Journal of Home Health Care Nursing (가정∙방문간호학회지)

Korean Academic Society of Home Health Care Nursing (한국가정∙방문간호학회)
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Historical Review of the Practice and Role Changes of Korean Advanced Practice Nurses in Home Health Care and Proposals for Future Development

한국 가정전문간호사의 업무와 역할 변화에 대한 역사고찰 및 미래발전 방안 제언

  • Lee, Hana (College of Nursing, Daegu Catholic University) ;
  • Mun, Minji (The Research Institute of Nursing Science, Seoul National University) ;
  • Woo, Kyungmi (College of Nursing, Seoul National University)
  • Received : 2025.11.21
  • Accepted : 2026.04.14
  • Published : 2026.04.30
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Abstract

Purpose: The objective of this study is to examine the historical transitions and evolving scope of practice of home health care advanced practice nurses in South Korea, with the goal of informing strategies for future role development and policy reform. Methods: Changes in the roles and responsibilities of home health care advanced practice nurses in South Korea over time were examined using a historical approach, drawing on domestic prior research, practice guidelines, newspapers, government reports, and relevant legislation. Data from July 2024 to October 2025 were collected, and all literature and documents publicly available by October 2025 were included. Sources comprised major government and academic platforms, including the Ministry of Health and Welfare, National Health Insurance Service, National Assembly Library, National Library of Korea, National Law Information Center, academic portals, and the archives of the Korean Academic Society of Home Health Care Nursing. Results: The roles and changes in practice of advanced practice nurses in home health care in South Korea were categorized into four periods: the incipient period (1970-1990), the preparatory period for institutionalization (1991-2000), the adjustment period (2001-2023), and the transitional resurgence period (2024-present). Conclusion: The roles of advanced practice nurses in home health care have been shaped by changes in policy and legislation. Clearly redefining their unique professional identity through expert consensus, enhancing understanding among the public, healthcare professionals, and policymakers while supporting targeted policy improvements and educational development is essential.

Keywords

Acknowledgement

본 논문은 2024년 한국·가정‧방문간호학회 연구비 지원을 받아 수행된 연구임.

