• Title/Summary/Keyword: Home health care service

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Nutritional Assessment of Patients Receiving Hospital-based Home Care Services (가정간호대상자의 영양상태 평가)

  • Kim, Kyoung-Rye;Kim, Mi-Ye;Kim, Gwang-Suk
    • Journal of Home Health Care Nursing
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    • v.15 no.2
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    • pp.99-105
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    • 2008
  • Purpose: We evaluated patient nutritional status in a home care setting. Method: We recruited 81 patients who received in-home care using a screening sheet. The level of nutrition-related serum marker (albumin) was checked via medical records and data analyzed using descriptive analysis, t-tests, and $X^2$-test. Results: Nutritional status varied according to the primary medical diagnosis. Poor nutritional status was significantly higher in cancer patients than in other diseases. Serum albumin levels were significantly lower in the malnutrition group than the good nutrition group. Conclusions: Nutrition screening can determine the nutritional status in home care patients. Home care nurse practitioners should consider nutritional status when assessing patient health.

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The Effects of Customized Home Visiting Health Service in Gangwon-do - Focused on Hypertension and DM Clients - (강원도 맞춤형 방문건강관리 사업 효과 - 고혈압.당뇨 사례관리 중심 -)

  • Yang, Soon-Ok;Ahn, Soo-Yeon;Yim, Eun-Shil;Kwon, Myung-Soon
    • Research in Community and Public Health Nursing
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    • v.19 no.1
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    • pp.88-100
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    • 2008
  • Purpose: This study was to present the effects of home visiting health service on hypertension and DM clients. Method: The one-group pretest-posttest design was applied to 127 hypertension and 116 DM clients. To evaluate the effects of visiting nursing service, biological indexes and self-care abilities were measured from April to July, 2007. Result: Biological indexes and self-care abilities were improved in the hypertension and DM clients who received visiting nursing service. Especially, blood pressure and fasting blood sugar showed a dramatic decrease. Conclusion: Home visiting health service by public health centers is considered to be an effective nursing service in Gangwon-do. Therefore, case management is demanded not only for hypertension and DM but also for other chronic diseases.

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Home Care Nursing: An Economic Analysis (가정간호의 경제성 평가에 관한 문헌분석)

  • Lim, Ji Young;Kim, Ji Young
    • Journal of Home Health Care Nursing
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    • v.20 no.2
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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.

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Factors Related to Family Caregiver Financial Burden of Out-Of Pocket Expenses for the Nursing home service under Long-term Care Insurance System (노인장기요양보험 시설서비스 본인부담금에 대한 가족수발자의 경제적 부담감 영향요인)

  • Han, Eun-Jeong;Lee, Jung-Suk;Kwon, Jinhee
    • Health Policy and Management
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    • v.22 no.3
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    • pp.383-402
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    • 2012
  • The purpose of this study is to investigate the factors affecting family caregiver financial burden of out-of pocket expenses for the nursing home service under Long-term Care Insurance System. We conducted a national cross-sectional descriptive survey from July to September 2010 to collect data based on the long-term care benefits cost specification. Total 1,016 family caregivers completed questionnaires. 185 subjects of total were excluded from the data analysis due to being answered by user(18 cases), or caregivers not to pay for services expenditures(122 cases), having a missing data on family caregivers characteristics(45 cases). Finally, 831 subjects were included in the study. The average financial burden was 3.18(${\pm}0.71$). We divided subjects into two groups by level of burden, high-burden group and low-burden group. In the result of the multiple logistic regression analysis, family caregiver financial burden was significantly higher in family caregivers with ages 40 to 49 compared to less than 40, lower educational level, unsatisfaction for long-term care service, high percentage(more than 50%) of cost-sharing and high total out-of pocket expenses(more than 300,000 won) for long-term care services. Also, Family caregivers who are spouse felt higher financial burden compared to son. This study is meaningful as the first attempt to measure family caregiver financial burden for long-term care service and to identify factors affecting the financial burden. Family caregivers felt financial burden of out-of pocket expenses for the nursing home service. The policy makers, the insurer, and the providers need to pay attention to ease family caregiver financial burden.

The Want, its Determinants and the Willingness to Pay of the Long Term Care Service (장기요양 서비스를 누가, 얼마나, 얼마에 원하고 있는가? - 장기요양 서비스의 욕구와 결정요인 및 지불의사금액 -)

