• 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.

• 가정∙방문간호학회지
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• 제7권1호
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• pp.39-57
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• 2000

This study was conducted to identify the current situation of home care nursing research and to propose future research in the area of home care nursing in Korea. The design was a retrospective descriptive study based on 171 studies. The studies were collected from nursing academic magazines, the national library web site and dissertations on home care. The data were classified according to the independent and dependent variables which were represented in the research title. The final category classification was defined by considering the research objectives and content as found in the 171 studies. Eight categories were created to describe the results of home care nursing research in Korea. They included: home care needs. home care services. home care costs. development of home care programs and equipment. management of home care services. effectiveness of home care services, development of an educational curriculum for home care, and recognition of home care services. Based on our research we have identified other future research areas that need to be developed such as community needs assessment, standards and guidelines for home care nursing, quality assurance and quality improvement for controlling home care quality, home care informatics. and a system of home care cost and ethics.

• 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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• 제9권2호
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• pp.138-152
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• 2002

The purpose of this study is to provide a basic data of home health care nursing centered in the hospital by analyzing home health care needs. Data were collected from June 15. 2000 to June 23. 2000 through questionnaires taken by 208 patients to be discharge in a general hospital. The Home Health Care Need instruments used for collecting data was developed by the researcher. The data obtained were analyzed using frequency. percentage. mean. standard deviation. Chi-square test. t-test. one-way ANOVA. Pearson's correlation coefficients. Cronbach's alpha coefficients and Factor Analysis. The results of the study were as follows: 1. The perception of home health care nursing were 65.4% of subjects had never heard about home health care service and 2.4% of subjects knew about the methods & contents in detail. About the demands of home health care, 58.2% of the subjects were willing to use home health care and 41.8% weren't. 2. Regarding the areas of home health care needs. basic nursing care area was the highest. Education/ counselling, exercise/ hygiene. therapeutic nursing care was orderly. Injection and medication management of basic nursing care area were the highest. 3. In relation to characteristic-related diseases and home health care needs. as for the discharge type, the existence of sores, paralysis showed significant differences with home health care needs in the area of exercise/ hygiene(p<,05). Home health care needs in the area of therapeutic nursing care and exercise/ hygiene showed significant differences with the existence of pain. Home health care needs in the area of therapeutic nursing and basic nursing areas were significantly different in the use of catheter/ assistant instrument(p<.05). Home health care needs in the area of therapeutic nursing. exercise/ hygiene and basic nursing care showed significant difference with diagnosis(p<,05). In conclusion, awareness about home health care nursing were very low, home health care needs in the area of basic nursing was the highest. Home health care needs showed significant difference with discharge type, sores, paralysis, existence of pain, use of catheter/ assistant instrument and diagnosis.

• 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.

• 간호행정학회지
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• 제5권3호
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• pp.415-424
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• 1999

The purpose of this study was to estimate the population requiring nursing home services for frail elders who received home care nursing services. This study identified the need of nursing home services and the proportion of elders over 60 years of age requiring nursing home services according to the admission eligibility including items with intensity of home care nursing services and the criteria for screening of patients requiring home care nursing services. In this study, survey research design was conducted. A total of 49 home care nurses were collected. They were asked to assess the need of nursing home services based on items with intensity of home care nursing services and the criteria for screening of patients requiring home care nursing services. Using secondary data analysis from the survey on 'The Evaluation of Home Care Nursing Service Program in 1994 in Korea', the proportion of elders requiring nursing home services was estimated. The estimated numbers and proportion of frail elders requiring nursing home services were 169 (86.2%) aged persons among community dwelling elders based on admission eligibility. However, the proportion of aged persons was 68% using the only criteria for screening of patients requiring for screening home care nursing services.

• 가정∙방문간호학회지
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• 제18권1호
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• pp.48-57
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• 2011

Purpose: The aim of this study was to develop and to analyze the task of hospital based home care nurse practitioners in Korea. Method: The definition of home care nurse practitioners and job description was developed based on developing a curriculum(DACUM) by 7 panels who have experienced in home care nursing. One hundred fifty four nurses who were working at hospital based on home care were participated. Result: Fourteen kinds of duties were identified : the selection of home care patients; basic home care nursing; advanced home care nursing; patient/family education and counseling; medical decision making and coordination of patient service; management of home care supplies and drugs for patients; management of medical records; management of home care the agency; management of home care personnel; management of the home care supplies for agency; home care public relations; improvement of home care quality; management of long-term care service; and self-improvement. Ninety-six tasks were classified. Conclusion: The abilities for quality improvement and the advanced nursing practice of home care nurses should be empowered.

• 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.

• 기본간호학회지
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• 제7권1호
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• pp.122-136
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• 2000

Stroke patient needs rehabilitation after receiving an acute treatment in a hospital. When stroke patient gets involved in an early discharge program, home care nurse plays a pivotal role to make them to gain a full strength and to come back to his/her prior life before he/she is sick. In spite of the importance of home care nursing intervention protocol for home care nurses to perform home care nursing autonomously, home care nursing intervention protocol for stroke patient is rarely developed. Therefore this study was conducted to develop home care nursing protocol that is applicable for stroke patients in home care nursing area. 41 home care nursing charts for stroke patients registered in home care nursing agencies from December 1st 1994 to August 31st 1999 at Y hospitals in Seoul and Won-Ju city were analyzed. 44 home care nurses who were having over three years' experience on stroke patients were participated in this study as a user validity validation group. The results of this study are as follows. 1. 28 nursing diagnoses were selected on the basis of evaluation of nursing diagnoses of stroke patients presented in a previous literature and case studies on home care nursing. 2. 17 nursing diagnoses were classified through the frequency analysis of home care nursing charts for 41 stroke patients who had received home care nursing. The order of sequence was like these: impaired skin integrity, risk for infection, nutritional deficit, impaired physical mobility, constipation, knowledge deficit, ineffective airway clearance, anxiety in family members, risk for aspiration, self care deficit, altered urinary elimination, ineffective individual coping, social isolation, risk for injury, self-esteem disturbance, impaired verbal communication, fatigue of family caregiver. 3. Based on validation on expert and user validities, 44 nursing interventions which were above ICV=.80 were chosen. 4. Nursing intervention protocols which showed above ICV=.90 were developed and were like these; pressure ulcer care, position change, preventive care for circulatory dysfunction, tube care : catheter, vital sign monitor, constipation/impaction management, artificial airway management, suction of airway secretion, environmental management : safety, and fall prevention.

• 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.