References

  1. Ministry of the Interior and Safety. Press release [Internet]. Seoul: Ministry of the Interior and Safety. 2024 Dec 24 [cited 2025 Jul 7]. Available from: https://www.mois.go.kr/frt/bbs/type010/commonSelectBoardArticle.do?bbsId=BBSMSTR_000000000008&nttId=114622
  2. Kang HJ, et al. Evaluation of the performance and future tasks of the Korean healthcare system (8th year): innovation performance and challenges in chronic disease management in primary care. Sejong: Korea Institute for Health and Social Affairs; 2023. [cited 2025 Jul 7]. Available from: https://doi.org/10.23060/kihasa.a.2023.47
  3. Cho MK. Healthcare transformed by COVID-19: home care becomes mainstream for medical care and nursing. [Internet]. ZDNet Korea. 2022 Mar 21 [cited 2025 Jul 7]. Available from: https://zdnet.co.kr/view/?no=20220321110424
  4. Park E. Current state and the future tasks of home visit nursing care in South Korea. Journal of Agricultural Medicine and Community Health. 2019;44(1):28-38. https://doi.org/10.5393/JAMCH.2019.44.1.028
  5. Korea Ministry of Government Legislation. Medical service act, Article 24 (Home nursing) [Internet]. Seoul: Korea Ministry of Government Legislation: 2021 [cited 2025 Jul 7]. Available from: https://law.go.kr/%EB%B2%95%EB%A0%B9/%EC%9D%98%EB%A3%8C%EB%B2%95%EC%8B%9C%ED%96%89%EA%B7%9C%EC%B9%99/%EC%A0%9C24%EC%A1%B0
  6. Korean Home Health Care Nurses Association. Current status of home nursing institutions. [cited 2025 Jul 7]. Available from: https://hcna.or.kr
  7. Baek HC, Lim JY, Cho YY, Kim IA, Jun EY, Noh JH, et al. Current status of home health in Korea: a study based on the 2020 home health nurses'working conditions survey. Journal of Korean Academic Society of Home Care Nursing. 2020;27(3):356-71. https://doi.org/10.22705/JKASHCN.2020.27.3.356
  8. Committee for Compilation of Home Health Nursing History. 20-year history and prospects of the home health nursing system. Seoul: Science; 2014.
  9. Kim YS. Easing qualification standards for 'home nursing' pursued... opposition citing decline in professionalism and quality. [Internet]. Seoul: Yonhap News Agency. 2023 Sep 30 [cited 2024 Mar 20]. Available from: https://www.yna.co.kr/view/AKR20230930032100530
  10. Home Care Nursing Association. Education institutions and graduate statistics [Internet]. 2025 [cited 2025 Jul 7]. Seoul: Ministry of Health and Welfare: Available from: https://www.hcna.or.kr/sub2/2_8.php
  11. Ministry of Health and Welfare. Notice of legislation for partial amendment of the Enforcement Rule of the Medical Service Act [Internet]. Seoul: Ministry of Health and Welfare; 2023 [cited 2026 Mar 11]. Available from: https://opinion.lawmaking.go.kr/gcom/ogLmPp/74598
  12. Home Care Nursing Association. Opinion on partial amendment of the Enforcement Rule of the Medical Service Act [Internet]. Seoul: Home Care Nursing Association; 2024 [cited 2024 Mar 20]. Available from: https://hcna.or.kr/sub4/4_1.php?mode=view&number=1367&page=1&b_name=notice
  13. Medical News. Welcomes easing of qualification requirements for home health advanced practice nurses. [Internet]. Seoul: Medical News; 2023 Nov 7 [cited 2024 Mar 20]. Available from: http://www.bosa.co.kr/news/articleView.html?idxno=2209385
  14. Baek HJ. Adequacy of supply and workforce of home health advanced practice nurses in Korea. Journal of Home Health Care Nursing. 2020;27(2):137-45. https://doi.org/10.22705/jkashcn.2020.27.2.137
  15. Kim NY, Kim JH, Kim HY, Lim CS, Chon MK, Choi SJ. A study on the systematization of the advanced practice nurse. In: Hospital Nurses Association, editor. 2019 annual report. Seoul: Hospital Nurses Association; 2019. p. 203-42.
  16. Ministry of Health and Welfare to implement "Community -Based Integrated Care 2.0". Korean Hospital Association News [Internet]. 2024 May 14 [cited 2025 Jul 7]. Available from: URL
  17. Ministry of Health and Welfare. Supplementary Guidelines II for Pilot Projects on Nurses'Work. Report. Seoul: Ministry of Health and Welfare; 2024.
