• Women's Health Nursing
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• v.24 no.1
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• pp.24-32
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• 2018

Purpose: To determine traits related to pregnancy and delivery, length of stay, health care cost, postpartum discomfort, and satisfaction with medical service of puerperas giving birth in midwifery clinic and hospitals. Methods: This study used a comparative survey design. Data were collected from a total of 140 postpartum mothers composed of 70 mothers who gave births in two hospitals and another 70 mothers who delivered in one midwifery clinic. Results: Delivery in midwifery clinic had higher Apgar score at 1 minute and 5 minutes after birth than hospital. Those who delivered in midwifery clinic had shorter stay in the clinic, fewer health care cost, less postpartum discomfort in physical, environmental, social, and cultural areas, higher satisfaction with medical services than those who delivered in hospitals. Conclusion: Results of this study can be used as a basis for studies on giving birth in midwifery clinic and hospitals. They might increase the autonomy of women in giving birth with positive effect on the delivery experience of the mother and her spouse.

• Journal of Korean Academy of Nursing
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• v.46 no.4
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• pp.562-571
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• 2016

Purpose: In this study the costs and benefits of a home health care program were examined to evaluate the economic feasibility of the program. Methods: The study participants included 349 patients in the community who had been registered at a home health care center for 5 years. The costs and benefits of the program were analyzed using performance data and health data. The benefits were classified as the effects of pressure ulcer care, skin wound care and catheters management. The program effect was evaluated on the change of progress using transition probability. Benefits were divided into direct benefit such as the savings in medical costs and transportation costs, and indirect benefits which included saving in productivity loss and lost future income. Results: Participants had an average of 1.82 health problems. The input cost was KRW 36.8~153.3 million, the benefit was KRW 95.4~279.7 million. Direct benefits accounted for 53.4%~81.2%, and was higher than indirect benefits. The net benefit was greater than 0 from 2006 to 2009, and then dropped below 0 in 2010. Conclusion: The average net benefit during 5 years was over 0 and the benefit cost ratoi was over 1.00, indicating that the home health care program si economical.

• Journal of Korean Academy of Nursing Administration
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• v.16 no.4
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• pp.409-418
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• 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 Korean Clinical Nursing Research
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• v.19 no.3
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• pp.321-332
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• 2013

Purpose: Korean health insurance extended application of the Diagnosis Related Groups (DRG) payment system to tertiary and general hospitals from July, 2013. This study was done to develop a DRG fee adjustment mechanism applied to levels of nurse staffing to assure quality nursing service. Methods: Nurse stafffing grades among hospitals in Korea were analyzed. Differences and ratio of inpatient costs by nurse staffing grades in DRG fees and differences of DRG fee between tertiary and general hospitals were compared. Results: In 2013, nurse staffing grades in tertiary and general hospitals had improved, but other hospital nurse staffing grades remained at the 2001 level. Gaps of inpatient costs between first and seventh nurse staffing grades were over 10% in 4 out of 7 DRG diagnosis; However differences of DRG fee between tertiary and general hospitals were only 4.51% and 4.72% respectively. A DRG fee adjustment mechanism was developed that included nurse staffing grades and hospitalization days as factors of the formula. Conclusion: Current DRG fees motivate hospitals to decrease nurse staffing grades because cost reduction is bigger than compensation. This DRG fee adjustment mechanism reflects nurse staffing supply to motivate hospitals to hire more nurses as a reasonable compensation system.

• Journal of Korean Academy of Nursing Administration
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• v.4 no.2
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• pp.351-361
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• 1998

The purpose of this study was to explore whether there is a point within the range of physical impairment after which the cost of home care exceeds the cost of nursing home care among the elderly who require long-term care. The provision of long-term care for the elderly is a major health policy issue, in part due to the aging of the American population and dramatic increase in health care costs. The framework for this study was guided by Pollak's(1973)model of costs of alternative care settings for the elderly. This study used a retrospective, descriptive correlational design. Physical impairment was measured by the modified Index of Activities of Daily Living(Katz et al. 1963). Cost of care was measured by the average cost per patient per day. The sample for this study included 67 patients receiving long-term care at home from the Long-term Home Health Care Programs (LTHHCPs) and 67 patients receiving long-term care in nursing homes. Data were collected on patient characteristics. including activities of daily living and cognitive impairment. and on the number of physician visits. emergency room visits. and hospitalization from the patient records. For each patient. Medicaid cost data for home care services/or nursing home services were collected from the financial department of each home care agency or nursing home. The living costs and informal care costs were estimated for home care patients. The results indicated that the home care sample and the nursing home sample were similar in terms of gender. ethnic background. and marital status. The elderly patients in the home care sample were: however. younger and less physically impaired than those in the nursing home sample. The hypotheses of this study were supported: For elderly persons with physical impairment scores below 12(possible range of 0 to 14), cost of care was lower in home care than in the nursing home care setting. However, for elderly persons with physical impairment scores above 12. the cost of care was higher in home care than in the nursing home care setting. Thus. in this sample for elderly patients with extreme physical impairment, the cost of home care exceeded the cost of nursing home care.