  • Kim Hyun Cheol;Hong Narei;Yeon Byeong Kil;Park Tae-Kyu;Chung Woo Jin;Jeong Jin Ook
    • Health Policy and Management
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    • v.15 no.4
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    • pp.136-160
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    • 2005
  • Before introducing the national long-term care insurance in 2008, the want for long term care service has to be estimated and analysed. This study estimates the demand and analyses what determines the want of long term care service. This study investigated data of 3f6 elderlies, that was collected by age stratified random sampling. The elderies resided in Onyang 4 - dong (urban area) and Dogo-myun (rural area) In the city of Asan. The researchers visited the elderlies and their care giver, and assessed their demand for the long term care service and examined physical, mental, socio-economic status by the assessment tools for Korean Long-Term Care System. $64\%$ of the those who are entitled to be served refuse the long term care service. $26.7\%$ of them wants for home care service and $7.9\%$ want facility care service. It is estimated that the want of home care service are three or four times as much as that of facility care service. The demand for long term care service is 5.155 times higher for those who live in rural area (p=0.000), 3.040 times higher for those who do not have spouse(p=0.057), and 3.356 times higher for the people who is in medicaid than medical insurance(p=0.029). However, income(p=0.782), means(p=0.614), living alone(p=0.223), number of family to live with (p=0.341) and age of the elderly(p=0.420) are not related with the demand of long term care service. The assessment tools for Korean Long-Term Care System for need evaluation of the long term care service can reflect the demand well.(p=0.024) If medical care will cover $80\%$ of total cost, the willingness to pay of the out of pocket money of the people with medical insurance is 67,400 Korean Won(66.77 US$) for the home care service and 182,500 Korean Won(180.78 US$) for the facility care service. There is possibility that long term care demand is still small after Introducing the long term care Insurance due to the care given by family members. When developing service delivery system of long term care insurance, rural area has to be given more consideration than urban area because of the higher demand. The people who do not have spouse or are in medicaid have to be given special consideration as well.

Effects of Case Management using Resident Assessment Instrument-Home Care(RAI-HC) in Home Health Services for Older People (재가노인 기능상태 평가도구를 이용한 재가노인 사례관리 프로그램의 효과 평가)

  • June, Kyung-Ja;Lee, Ji-Yun;Yoon, Jong-Lull
    • Journal of Korean Academy of Nursing
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    • v.39 no.3
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    • pp.366-375
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    • 2009
  • Purpose: To evaluate the effects of case management using Resident Assessment Instrument-Home Care(RAI-HC) in home health service for older people. Methods: All elders were assessed at baseline and 3 months later using RAI-HC. The change of function in the intervention group was compared with that of a conventional intervention group. Function was measured with Activities of Daily Living(ADL), Instrumental Activities of Daily Living(IADL), Cognitive Performance Scale(CPS), Depression Rating Scale(DRS), Pain and the number of Clinical Assessment Protocols(CAP). Results: Among ninety two elders participated in the program, 59 were allocated to the case management group and 33 to the conventional group. The intervention, home health service by a nurse over a 3 month period, consisted of comprehensive assessment, case conference for care plan, direct care, education and referral, and outcome evaluation. The percent of elders whose function improved in the intervention group was greater than the conventional group for depression(odds ratio [OR]: 10.941, confidence interval [CI]: 2.338-51.206), IADL(OR: 4.423, CI: 1.151-16.999) and the number of CAP(OR: 11.443, CI: 3.805-34.410). Conclusion: Case management was effective for older people in the community. The effect might have resulted from individual, systematic intervention, however, standards of service including eligibility criteria for case management and collaboration of multi-disciplines is required for more effective home health service programs.

The Comparison of Cost Analysis Researches for the Home Care Nursing Service (가정간호서비스에 대한 국내 비용분석 연구비교)

  • Lim, Ji-Young
    • Journal of Home Health Care Nursing
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    • v.10 no.2
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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.

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Development of Home Visiting Nursing Standards Base on a Long-Term Care Insurance for the Elderly Program (노인장기요양보험제도에 의한 방문간호 표준개발)

  • Kim, Myung-Hee
    • Journal of Korean Public Health Nursing
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    • v.24 no.2
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    • pp.285-301
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    • 2010
  • Purpose: The study was aimed at qualitatively enhancing and promoting a home visiting nursing program established in Korea on July 1, 2008, as part of the Long-Term Care Insurance for the Elderly program. Methods: Structural, procedural and consequential aspects of home visiting nursing care wereclassified on the horizontal axis by applying the standard notions for the evaluation of medical care (Donabedian, 1998). At the same time, the home visiting nursing care service support system and the service provision system weredivided on the vertical axis with reference to the accreditation standards for home visiting nursing care organizations suggested by the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO, 2008). The data were collected from June 4, 2008 to October 27, 2008, and were analyzed using SPSS ver. 15.0. Results: Twenty-two (proposed) standards, centered on the standard elements under the conceptual framework of the study, were developed, and comprised structural aspects (n=10), procedural aspects (n=6) and consequential aspects (n=6). Those criteria and indicators underwent two content validity surveys among groups of home visiting nursing care research and training experts. The research produced 22 proposed standards, 50 proposed criteria and 166 proposed indicators. Conclusion: The home visiting nursing care standards developed pursuant to the Long-Term Care Insurance for the Elderly Act and the applicability of these standards need to be verified by home visiting nurses. These proposed standards should prove useful in developing an assessment tool to encourage the qualitative enhancement of visiting nursing care in Korea.

