• 가정∙방문간호학회지
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• 제10권1호
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• pp.5-14
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• 2003

Recently, there has been an increasing need for long-term care and comprehensive health care services in community settings. The Ministry of Health and Welfare introduced the Hospital-Based Home Nursing Care Program in 2000. Before this initiative, there was a Home Nursing Demonstration Center, affiliated with the Seoul Nurse Association, had offered home nursing services with the financial support from the local government. since 1993, the Center's nursing staff has been engaged in a general hospital in an effort to provide home nursing care services within Korea's health care system. The purpose of this study was to analyze and identify characteristics of community-based home nursing care supplied by a community-based home nursing team engaged in a general hospital. Also. visit nursing care services provided by public health centers were evaluated in terms of accessibility and supply versus demand, to enhance the accessibility of low-income patients living in Seoul to home nursing care services. Data were collected from home nursing insurance reimbursement claims submitted by the community-based home nursing care team from March 1 to October 30 in 2001 and a questionnaire survey on home-visit nursing services of 25 public health centers in Seoul. The subjects consisted of 197 patients and 12 public health centers. The result were as follows. First, medical institution's community-based home nursing care program was better in technical quality than health-center-based home-visit nursing care. In addition. the pattern of the subject patients was similar to that of hospital-based home nursing care program. Second, there was a high demand for community-based home nursing care while only a small number of home-visiting nurses served at public health centers in Seoul. As a result, many patients could not receive adequate care. Finally, we suggest that community-based home nursing care program should be introduced in the national health system to meet the at-home care needs of severely ill low-income patients. Furthermore, to better utilize home nursing and visit-nursing care resources and offer continued care for patients in community settings, an efficient referral network should be built among related institutions. This would require improvement of reimbursement system and amendment of the law related to health insurance system and community-based home nursing care services.

• 가정∙방문간호학회지
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• 제29권1호
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• pp.5-17
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• 2022

Purpose: This study aimed to investigate the role of hospital-based home health nursing in community care by examining the institutional progress of hospital-based home health nursing and the current status of home health nursing in Korea. Methods: Korean research data, national statistical data, government press releases, and related laws were investigated to clarify the role of hospital-based home health nursing in community care. Results: Korean visiting medical care services, including hospital-based home health nursing, was not found to be sufficient nationwide. The supply of home health nursing did not increase due to the nature of the visiting services that required transportation time, poor profitability due to insufficient insurance fees, and increase in acute beds. Conclusion: The nature of the Korean medical environment and visiting medical care makes it challenging to establish a visiting medical supply system for community care. Therefore, hospital-based home health nursing is an important infrastructure for visiting medical care, and will be a valuable resource to link discharged patients returning to the community when moving health care services. Hence, laws and institutional supplementation to expand the role of home health nursing agencies nationwide are needed along with addressing the limitations in the supply of home health nurses.

• 대한간호학회지
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• 제45권5호
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• pp.742-751
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• 2015

Purpose: The purpose of this study was to examine the current status of home care nursing services provided by community health nurses and to identify barriers to the services. Methods: A cross-sectional survey was conducted with three types of community health care nurses. Participants were 257 nurses, 46 of whom were hospital based home care nurses, 176 were community based visiting nurses, and 35 were long term care insurance based visiting nurses. A structured questionnaire on 7 domains of home care nursing services with a 4-point Likert scale was used to measure activities and barriers to care. Data were analyzed using SPSS WIN 21.0 program. Results: Hospital based home care nurses showed a high level of service performance activity in the domain of clinical laboratory tests, medications and injections, therapeutic nursing, and education. Community based visiting nurses had a high level of service performance in the reference domain. Long term care insurance based visiting nurses showed a high level of performance in the service domains of fundamental nursing and counseling. Conclusion: The results show that although health care service provided by the three types of community health nurse overlapped, the focus of the service is differentiated. Therefore, these results suggest that existing home care services will need to be utilized efficiently in the development of a new nursing care service for patients living in the community after hospital discharge.