• Research in Community and Public Health Nursing
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• v.21 no.3
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• pp.362-373
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• 2010

Purpose: The purpose of this study is to evaluate the costs and benefits of individual home visiting health care using secondary data and literature review. Methods: The total number of subjects was 1,008,837. A specific program was classified into disease management, care of infant, child and women, or elderly care. The costs and effects of a program were identified from a societal perspective, and the effects were converted into monetary terms or benefits. The total cost was calculated in the way that medical expenses, travel costs and productivity losses were offset by the decrease in benefits and thus only the program budget was included in the total cost. Results: The total program cost was 47.6 billion won per year and the total annual benefit was estimated at 435.6 billion won. The benefits of arthritis management were the biggest among disease management programs. The net benefit was 388.0 billion won per year and the benefit/cost ratio was 9.16. Conclusion: Home visiting health care was validated to be economically effective. It made a positive contribution to improving the health status of vulnerable populations and reducing medical expenses. These results suggest that home visiting care should be extended more broadly to vulnerable populations.

• 한국노년학
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• v.40 no.2
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• pp.311-323
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• 2020

Older adults are at a high risk of falling, causing severe injuries and increased hospital stays and treatment costs. This can be a burden not only on the family but also on the national economy. Thus, fall prevention is very important in nurses' and nursing assistants' work. This study intended to grasp the real situation faced by nurses and nursing-assistants working at geriatric hospitals in J province, Korea. The researcher interviewed thirty-six nurses and nursing-assistants in four geriatric hospitals and performed four focus group interviews. Data were analyzed through an inductive content analysis based on Elo & Kyngäs's approach. Three categories and five subcategories were identified. Categories were patients, environmental, and personal factors. Patient factors included patients' impaired cognitive function. Environmental factors included lack of personnel support and assignment of inpatients without regard to fall risk. Personal factors included hopelessness regarding improvement and fear of being blamed. Promotion of fall prevention practice needs a gradual increase in nursing staff at geriatric hospitals, a system for assigning hospital room according to fall risk, and education and support system to reduce nursing burden.

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

• The Journal of the Korea Contents Association
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• v.19 no.2
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• pp.661-670
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• 2019

The purpose of the study was to review the evidence of effects of virtual reality (VR) technology in nursing education. Four databases were searched for articles publised until November 2018 that databases include PubMed, Proquest (nursing and allied health), CINAHL, & RISS. Key word used for search include 'education, nursing', 'simulation', 'skill training', 'virtual reality' and 'VR'. Of 695 papers searched, Seven studies were selected for data analysis. Of seven studies, five studies used quasi-experimental design and two used one group design. There were two studies used VR technology for skill training and five were scenario based VR simulation program. Studies evaluated outcomes including students performance, time spent on practice, self-efficacy and communication ability that most studies reported positive effects while some figures were not statistically significant. The findings of this study provides evidence of nursing education program using VR, however, additional research with rigorously designed studies using systematized measurements for study outcomes are required. In addition, comparison with existing skill training and simulation education should be considered in the future studies.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.26 no.1
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• pp.36-50
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• 2019

Purpose: The purpose of this study is to analyze the status quo of hospital-based home care utilization in Korea from 2008 to 2017. Methods: Data from a total of 1,396 medical institutions, 350,390 patients, and 3,563 home care nurses were analyzed using claim data from the Health Insurance Review & Assessment Service. Results: The number of hospital-based home care agencies decreased from 177 in 2008 to 115 in 2014. This number started to increase in 2015 and reached 179 in 2017. The number of hospital-based home care patients declined from 35,056 in 2008 to a low of 26,848 in 2013. This number started to increase in 2014 and reached 67,863 in 2017. Essential hypertension was the most common disease among hospital-based home care patients from 2008 to 2015. The number of hospital-based home care visits declined from about 500,000 in 2008 to a low of 362,000 in 2013. This number started to increase in 2014 and reached 658,000 in 2017. Conclusion: It is necessary to vigilantly monitor hospital-based home care agencies, patients, and the utilization of services. This may help establish platforms for providing community and home-based nursing services for the super-aged society in Korea.