• 대한간호학회지
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• 제36권3호
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• pp.503-513
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• 2006

Purpose: This study focused on analysing costs per home health care nursing visit based on home health care nursing activities in medical institutes. Method: The data was collected in three stages. First, the cost elements of home health care nursing services were collected and 31 home care nurses participated. Second, the workload and caseload of home care nursing activities were measured by the Easley-Storfjell Instrument(1997). Third, the opinions on improving the home health care nursing reimbursement system were collected by a nation-wide mailing survey from a total of 125 home care agencies. Result: The cost of home health care nursing per visit was calculated as 50,626\. This was composed of a basic visiting fee of $35,090{\\}({\fallingdotseq}355$)$ and travel fee of $15,536{\\}({\fallingdotseq}15$)$. The major problems of the home care nursing payment system were the low level of the cost per visit, no distinction between first visit and revisits, and the limitations in health insurance coverage for home health care nursing services. Conclusion: This study's results will contribute as a baseline for establishing policies for improvement of the home health care nursing cost and for applying a community-based visiting nursing service cost.

• 가정∙방문간호학회지
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• 제10권1호
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• pp.52-57
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• 2003

The purpose of this study was to evaluate appropriateness of home health care travel cost. For the evaluation, investigated the operating costs of vehicles used by home care nurses and then were components of home care nurses's annual salaries. Travel costs were then calculated based on actual travel expenses of home health care service. Actual data of 23 hospital-based home care agencies between July, 2002 to December, 2002 were collected for the analysis of the travel costs. The results of this study are : 1) For home visit, 65% of home care agencies turned out to be using only hospital owned cars, and 17.1% be depending purely on home care nurses' cars. On average, 1.9 cars used for home visit. 2) Out of 89 agencies, 23 agencies responded to the travel cost survey. Total maintenance cost of a car per month was 381,457 won. 3) Average per visit personal expenses of home care nurses during travel time turned out to be 7,124won assuming 8 working hours per day, 4 visits per day, and 30 minuets of travel time for each visit. 4) Total home health care travel cost per visit was 12,069 won, which was the sum of actually paid travel cost of 4,945 won and personal expenses during travel time of 7,124. In conclusion. we reckon that current compensation price of home care nurses' travel is inappropriate because total home health care travel costs of 12,069 won per visit turned out to be 2.1 times of currently prevailing standard compensation price of 5,830 per visit.

• 가정∙방문간호학회지
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• 제6권
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• pp.19-32
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• 1999

The purpose of this study was to develop of home nursing care classification and home health care costs of the free-standing home nursing care agency. This study was done through 3 steps The First stage, home nursing care classification was identified and classified by literature, review-committee and expert meeting. The second stage, cost elements for home nursing care visit were identified and accounted. That were divided into direct nursing care cost, indirect nursing care cost, management cost and transportation cost. Third stage, total cost of per visit was produced. Data were collected from 810 visits of 120 patients received home dare and from January. 1999 to November, 1999, and analysed with EXCEL program. The obtained results are as follows : 1. Home nursing care classification was consisted of 6 high level classification domain and 10 low level classification domain and 163 home nursing care behavior. 2. The cost of home nursing care per visit was 30,638 won which were direct and indirect nursing care cost(16.305won), management cost(5,255won) and transportation cost (9,098won). In conclusion. Home nursing behavior care classification developed in this study would be used as home health care standard. And the home nursing care costs can be used as a fundamental data for the further development of home health care costs in Korea.

• 지역사회간호학회지
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• 제12권1호
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• pp.22-31
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• 2001

Purpose of this study is to compare the cost effectiveness of home care services for the cerebrovascular accident patients by the type of institution. The method is the secondary analysis using the patients' charts. 107 subjects and 1.417 visits were sampled from each type of home care institution such as one hospital based home care center. one KNA home care center, one urban health center, one rural health center and one health care post. Result: There were differences in the functional status of patients and the service contents and frequencies provided by the type of home care institution, The cost per visit for one unit of ADL by the hospital based home care was higher than by the community-based home care. Conclusion: It was suggested that the referral system among the home care institutions would be developed to improve the cost-effectiveness.

• 간호행정학회지
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• 제12권2호
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• pp.225-232
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• 2006

Purpose: The purpose of this study was to analyze the services and cost of CVA patients in hospital-based home health care and compare the differences of home health care cost by hospital types. Methods: The subjects of this study were 5,756 home care patients with cerebrovascular disease. Data were collected by using home health care medical expense claims from 127 hospitals in 2004. Results: The home care service 'indewelling catheterization' was the highest(19.28%), and then 'nasogastric tube insertion and change(16.72%)', 'bladder irrigation(15.98)', 'wound management(simple dressing)(10.42%)' followed. Average home health care cost per visit was 39,943 won, and the highest 46,058 won in general hospitals and the lowest 33,922 won in tertiary hospitals, so there were statistically significant among the types of hospitals(F=1112.47, p<0.0001). Conclusions: The number of home health care patients has been rapidly growing with the increase of aged population and demand for home care services is rising. So, it could be urgent to develop a reasonable cost reimbursement system for home health services and to expend scopes of the roles of home care specialist nurses. Amid the demand of more detail understanding the present status of home care, our study can be contributed to provide fundamental information of home care in Korea.

