• Research in Community and Public Health Nursing
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• v.9 no.1
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• pp.163-180
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• 1998

The purpose of this study is to evaluate the community based home care service, and make reorientation for better service. The data was collected from the public health center, which was operated for one year, 1997. This case is evaluated and reoriented according to five elements of public health care system; system of resources for public health, organization and administration, health care delivery system of financing, management. In resources for public health, available health personnels are 15 physicians, 17 nurses, 11 nurse aides and 2 other persons. One professional health personnel take care of 609 clients, The equipments used for elderly and the disabled are 6 wheelchairs, 4 walkers, 1 hairwashers and 30 viberations. But these equipments are not enough to deal all clients. In organization and administration, planning and setting goals for community home care are made by the director, supervisor of family department and public health nurse. So there is no regular commitee for home care services in this community. The form of delivery of health care is focused on preventive health care. The important works of public health nurse are health education, preventive care for hypertension, D.M. and vaccination of communicable desease. In finaning system, funds come from central government(8.3%), local goverment(16.7%) and health center itself(3.8%), The services consist of health education, vaccination, clinical test and equipment. There are several local volunteers, which are local hospitals, a college, a christian association, a catholic association, a drivers association and a disabled association. The volunteer groups give physical and mental support to the clients. In management, this health center has three evaluation methods. One is done by local government, one is done by health center itself, and the other is done by clients with questionair. But the evaluation tools are deferent between agency. Home care services must be planned and evaluated. This public health center has to have more personnel, equipments, education for professional kowledge and meetings with community volunteer agencies.

• Journal of Korean Academy of Nursing
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• v.45 no.5
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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.

• Journal of Korean Public Health Nursing
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• v.19 no.1
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• pp.148-160
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• 2005

Presented here are policy alternatives for understanding home health care for the long-term health care insurance system which is being developed for elderly people starting 2007. The summary of issues concerning home health nursing care under the long-term care insurance system include; 1) absence of comprehensive and systematic policy in home health care deliverly systems; 2) absence of community based home health agencies that are considered as the community residents in general. In order to overcome these problems and Issues, policy alternatives of home health care should 1) establish a comprehensive home health care policy for homebound persons; 2) establish the foundations for home health care nurses and community based home health care systems; 3) establish home health care facilities and infrastructure; and 4) promote research and development concerning home health care. Conclusively, a home health care system should be built on a comprehensive policy vision based on health policy, especially long-term care insurance system in the near future. Every homebound residents service has to be constructed systematically under suitable facilities considering the consumer characteristics and health conditions. By doing this, the consumer based comprehensive community home health care delivery system can be constructed in view of the long-term health care insurance system for elderly people.

• The Journal of Korean Physical Therapy
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• v.11 no.1
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• pp.179-185
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• 1999

The Purpose of this study was to review the necessity of home care service for the handicapped. The Present momentum for home care for the handicapped become when the circulating rehabilitation service center for the handicapped was designated by the government in Korea. That was 1992. Home care service is a burgeoning segment of Korea health Service, driven by factors which include an expanding elderly population and increasing the disabled persons. To ensure quality of life for the disabled persons with diminishing financial resources allocated to health me, it is essential that community based rehabilitation and home care service be extended.

• Journal of Home Health Care Nursing
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• v.8 no.2
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• pp.159-170
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• 2001

Client(patient) satisfaction has been used for a variety of purposes in different settings, yet, those receiving home care services have been the focus of few satisfaction studies. Satisfaction is considered an indicator of quality of care and is also being used to assess the performance of home care providers and home health care delivery at multiple levels. The aim of this study was to develop the tool for evaluating client satisfaction in several aspects with home care service while maintaining or achieving acceptable reliability and validity. Firstly, Client Satisfaction Instrument made preliminary of 43 items composed basic 6 criteria and 7 indicators, based on a review of literature, quality improvement and client satisfaction findings in home care. Secondly, there were consisted in two expert panel groups who were made in professionals of research and practice in home care field. The tool was modified to 6 criteria and 7 indicators, 25 items after reviewing by two expert panel groups. The content validity index of the tool was above 0.8 and the results of internal consistency was more than 0.8 in all items. Finally. The Client Satisfaction Instrument in Home Care Service was made up 6 criteria such as client satisfaction of nurses's instruction of home care educational need. knowledge/technique/attitude of homecare nurses's performance. interpersonal relationship and emotional support of nurse. easiness of homecare accessibility, continuity of homecare service. overall efficacy of homecare use, 7 indicators. and 25 items. The results of evaluating client satisfaction will be able to contribute in quality improvement and service marketing in home care.

