the National Health Insurance Service databases between 2006 and 2010. This study examined the participants' social-economic and health status factors related to total medical expense. Cost-benefit analysis was done using the net benefit and benefit/cost ratio. Results: Based on the use of home visiting service, the effect was reduced by 223,914 won. The cost for 952,109 people aged 65 or older was 39,891,462,882 won and the benefit was 213,190,534,626 won. The net benefit was 173,299,071,744 won and the benefit/cost ratio was 5.34 times, which was very economical. Conclusion: Home visiting health care should continue to expand as a means of economically effective health care for people aged 65 and older and to ensure health equity for vulnerable groups.

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References

  1. Dickinson, E. (1996). Long term care of older people. BMJ, 312, 862-863. https://doi.org/10.1136/bmj.312.7035.862
  2. Elkan, R., Kendrick, D., Dewey, M., Hewitt, M., Robinson, J., Blair, M., et al. (2001). Effectiveness of home-based support for older people. BMJ, 323, 719-724. https://doi.org/10.1136/bmj.323.7315.719
  3. Haastregt, J. C. M., Diederiks, J. P. M., Rossum, E., Witte, L. P., & Crebolder, H. F. (2000). Effects of preventive home visits to elderly people living in the community: A systematic review. BMJ, 320(7237), 754-758. https://doi.org/10.1186/s12960-019-0356-6
  4. Health Insurance Review, & Assessment Service. (2011). 2010 Medical expense statistics. Retrieved February 28, 2020, from: https://www.hira.or.kr/bbsDummy.do?pgmid=HIRAA020045030000&brdScnBltNo=4&brdBltNo=2350&pageIndex=5#none
  5. Huang, S. J., Galarraga, O. G., Smith, K. A., Fuimaono, S., & Mc-Garvey, S. T. (2019). Cost-effectiveness analysis of a cluster-randomized, culturally tailored, community health worker home-visiting diabetes intervention versus standard care in American Samoa. Human Resources for Health, 17(1), 2-9. https://doi.org/10.1186/s12960-018-0340-6
  6. Huss, A., Stuck, A. E., Rubenstein, L. Z., Egger, M., & Clough-Gorr, K. (2008). Multidimensional preventive home visit programs for community-dwelling older adults: A systematic review and meta-analysis of randomized controlled trials. The Journals of Gerontology Series A Biological Sciences and Medical Sciences, 63(3), 298-307. https://doi.org/10.1093/gerona/63.3.298
  7. Hyoung, H. K., & Jang, H. S. (2011). The comparison of health status and health behavior among hypertension group, DM group, and hypertension DM group for the aged provided with customized home care service by visiting nurses. Journal of Korean Academy of Community Health Nursing, 22(1), 11-21. https://doi.org/10.12799/jkachn.2011.22.1.11
  8. Kim, H. G. (2015). The effects of home visit healthcare using a complex program on community-dwelling frail elders' strength, frailty, and depression. Journal of Korean Academy of Community Health Nursing, 26(4), 405-414. https://doi.org/10.12799/jkachn.2015.26.4.405
  9. Kim, J. H., Lee, T. J., Lee, J. H., Shin, S. J., & Lee, E. H. (2010). A cost benefit analysis of individual home visiting health care. Journal of Korean Academy of Community Health Nursing, 21(3), 362-373. https://doi.org/10.12799/jkachn.2010.21.3.362
  10. Kim, J. I. (2013). Levels of health-related quality of life (EQ-5D) and its related factors among vulnerable elders receiving home visiting health care services in some rural areas. Journal of Korean Academy of Community Health Nursing, 24(1), 99-109. https://doi.org/10.12799/jkachn.2013.24.1.99
  11. Ko, Y., & Lee, I. S. (2011). Cost-benefit analysis of home visiting care for vulnerable populations with hypertension. Journal of Korean Academy of Community Health Nursing, 22(4), 438-450. https://doi.org/10.12799/jkachn.2011.22.4.438
  12. Lee, H. Z., & Yom, Y. H. (2017). Age difference in the trajectory of medical service utilization, medical expenses and health outcome among the elderly: A latent growth model analysis. Health and Social Welfare Review, 37(2), 287-324. https://doi.org/10.15709/hswr.2017.37.2.287
  13. Liimatta, H. (2009). Effectiveness of preventive home visits among community-dwelling older people. Unpublished doctoral dissertation, University of Helsinki. Finland.
  14. Liimatta, H., Lampela, P., Laitinen-Parkkonen, P., & Pitkala, K. H. (2016). Effects of preventive home visits on older people's use and costs of health care services: A systematic review. European Geriatric Medicine, 7(6), 571-580. https://doi.org/10.1016/j.eurger.2016.08.006
  15. Lim, Y. L., Im, J. N., Kim, I. A., & Ko, S. K. (2010). An evaluation of effects on hypertension and diabetes mellitus management of a community-based nursing care center using cost-benefit analysis. Journal of Korean Academic of Nursing Administration, 16(3), 295-305. https://doi.org/10.11111/jkana.2010.16.3.295
  16. Ministry of Health and Welfare, & Korea Health Promotion Institute. (2020). Community integrated health promotion project in 2020-home visiting health care. Seoul: Korea Health Promotion Institute.
  17. Ministry of Health and Welfare. (2019, December). Korean national health & nutrition examination survey 2018. Sejong: Author.
  18. Statistics Korea. (2019). 2019 older population and housing census result. Retrieved February 28, 2020, from: http://kostat.go.kr/portal/korea/kor_nw/1/1/index.board?bmode=read&bSeq=&aSeq=377701&pageNo=1&rowNum=10&navCount=10&currPg=&searchInfo=srch&sTarget=title&sTxt=%EA%B3%A0%EB%A0%B9
  19. Stuck, A. E., Egger, M., Hammer, A., Minder, C. E., & Beck, J. C. (2002). Home visits to prevent nursing home admission and functional decline in elderly people: Systematic review and meta-regression analysis. Journal of the American Medical Association, 287(8), 1022-1028. https://doi.org/10.1001/jama.287.8.1022
  20. Yang, S. O., Kwon, M. S., Choi, Y. J., & Lee, S. H. (2011). The effects of a case management program of customized home visiting health service for clients with arthritis. Journal of Korean Academy of Community Health Nursing, 22(2), 151-161. https://doi.org/10.12799/jkachn.2011.22.2.151
  21. Yim, E. S. (2009). Cost-benefit analysis of the case management for the elderly patients with hypertension. Unpublished doctoral dissertation, Yonsei University, Korea.