  18. Korean Health and Medical Workers 'Union. Reality and issues of dedicated nurses'work without legal protection [Internet]. Seoul: Korean Health and Medical Workers'Union; 2025 [cited 2025 Jul 7]. Available from: https://bogun.nodong.org/xe/khmwu_5_7/813624
  19. Lee JH. Controversy over dedicated nurse system raises concerns among advanced practice nurses. [Internet]. Seoul: Medical Times; 2025 Apr 15 [cited 2025 Jul 7]. Available from: https://www.medicaltimes.com/Main/News/NewsView.html?ID=1163193
  20. Korean Academic Society of Home Health Care Nursing. Official Statement Calling for the Withdrawal of the Proposed "Home-based Advanced Nursing Care"Field [Internet]. Seoul: Korean Academic Society of Home Health Care Nursing; 2025 Apr 22 [cited 2025 Oct 7]. Available from: https://www.kahhn.or.kr/sub_community/notice.php?mode=view&number=49&page=1&b_name=notice
  21. Hwang MS, Lee MK, Lee SJ, Lim NY. Job analysis of home health advanced practice nurses in medical institutions. Journal of Korean Academic Society of Home Care Nursing. 2011;18(1):48-57.
  22. Battalio JT. A Methodology for Streamlining Historical Research: The Analysis of Technical and Scientific Publications. IEEE Transactions on Professional Communication. 2002;45(1):21-38.
  23. Ko YH, Kwak SL, Kim SH, Kim YO, Kim HK, Park HJ, Park HM, Baek HJ, Song JR. 20-year history and perspectives on home health care. Seoul: HN Science; 2014.
  24. Kim SJ. Wonju Christian Hospital's Home Health Care Service. Journal of the Korean Hospital Association, 1990;19(3), 8-11.
  25. Seo MH. Prospects of home nursing services: Operation and education of home nursing services in a general hospital - The case of Wonju Christian Hospital. Journal of Nursing Inquiry. 1993;2(1):100-114.
  26. Kim HJ. A study on the competency-based curriculum for the home nursing services. Journal of Public Health Studies. 1991;28(1):34-49.
  27. Song KY, Kim YI, Kim KS, Park YW, Yoon CG, Oh YH. A study on tertiary care institutions in Daejin medical service area. Report. Seoul: Korea Institute for Health and Social Affairs; 1990. Report No.:1990-3. https://www.kihasa.re.kr/publish/report/research/view?seq=26980
  28. Korean Diabetes Association. Countdown to the introduction of the home visiting nurse system. A Monthly Diabetes Magazine. 1992;36:66-71.
  29. Seol MI, Shin YA, Lim KC, Lim CS, Choi JH, Jung JS. Korean advanced practice nurse system: current status and strategies for activation. Perspect Nurs Sci. 2017;14(1):37-44.
  30. Ministry of Health and Welfare. Medical institution home nursing business work manual. Seoul: Health Care Policy Division, Ministry of Health and Welfare; 2023 Jan 4. [cited 2025 Oct 16]. Available from: https://www.mohw.go.kr/board.es?mid=a10409020000&bid=0026&act=view&list_no=374453&tag=&nPage=76
  31. Kim HJ. Home health care service system. The Korean nurse. 1991;30(2) no.160:13-22.
  32. Lee HW, Park JS. Prospects of home nursing services: Operation and education of home nursing services—Home visiting nurse job training curriculum, Yonsei University College of Nursing case. Journal of Nursing Inquiry. 1993;2(1):90-99.
  33. Hwang N. Evaluation of the hospital-based home care pilot project. Seoul: Korea Institute for Health and Social Affairs; 1996. Report No.:1996-04
  34. Park JH, Kim MJ, Hong KJ, Han KJ, Park SA, Yoon SN, et al. Community-based home health care project operation study (Development of information delivery system for home health care project II). Journal of Home Health Care Nursing. 1998;5:20-31.
  35. Yu HY, editor. Home Nursing Guidelines. Seoul: Hyunmoonsa; 1993 Nov 30. Published by Seoul Branch, Korean Nurses Association.
  36. Park JH, Kim MJ, Hong KJ, Han KJ, Park SA, Yoon SN, et al. Development of an information delivery system for home health care project I (Establishment of home care database and computerized home care for stroke patients). Journal of Korean Academy of Society of Home Care Nursing. 1997;4:5-22.
  37. Lee SJ, Lee JK, Yu HS. A preliminary study for expanding the scope of management targets in hospital-based home health care services. Journal of Home Health Care Nursing. 1999;6:5-18.