• 지역사회간호학회지
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• 제27권3호
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• pp.272-283
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• 2016

Purpose: This is a comparative study using secondary data from the Korean national long term care (LTC) insurance. Methods: Visiting nursing (VN) service users (n=666) and non-users (n=4,375) were extracted and compared in terms of medical expenditures, length of hospitalization, and annual number of ambulatory care visits to investigate effects of VN services in LTC. Results: Total health care expenditures were compared between the two groups and it was found that VN service users spent about $ 1700 than non-users for their medical costs between 2009 and 2011. The average length of in-hospital stay for VN service users was 19.4 days shorter than that of non-users. However, using VN services did not significantly influence the annual number of ambulatory care visits. Conclusion: The study has found that VN services are effective ways of providing community-based LTC services. We recommend LTC policy makers to further utilize VN services to deliver cost effective health care services.

• 한국임상보건과학회지
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• 제4권3호
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• pp.603-614
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• 2016

Purpose. The purpose of this study was to provide basic data regarding the intention to use community care service based on special grading for dementia in the South Korean Society. Methods. A survey was conducted using a questionnaire adapted on the basis of literature review regarding the first to fourth grade under the long-term care insurance system for the aged from May 1 to 30, 2015 and a total of 272 questionnaires were statistically processed using SPSS 21.0. Frequency analysis, descriptive statistics, and cross-tabulation analysis were performed. The non-parametric type of test, ${\chi}^2$ test, was used for statistical testing. Results. This study obtained the following results: First, caregivers had greater intention to ask recipients to use daytime and nighttime care service. Second, there were statistically significant differences in caregivers' education, occupation, monthly average income, co-residence status, intimacy, and care-giving burden (emotional, financial, and social) and recipients' activities of daily living, instrumental activities of daily living, mental health status, dementia status, and intention to use community care service based on special grading for dementia. Conclusions. There are very few statistical data and academic materials regarding special grading for dementia, which has recently been established. The results of this study are therefore expected to help make a systematic analysis of the intention to use community care service by caregivers based on special grading for dementia.

• 한국주거학회논문집
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• 제25권2호
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• pp.99-107
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• 2014

This study attempts to provide implications for developing more efficient and effective community-based support system with AIP perspective for the elderly in Korea. The main purpose of this study is to analyze Japan's community-based integrated care system that respond to the concept of aging in place (AIP) and its cases. In Japan, they have offered Community-Based Service since 2005, and the advanced system which include integrated support categories and consolidated community/local resources will started in 2015 by The revision of Long-term Care Insurance policy, 2012. The result of policy analysis and case studies are as follows: 1) The suggestion for ideal support system model promoted a relationship of multiple agents include private sectors even resident and senior and specified responsibility sharing, 2) the system proposed Not only health and medical care support, living care and residence are also addressed as a comprehensive support. and 3) the amount of available community resource is different by each local government, but the effort to get the understanding of community residents and to connect with a potential community resource is also essential aspect to set effective community-based support system.

• 가정∙방문간호학회지
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• 제14권2호
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• pp.98-105
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• 2007

Home health care system in Korea has been classified into three types of home care programs based on different laws and regulations; for example, home health care nursing(HHCN) is based on medical laws, visiting health care nursing (VHCN) is based on long-term health care insurance, and visiting health care(VHC) is based on the regional health care act. HHCN in Korea has taken on an important role under the mandate of the national health care system since 2000. VHCN will commence its role under the long term health care insurance system in 2008. The strengthening of VHC commanded health promotion and prevention for vulnerable families in the community in 2007. This is an important turning point for increasing quality management for home health care program; it suggests certain possibilities for building a foundation for further changes in the service delivery structure. Accordingly, the home health care policy makers in Korea have a major function and role that consists of developing an agenda and alternatives for policy making in a systematic manner and clearly presenting implementation strategies for elderly health care system.