• 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 Home Health Care Nursing
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• v.14 no.1
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• pp.23-30
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• 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.

• Journal of Home Health Care Nursing
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• v.10 no.2
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• pp.158-169
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• 2003

Purpose: This study is to investigate the recognition regarding Hospital - Based Home Care Service among physicians and nurses in a G University Hospital. Method: Data were gathered from 92 physicians and 257 nurses. working at G University Hospital. from January 15 to January 22. 2003 by questionnaire. The data were analyzed by using the SPSS/PC +. Result: 1) As to the previous information about a hospital based home care service. those who have been familiar to it were 85.9% of the physicians. and 98.8% of the nurses. 55.4% of the physicians and 55.1% of the nurses responded that they are willing to refer their patients to the home health care only if their patients and families want to. 47.8% of the physicians and 44.4% of the nurses perceived the present cost of a hospital based home care service to be moderate. 2) Most of the physicians and nurses reported that the most available service was 'wound dressing' (98.4%, 92.6%) and the least available service was 'incision and drainage'(1l7.4%, 42.8%). 3) As to the necessity of home nursing business and the anticipated effects. nurses perceived higher than physicians($3.46\pm.74$). and both showed a significant difference according to age of subjects. Conclusion: For the stabilization and successful implementation of a hospital based home care service. it should be accompanied with education programs about home care for physicians. in particular junior staff.

• Journal of Home Health Care Nursing
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• v.8 no.2
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• pp.121-134
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• 2001

The purpose of this study were to analyze the home care services and to evaluate the client's satisfaction with the home care services provided by home care service center in the C hospital. The data were collected by reviewing charts of 128 home care clients who were receiving home care services at C hospital from October 1997 to September 2000. The subjects for satisfaction of home care service were 20 clients from July 10 to September 30, 2000. The tool for measurement of present condition of home care service was developed by the researchers. The satisfactions of the home care services were measured by using the instrument developed by Im(997). The data were analyzed by using the SPSS/PC+. The results of this study were as followings : 1. Majority of the subjects was female(61.7%). The average of age was 63.5 years. The service has been used mostly by the elderly 60 years of age or older(71.1%). The economic level of most of subjects was in middle class(94.5%). 2. Majority of the subject had a cancer(55.4%), following stroke(25.0%). The average duration of disease for the subjects was 31 months. The average time of hospitalization for the subjects was 3.3 times. The duration of hospitalization was 10$\sim$30 days(26.6%), 30$\sim$60 days(23.4%) and above of the 210 days(9.4%). 3. Most of the subjects used his/her doctor (47.7%), as a consultant, following his/her nurse (28.1%), other patients or their family (21.9%). Most of reasons for a consultation were supportive management(Infusion or medication, 60.94%), following tube management(L-tube or T-tube, 25%), Foley catheter management (15.63%) etc. 4. 28 types of nursing diagnoses were used by the home care service. The nursing diagnosis altered nutrition: less than body requirement were used mostly by the home care service, following risk for infection, impaired skin integrity, impaired swallowing, ineffective airway clearance altered comfort: pain, impaired physical mobility. By the human-response pattern, exchanging(63.2%), moving(7.5%), feeling(10.4%), knowing(5.2%), communicating (2.6%), relating(0.5%) perceiving(0.4%) and choosing(0.3%). There were 42 nursing intervention types were performed by the home care service. By the NIC(nursing intervention classification. McCloskey. Bulech. 1996). physiologic: complex (30.3%) was the most, safety(28.3%), behavioral(20.0%), physiologic: basic(10.8%) and health system(1.7%). Observation or assessment was the most nursing intervention performed by the home care service. following IV infusion. vital sign observation. infusion management and fluid-electrolyte balance management. 5. The level of client's satisfaction with provided home care services showed considerably high(2.67/ 3).

• Journal of Home Health Care Nursing
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• v.7 no.1
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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.