A Study on Willingness by Doctors and Patients to Use Hospital Based Home Nursing Service (병원중심 가정간호사업의 이용의사에 관한 조사 연구)

  • Song, Myung-Soon;Chon, Si-Ja
    • Journal of Home Health Care Nursing
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    • v.8 no.1
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    • pp.74-84
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    • 2001
  • This descriptive study was conducted to determine the awareness by doctors and patients of the hospital based home nursing service, and the willingness of the patients as well as the doctors to use the service if provided. The convenience samples consisted of 240 hospitalized medical-surgical patients, and 64 doctors from one' hospital. The data was collected from June 1 to June 30, 2000, by questionnairs and interviews. The results of the study were as follows: 1. 57.4% of the subjects were male patients. 35.8% were over 60 years old. and incomes ranged from 1.000,000 to 1.990,000 Won per month in 33.2% of the subjects. 2. 61.3% were unaware of home nursing. 52.7% of the subjects got information about home nursing via TV, magazines, and newspapers, and 83.4% of them showed a willingness to use the service if available. For doctors, 87%, of them said that they were aware of home nursing, and 84.4% viewed the service as necessary. However, only 39.1% responded that they are willing to refer their patients to the home nursing service if it is available. 3. Those who know about the service perceived it more advantageous; however, many do not know about it. Based on the above findings, the following suggestions are made: (1) It is necessary to hold a workshop or a seminar about hospital based home nursing service to draw attention of hospital personnel. (2) There is a need to publicize home nursing service to patients and their family members. (3) Further research is necessary to analyze cost/effectiveness of a hospital based home nursing service for the hospital.

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A Survey on Clients' Home Care Satisfaction in Taejon City in Korea (일개 시지역의 가정간호 수혜자들의 만족도 조사)

  • Kim, Sun-Sook;So, Hee-Young;Lee, Tae-Yong
    • Journal of Home Health Care Nursing
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    • v.5
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    • pp.73-83
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    • 1998
  • This study enrolled one thousand five hundred twenty one clients that were receiving home care services at five health centers and a home care services center in the city of Taejon from November 17 through December 7, 1997. The purpose of this study was to analyze satisfaction levels, general characteristics and efficacies, of the client served home care. The main results were as follows; The age group of most of the subjects was 70-79 years: 76.9% of them were female and 87.3% were over 65 years. In education variables, over 90% of the clients were below primary school. In marital status variables, 63.4% of them had no spouse, 57.5% of them were widows and widowers. In living arrangement variables, alone(35.8%) was the most. In insurance status variables, medical aid(69.9%) was the most. In household income variables, below 000 won(72.6%) was the most. In hospitalization variables, 53% of the clients had no hospitalization. The satisfaction level of home care service of male and female was similar. The older the age, the higher the satisfaction level. The satisfaction level of the group having religion was higher than the group having no religion and the Christianity group had the highest satisfaction level(p<0.001). In education variables, the over high school group was the highest satisfaction level(p<0.01). In living arrangement variables, the other (sisters or neighbors etc.) group indicated the highest satisfaction level(p<0.001). In insurance status variables, the other group(except for medical aid) was the highest satisfaction level(p<0.001). In household income variables, below 390,000 won was the highest satisfaction level(p<0.001). In hospitalization variables, 'over 4 times' group indicated the highest satisfaction level (p<0.01). Home care took place more in health centers than in home care services center. In frequency of home care per month three times was the most. In opinion of home care frequency per month 82.8% of the people answered 'proper'. A lot of present illness was neuralgia, arthritis, digestive disease, hypertension & CVA. In contents of home care services variables, education & counselling was the most and medication was second. In duration of illness variables, over 10 years was the most. In place of treatment before home care service variables, hospital(57%) was the most. In illness condition after home care variables, 'moderate' was the most and 'much better'(85.5%) was second. In help of home care variables, 'much help'(71.5%) was the most and 'moderate'(28.1%) was second. In contents of counselling variables, treatment method of illness was the most. Home care services center indicated higher level of satisfaction than health center(p<0.001). In opinion of home care frequency per month variables, 'less' was the highest satisfaction level (p<0.001). In duration of illness variables, below one year was the highest and over 10 years was second(p<0.001). In place of treatment before home care service variables, health center was the highest (p<0.001). In illness condition after home care variables 'much better' was the highest and 'worse' was second (p<0.001). I n help of home care variables, 'much help' was the highest (p<0.001). In contents of counselling variables, cause of illness was the highest(p<0.001). According to the 14 items which consisted of 3 point scales the total level of satisfaction of home care service was very high, with total mean score 36. According to the above results, most clients taking home care services are satisfied. However, organization and a fund are required to support high quality home care services to those who need them. Furthermore, a follow-up survey should be accomplished to evaluate the status of clients.

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