• 간호행정학회지
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• 제4권2호
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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.

• 간호행정학회지
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• 제16권4호
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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.

• 가정∙방문간호학회지
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• 제7권1호
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• pp.26-38
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• 2000

The purpose of this study was to estimate home care nursing cost for the patient with Cerebrovascular Disease based on a bundle of home care nursing services This study was conducted through four steps. The first step was to investigate home care nursing activities that were offered to the patient with Cerebrovascular Disease(CD) by home care nurse. The second step was to investigate the time spent on home care nursing service and to calculate labor and manufacturing cost. The third step was to calculate home care nursing cost per minute. And at the fourth step, home care nursing cost for a patient with Cerebrovascular Disease based on a bundle of home care nursing service was calculated. The results of the study were as follows: 1) The number of direct home care nursing activities for the patient with CD was 108, and the time of each activity was spent from 1 to 10 minutes. 2) Average time per visit was 51 minute, and the firs visit time were spent 1.6 times higher than 2nd visit time. 3) Nursing cost per minute(cost per visit ${\\}\;22,565\;\div\;$ average time per visit 51 minutes) was ${\\}\;442$. The cost per visit was calculated on Basic visiting cost(nurse's labor cost ${\\}\;15,760$ + management cost ${\\}\;6,805$) divided by average time per visit(51 minutes). 4) Home care nursing cost to the patient with CD based on bundle of home care nursing service was consisted of basic home care nursing cost, the cost of a bundle of service practiced on visit. and transportation fee. Basic home nursing cost(the time spent on basic home nursing service 20 minutes ${\times}$ nursing cost per minute ${\\}\;442$) was ${\\}\;8,840$. The cost of the bundle of home care nursing services to the patient with CD was calculated as self care ${\\}\;2.898$, Tracheostomy care ${\\}\;10,166$, immobility care ${\\}\;6,188$, sore care ${\\}\;6,188$. Foley care ${\\}\;6,630$, and Levin tube or Gastrostomy care ${\\}\;7.514$. Transportation fee which was composed of the labor cost for transportation(${\\}\;5,122$) and the car management cost(${\\}\;3.876$) was ${\\}\;8,998$. Home care nursing cost to the patient with CD based on bundle of home care nursing services consisted of basic home care nursing cost, the cost of a bundle of service practiced on visit, and transportation fee. It will contribute to improve quality of home care service, because of giving appreciate incentives to home care nurses. And it will be more efficient than current cost of hospital based home care. But it need to management than calculation of the current fee-for-services of home care.

• 가정∙방문간호학회지
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• 제10권2호
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• pp.113-122
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• 2003

Purpose: This is a simple survey for discussion about cost analysis methodological issues in home care nursing service studies. Method: The subject of this study were articles published in Korea from 1961 to August, 2002, and searched by key word 'cost' and 'nursing' from various DB(National Assembly Library, The National Library of Korea, RICH etc). Finally, 13 articles were collected. Result: 1) The major type of cost analysis studies was a cost comparison or a simple cost study. 2) The important methodological weaknesses were as followers; (1) few studies were suggested cost analysis framework or analytic perspective, (2) it ,was not enough to describe for basis of selection of cost/effectiveness items, (3) few studies were done by sensitivity analysis. Conclusion: These above results will be used to develop a more proper cost analysis methodological framework in home care nursing services and also to contribute as a guideline for further studies.

• 가정∙방문간호학회지
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• 제20권2호
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• pp.141-151
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• 2013

Purpose: The purpose of this study was to examine the economic effectiveness of by conducting a literature review of published articles, masters theses, and doctoral dissertations. Method: Prior to the literature review, inclusion-exclusion criteria were established. We then reviewed 1,029 CINAHL, MEDLINE, and Cochrane DB papers, and 153 RISS papers collected between Results: A total of 12 studies met the inclusion-exclusion criteria.-effectiveness: 6 cost-effectiveness studies, 1 cost-utility studies, and 5 cost-benefit studies. Each of the 12 reviewed studies concluded that home care nursing had greater economic benefits than other compared healthcare services. Conclusion: Home care nursing has significant economic benefits in multi health care service settings and for various patient groups. Therefore these results will be used a critical evidence for the development of economically effective home based health care systems for future policy making.