• 지역사회간호학회지
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• 제33권1호
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• pp.1-12
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• 2022

Purpose: This secondary data analysis study evaluated the effects of ICT enhanced home-visit nursing in long-term care insurance on health-related quality of life among community-dwelling older adults. Methods: This study included data of 131 older adults who had experienced a pilot service for ICT enhanced home-visit nursing. ICT enhanced home-visit nursing refers to a method of sharing health records and teleconference between a visiting nurse and a doctor during the home-visit nursing services to community-dwelling older adults. Health-related quality of life and influencing factors were analyzed by t-tests, logistic regression analysis using the Stata 17/SE program. Results: After a pilot service for ICT enhanced home-visit nursing, their health-related quality of life increased. The teleconferencing method had a significant effect on the increase in health-related quality of life. Conclusion: The findings indicate a pilot service for ICT enhanced home-visit nursing can be applied to the domestic community-based healthcare service model in terms of health management. In the future, the advanced service model of a pilot service for ICT enhanced home-visit nursing in which subjects conduct detailed for each health problem, and a well-designed evaluation system should be developed.

• 한국정보통신학회:학술대회논문집
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• 한국정보통신학회 2022년도 추계학술대회
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• pp.309-313
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• 2022

본 연구는 건강보험제도를 활용한 중증외상 환자의 응급실 이용현황을 분석해, 그 특성을 파악하고자 시도되었다. 본 연구는 2018년 1월 1일부터 2019년 12월 31일까지 조사된 '지역사회기반 중증외상조사(Community-based Severe Trauma Surveillance)' 자료를 이용하였다. 연구 결과, 의료보험종류에 따라 손상 후 장애 정도, 치료(수술, 외상색전술, 수혈) 시행여부에서 차이를 보였으며(p<.001), 의료보험종류에 따라 손상 전 장애정도와 손상 후 장애정도 간에도 통계적으로 유의미한 차이가 있음을 알 수 있었다(p<.001). 국민의 안녕을 위해 자리하고 있는 건강보험제도에 대한 다양한 각도에서의 검토가 지속되어야하며, 이에 대한 구체적인 개선안이 제시되어야할 것이다.

• 보건교육건강증진학회지
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• 제20권1호
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• pp.41-60
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• 2003

This study, performed to analyze the factors associated with health and cancer screening using preventive programs form health insurance among the women of a community, through a survey of about 923 women in Euijungbu-city. The subjects of the study were selected by a proportional cluster sampling method. The self-reported questionnaire was intended to fine factors associated with health screening and cancer screening. The results of this study were as follows: 1. In the case of health screening using health insurance, 14.1% of the subjects turned out to have been screened once or more in their respective life-time. Reasons given for non-participation in the screening were : 'lacking screening information', a belief that' it's not useful' and a belief that they' weren't sick'. 2. The factors associated with health screening behavior were age, educational level, number of doctor visits, BMI and health promotion behavior(p<0.01, p<0.05). Also, the factors associated with health screening behavior were cue to action and health status, and the predictors on health screening behavior were age and health promotion behavior(p<0.01, p<0.05). 3. In the case of cancer screening through the health insurance, 7.4% of the subjects turned out to have been screened once or more respectively in their life-times. Reasons given for non-participation in the screening were : 'lacking screening information', a belief they 'weren't sick' and that it's not useful'. 4. The factors associated with cancer screening behavior were age, educational level, income, alcholol intake, exercise, number of doctor visits and BMI(p<0.01, p<0.05). Aditional factors associated with cancer screening behavior were cue to action, health belief score and health status. Predictors for cancer screening behavior were: age, health belief score, screening attitude and health status(p<0.01, p<0.05). As indicated by the above results, a lack of information was an important factor for a lack of participation in screening. Age and cue to action were also important factors in promoting the cancer screening rate. Therefore, a dissemination of information about cancer screening contributes to the promotion of a screening rate, and cooperation between health insurance and local health cancer facilitates to be public the community-based cancer screening program.