• Research in Community and Public Health Nursing
• /
• v.32 no.3
• /
• pp.356-367
• /
• 2021

Purpose: This study conducted an economic evaluation of hospital-based home care services for the patients who had undergone breast cancer surgery. Methods: A total of 12,483 patients over 18 years of age who had received breast cancer surgery in 26 tertiary hospitals in 2018 were analyzed with the claim data from the Health Insurance Review & Assessment Service using cost-minimization analysis and societal perspectives. Results: There were 156 patients who utilized hospital-based home care services within 30 days after breast cancer surgery, and they received 2.17 (SD=1.17) hospital-based home care service on average. The average total cost was 5,250,028 KRW (SD=1,905,428) for the group receiving continuous hospital-based home care and 6,113,402 KRW (SD=2,033,739) for the group not receiving continuous hospital-based home care (p<.001). The results of the economic evaluation of continuous hospital-based home care services in patients who had undergone breast cancer surgery indicated a total benefit of 953,691,000 KRW, a total cost of 819,004,000 KRW, and a benefit-cost ratio of 1.16 in 2018. Conclusion: Continuous hospital-based home care was considered economically feasible as the total costs for the group receiving continuous hospital-based home care were lower than those of the group not receiving continuous hospital-based home care. Therefore, policy modification and financial incentives are recommended to increase the utilization of hospital-based home care services for patients who had undergone breast cancer surgery.

• Journal of Korean Academy of Nursing
• /
• v.45 no.3
• /
• pp.429-438
• /
• 2015

Purpose: This study was conducted to develop key performance indicators (KPIs) for home care nursing (HCN) based on a balanced scorecard, and to construct a performance prediction model of strategic objectives using the Bayesian Belief Network (BBN). Methods: This methodological study included four steps: establishment of KPIs, performance prediction modeling, development of a performance prediction model using BBN, and simulation of a suggested nursing management strategy. An HCN expert group and a staff group participated. The content validity index was analyzed using STATA 13.0, and BBN was analyzed using HUGIN 8.0. Results: We generated a list of KPIs composed of 4 perspectives, 10 strategic objectives, and 31 KPIs. In the validity test of the performance prediction model, the factor with the greatest variance for increasing profit was maximum cost reduction of HCN services. The factor with the smallest variance for increasing profit was a minimum image improvement for HCN. During sensitivity analysis, the probability of the expert group did not affect the sensitivity. Furthermore, simulation of a 10% image improvement predicted the most effective way to increase profit. Conclusion: KPIs of HCN can estimate financial and non-financial performance. The performance prediction model for HCN will be useful to improve performance.

• Journal of Korean Academy of Nursing Administration
• /
• v.16 no.4
• /
• pp.409-418
• /
• 2010

Purpose: The purpose of this study was to compare the costs and benefits of home nursing care services between public health centers (PHC) and private hospitals. Method: Participants were 105 patients who had received home nursing care services from a private hospital or public health center. From a societal perspective, the researcher identified the costs and benefits of the services using performance data and calculated the net benefit and benefit/cost ratio. Result: The net benefit of the home nursing care service based in the PHC was 165.9 million won and benefit/cost ratio was 2.0, while the net benefit of the home nursing care services by the private hospital was 141.1 million won and benefit/cost ratio was 1.7. Both types of programs were economically validated. Conclusion: Home nursing care services were basically efficient as the results showed a positive net benefit. A cost-benefit analysis indicated that the PHC-based home nursing care services were more efficient than that of the private hospital. With limited human resources and management standards in public health centers, results suggest the need for a more systematic management of the home nursing care service to improve the health of this vulnerable community population.

• Journal of Home Health Care Nursing
• /
• v.7 no.1
• /
• pp.15-25
• /
• 2000

This article was trying to suggest an agenda and alternatives of home health care policy for the future home care growth and development and examine the significance of new health care law and regulations. In addition. It was to analyze and drive the home care system problems. of which was made an announcement on the 11th of April. that home health care project must be centered from the nationwide general hospital. As we have learned from the developed countries, the home health care have been closely related health care policy among the field of nursing area. Therefore. we need to understand our national health care policy and need to predict the future direction and goal of our home health care policy in order to enhance the growth and activation of health care system. Additionally. we also need to have a vision and ability to develop under our own health care policy with systematic and rational home care business escaping from past perspective and standpoint. We must create a master plan of home care system to fulfill one part of system of the function and an important role in order to pursue an advanced health care plan under our system. For instance. in the 21th century as we establish a master plan for the growth of our country home care plan with improving plan systematically and also we need to produce many highly qualified researching and good personal who can develop and maintain the system efficiently. Specially. based on the unique characteristics of our health care system and the direction of development of plan, we need to find and correct the problems which we have faced the present time, so that we can provide and reach the goal of advanced health care system which our government want to pursue. Finally. we have to strive our best effort to make our home health care system can be positioned and stand the right direction to have the benefit for every individual citizen in our country.

• Journal of Home Health Care Nursing
• /
• v.12 no.2
• /
• pp.45-62
• /
• 2005

Purpose: To provide the data for improving home health care through investigating the recognition of home care services and the possibility of providing it by nurses, doctors and patients. Method: The subjects were 167 nurses and 71 doctors who were working at a general hospital in Seoul and 72 patients who were admitted to that hospital. Data were collected through questionnaire surveys from November 29 to December 17 in 2004. Result: Home care services were recognized by 70.7% of nurses, 64.8% of doctors and 58.4% of patients. The percentages of agreement regarding the necessity of home care services were 70.7% of nurses, 47.9% of doctors and 86.1% of patients. The percentages of agreement to refer the patients to home care when they only want to receive it, were 58.1% of nurses and 57.7% of doctors. There were significantly higher in nurses than doctors between the differences of possible or impossible percentages in agreements about each items in the test-related services, medication-related services and treatment-related services. Conclusion: The above findings indicated that more specific and continuous educations and advertisements are needed to enlarge home care services in general hospitals.