  38. Song CR. Development of Korean standards of home health nursing practice. [master's thesis]. Seoul: Yonsei University Graduate School of Public Health, Department of Community Health Nursing; 1999. 8.
  39. Ministry of Health and Welfare. Enforcement Rule of the Medical Service Act, Article 54 [Internet]. Seoul: Ministry of Health and Welfare; 2003 Oct 1 [cited 2025 Jul 7]. Available from: https://www.law.go.kr/LSW/lsInfoP.do?lsiSeq=75004&viewCls=lsRvsDocInfoR#54
  40. Ryu HS. Home health care in Korea: Home health nursing, visiting health care nursing, and visiting health care. Journal of Korean Academy of Home Health Care Nursing. 2007;14(2):98-105.
  41. Ministry of Health and Welfare. Medical Service Act, Article 30 [Internet]. Seoul: Ministry of Health and Welfare; 2000 [cited 2025 Jul 7]. Available from: https://www.law.go.kr/LSW/lsInfoP.do?lsiSeq=53129&efYd=20000112#0000
  42. Korea Ministry of Government Legislation. Enforcement Rule of the Medical Service Act. Amended Oct 21, 2000 [cited 2026 Mar 7]. National Law Information Center. Available from: https://www.law.go.kr
  43. Ryu HS. Current Status of Costs and Utilizations of Hospital Based Home Health Nursing Care in Korea. 2006;36(7):1193-1203.
  44. Ryu HS, Jeong GS, Lim JY. Test on the Cost and Development on the Payment System of Home Health Care Nursing. Journal of Korean Academy of Nursing. 2006;36(4):503-513. https://doi.org/10.4040/jkan.2006.36.3.503
  45. Jin YR, Hong WR. Changes on Hospital-based Home Care Services Utilization After Long-term Care Insurance Launch. Korean Journal of Gerontology. 2011;31(2):371-380.
  46. Shin KR, Joo SK, Chung DY, Kim HY, Kim BH, Yang SJ. The Development of Certificates Criteria and Curriculum in Home Healthcare Nurse Specialist Program. Journal of Korean Academy of Nursing. 2003;33(3):395-404. https://doi.org/10.4040/jkan.2003.33.3.395
  47. Kim HY, Chung HS, Jeon BH, Shin MH. Educational Needs Analysis for Development of Home Healthcare Nurse Specialist Education Program. Journal of Korean Academy of Home Health Care Nursing. 2010;17(2):135-143.
  48. Jung KS. Home health care coverage expanded from eight visits per month to ninety-six visits per year. Nurse News; 2007 July 4. [cited 2026 Feb 20]. Available from: http://www.bosa.co.kr/news/articleView.html?idxno=2209385
  49. Song, Y. The Impact of Competition on the Price of Non-Covered Services in Long-Term Care Insurance: Evidence from Meal Ingredient Prices. Health and Social Welfare Review, 2024; 44(3): 163–181. https://doi.org/10.15709/HSWR.2024.44.3.163
  50. Song CR, Kang IO, Kim YO, Jo HS, Hwang MS. Status of hospital-based home health care services for the elderly. Journal of Korean Academy of Community Health Nursing. 2008;19(4):660-672.
  51. Ministry of Health and Welfare. Notification on standards and methods for home health care benefits (MOHW Notification No. 2007-202) [Internet]. Seoul: Ministry of Health and Welfare; 2007 May 30. [cited 2025 June 16]. Available from: https://bktimes.net/data/board_notice/1401938423-91.pdf
  52. Kim JS, Hwang MS, Lee MK, Song CR, Lee JY. IIncidence of Medical Services and Needs for Hospital-based Home Care Nursing in Elder Care Institutions. Journal of Korean Academy of Home Health Care Nursing. 2009;16(1):49-58.
  53. Song CR. Home care services: crisis and prospects. Perspectives in Nursing Science. 2009;6(1):55-65
  54. Hwang MS, Lee SJ, Lim NY, Lee MK. Job Descriptions of Hospital Based Home Care Nurse Practitioners in Korea by DACUM Technique. Journal of Korean Academy of Home Health Care Nursing. 2011;18(1):48-57.
  55. Kwon YE, Ahn SH. Attitudes and perceptions of home health nurse practitioners toward end-of-life decision-making and patient self-determination. Bioethics. 2013;14(2):53-66.
  56. Jung KS. Promulgation of the amended Medical Service Act related to nurse practitioners. [Internet] Seoul: Nurses News; 2018 Apr 3 [cited 2025 Jun 28]. Available from: http://www.nursenews.co.kr/main/ArticleDetailView.asp?sSection=133&idx=22654&intPage=4
  57. Ministry of Health and Welfare. Press release: Guidebook for local governments independently implementing community integrated care published. 2020 Jul 27. [cited 2025 Jun 28]. Available from: https://www.mohw.go.kr/board.es?mid=a10503010100&bid=0027&act=view&list_no=357215&tag=&nPage=320
  58. Ministry of Health and Welfare. Announcement of the "Community Integrated Care Master Plan (Phase 1: Senior Community Care) [Internet] Sejong: Ministry of Heatlh and Welfare; 2020 Nov 18. [cited 2025 Jun 28]. Available from: https://www.mohw.go.kr/gallery.es?act=view&bid=0003&list_no=346730&mid=a10607030000
  59. Ministry of Health and Welfare. Detailed standards for the application criteria and methods of National Health Insurance benefits (MOHW Notice). Sejong: Ministry of Health and Welfare; 2019. [cited 2026 Jan 28]. Available from: https://www.mohw.go.kr/board.es?mid=a10409020000&bid=0026&act=view&list_no=352065
  60. Song CR. Role of hospital-based home health nursing in community care. Journal of Home Health Care Nursing. 2022;29(1):5-17. https://doi.org/10.22705/jkashcn.2022.29.1.
  61. Han YR, Hwang RI, Ham OK, Jeong SO, Yang SJ, Yoon OJ, et al. A study on the development of a nurse-led community integrated home visiting nursing center model. Journal of Korean Public Health Nursing. 2025;39(1):48-63. https://doi.org/10.5932/JKPHN.2025.39.1.48
  62. Asan Medical Center. Integrated Care Support Team takes responsibility for elderly patients from admission to post-discharge [Internet]. Seoul: Asan Medical Center; 2024 [cited 2025 Jul 7]. Available from: https://news.amc.seoul.kr/news/con/detail.do?cntId=9829
  63. Ministry of Government Legislation. Medical Service Act, Article 24 [cited 2026 Mar 7]. Available from: https://www.law.go.kr/LSW//lumLsLinkPop.do?lspttninfSeq=61695&chrClsCd=010202#AJAX
  64. Kim SM, Choi JS, Suh SH, Hun YR. Evaluation of the pilot project for patient referral and return of care among partnered medical institutions. Wonju: Health Insurance Review & Assessment Service; 2024 Dec. Publication Registration Number: G000F8L-2024-161.
  65. Song JR, Lee JE. Impact of the revision of the Enforcement Rule of the Medical Service Act on home health care personnel and strategic responses. Journal of Home Health Care Nursing. 2025;32(2):121-125. https://doi.org/10.22705/jkashcn.2025.32.2.121
  66. Carter NM, Kaasalainen S, Martin-Misener R, Kilpatrick K, Harbman P, Bryant-Lukosius D, et al. A historical overview of the development of advanced practice nursing roles in Canada. Nursing Leadership. 2010;23:35-60. http://doi.org/10.12927/cjnl.2010.22268
  67. Lewis R. The evolution of advanced nursing practice: Gender, identity, power and patriarchy. Nursing inquiry 2022; 29(4):e12489. https://doi.org/10.1111/nin.12489
  68. Hwang MS, Park HY, Chang SJ. Difficulties and Coping Experienced by Advanced Practice Nurses in Home Health Nursing Field. Journal of Korean Academy of Community Health Nursing. 2020;31(2):143-153. https://doi.org/10.12799/jkachn.2020.31.2.143
  69. The Omaha System. Omaha System Overview [Internet]. [place unknown]: The Omaha System; 2025 [cited 2025 Jun 28]. Available from: https://www.omahasystem.org/overview
  70. Health Insurance Review & Assessment Service. Notice on the Revision of the Guidelines for the Home-Based Medical Care Pilot Project for Children with Severe Conditions [Internet]. Wonju: Health Insurance Review & Assessment Service; 2025 Oct 28 [cited 2025 October 28]. Available from: https://www.hira.or.kr/bbsDummy.do?pgmid=HIRAA020002000100&brdScnBltNo=4&brdBltNo=11282&pageIndex=1&pageIndex2=1#none
  71. Korean Academy of Home Health Care Nursing. Statement on withdrawal of the home-based dedicated nursing field [Internet]. Seoul: Korean Academy of Home Health Care Nursing; 2025 Apr 22 [cited 2025 Jul 7]. Available from: http://kahhn.inetpf.co.kr/sub_community/notice.php?mode=view&number=49
  72. Keeling AW. Historical perspectives on an expanded role for nursing. OJIN: The Online Journal of Issues in Nursing. 2015;20(2):Manuscript 2.