• Journal of Home Health Care Nursing
• /
• v.23 no.2
• /
• pp.195-205
• /
• 2016

Purpose: The aims of this study were to describe the levels of personal coping resources, perceived organizational supports, and job stress, and to examine factors that affect job stress in hospital-based home care nurse practitioners. Methods: A cross-sectional survey was conducted. Data were collected from 170 subjects with a structured questionnaire from April to July, 2016 and analyzed using descriptive statistics, t-tests, One-way ANOVA, Pearson's correlation, and multiple regressions. Results: The means for personal coping resources, perceived organizational supports, and job stress were $3.7{\pm}0.43$, $3.4{\pm}0.55$, and $3.4{\pm}0.55$ out of 5, respectively. Personal coping resources and perceived organizational supports were significantly correlated. However, both had no associations with job stress. In the multiple regression analysis, the experiences of home care nursing and hospital location were found to be predictors of job stress. Both personal coping resources and perceived organizational supports were not statistically significant predictors of job stress. Conclusions: It is necessary to carry out organization-based educational programs and support systems aimed at enhancing personal abilities to cope with stress at work. Additionally, further studies are needed to identify other hospital-related characteristics that can lead to job stress in home care nurse practitioners.

• Journal of Home Health Care Nursing
• /
• v.14 no.1
• /
• pp.23-30
• /
• 2007

Purpose: The aim of this study was to establish basic data for developing education program of tailor made visiting home health care. Method: For this study, the subject was recruited in one directorial area among 14 nation-wide areas. The data collection was done using self-report questionnaire developed by Korea Health Industry Development Institute. Ninety one questionnaires were analyzed and response rare was 88.3%. Result: The major results were as follows. Aspect of education operations, the satisfaction of education space was revealed high. However, the satisfaction of education time, hour, and schedule were low. The overall satisfaction of education contents were revealed high. The most useful curriculums were found Chronic disease management, Infant & toddler health management, and Case management of tailor made visiting home health care. However the most unuseful curriculums were Nutritional management according to subject's health problem, Health promotion for poor family, and Understanding of visiting service in community health center. Conclusion: With these results, it was identified that the most needed contents of tailor made visiting home health care education program. So these results will be used to develop the more effective education program to activate tailor made visiting home health care service in community health center.

• Research in Community and Public Health Nursing
• /
• v.19 no.4
• /
• pp.673-683
• /
• 2008

Purpose: This study was aimed to evaluate the performance of a community-based home care services model. Method: The subjects were 138 patients who have been enrolled during a 6 month's period, nursing records and nursing service bills. The data was collected by self report and chart review. The mean cost per visit was compared with those of hospitalization & clinic visit in the data from National Health Insurance Corporation. Result: A significant number of patients were bed ridden(63.8%) and unconscious (27.5%), and most of the patients had complex chronic diseases. Except nursing assessment, bed sore care was the most frequent nursing treatment(25.1%) in home care services. The mean cost per visit of home care services was 34,665 won, which was lower than those of hospitalization & clinic visit for medical aid. The patients were highly satisfied with the services by visiting nurse specialists. Conclusion: Community-based home care services provided cost-effective and satisfied services. Community-based home care services needs systematic supports to expand it's domain for promoting community health.

• Journal of Home Health Care Nursing
• /
• v.14 no.1
• /
• pp.11-17
• /
• 2007

The purpose of this study was to describe the policy agenda and alternatives for the home health care system in Korea. The home health care system development was not fully integrated while the medical laws were established in 2000, community health law in 1995, and elderly long-term health insurance law in 2007. Because of the increasing population of people over the age of 65 and dramatically decreasing fertility rate, the burden of various health-care expenses has become a great obstacle for the Korean government. Under these circumstances, the home of home health care system in has taken on an important role under the mandate of the national health care system. The types of home health care system in Korean shows a greater contrast from those utilized in other more industrialized countries, such as, U.S. or Japan. In conclusion, the strategy in overcoming the obstacles to enhance home health care system under the national health system would be developing it as a comprehensive and exchangeable consumer-focused organization.

• Journal of Home Health Care Nursing
• /
• v.11 no.1
• /
• pp.23-32
• /
• 2004

Purpose: The purpose of this research is to give basic data about a way of connection to individual centers and vitalization of visiting nursing program on Busan. Method: The research is done with survey for eight hospitals. sixteen public heath centers, forty-six social welfare centers to be practised visiting nursing program on Busan for actual condition of that. Results: 1. The average nursing career is below 5-10 years. But visiting nursing career is below 3 years(70%) in hospital. public, public heath center, and heath center. 2. Hospitals coverage of visiting nursing service is city as a whole. Whereas public heath center and social welfare center covered some local area. 3. Client of visiting nursing service possess in order of alone lived elderly, person in uncomplete movement, a disabled person, and a chronic disease person. 4. The main service in visiting is patient assessment, basic nursing activity, and treatment nursing activity with medication care, B.P check, dressing, bedsore care, catheter care and exchange, fluid therapy. Particularly, the hospital runs parallel to basic care and treat care in 100%. The social service center has 65.0% in a patient assessment and basic nursing activity. 5. The concern about services connecting with other center is very high. Conclusion: Actual conditions of visiting nursing program on Busan, which is presented in this study. The results of this study will become the pillar of visiting nursing program planning and application.