• Title/Summary/Keyword: Hospital-based home health care

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Economic Evaluation of Visitng Nurse Services for the Low.;.income Elderly with Long-term Care Needs (도시 저소득층 만성질환노인을 위한 보건소 방문간호서비스의 경제성 분석)

  • 이태화
    • Journal of Korean Academy of Nursing
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    • v.34 no.1
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    • pp.191-201
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    • 2004
  • Purpose: This study aimed to evaluate economic viability of public health center visiting nurse services for the low-income elderly with long-term care needs. Method: The sample consisted of 252 community dwelling elderly who enrolled in public health center visiting nurse services for three months or more. Data was collected on physical (ADL and IADL) and cognitive impairments of the elderly, contents and frequency of visiting nurse services, cost per visit, and costs of alternative services for long-term care. Result: The mean score of ADL and IADL levels of the elderly was 2.80.4904, which indicated these patients were mostly independent. Eighty four percent of the elderly subjects were cognitively intact. Among visiting nurse services supplied, providing assessment was 34%, followed by education and counseling 26%, medication 22%, and referral. The mean cost per visit was 17,824.1 won, which transformed into a total cost per person per year of 161,130.2 won. Comparing the cost of a visiting nurse service with those of other long-term care alternatives, the visiting nurse service was the least costly alternative, followed by an outpatient clinic, hospital based home care, and nursing home. Conclusion: Overall, the results of the study provide evidence of the economic viability of visiting nurse services for the low-income elderly among long-term care alternatives.

Evaluation of Efficiency of Outpatient Clinic in a General Hospital using Data Envelopment Analysis (DEA) (일 종합병원 외래간호단위의 효율성 평가 -자료포락분석법(Data Envelopment Analysis)의 적용)

  • Im, Hye-Bin;Lim, Ji-Young
    • Journal of Home Health Care Nursing
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    • v.19 no.1
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    • pp.11-18
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    • 2012
  • Purpose: The aim of this study is to evaluate the efficiency of the outpatient clinics in a hospital, using DEA. Methods: Data were collected using an activity-based costing system, medical information system, and annual reports of customer satisfaction management team of a general hospital in a city. The input variables were the number of doctors, the number of nurses, and the number of staffs. The output variables were the number of treatment times, the number of outpatient clinic patients, the total profits from outpatient clinic, the patient's satisfaction score, and the number of re-visit appointments. EMS Window version 3.1 was used to measure the efficiency score and benchmarking analysis. Results: The average efficiency score of 24 outpatient clinics was about 82.01%. Thirteen outpatient clinics had 100% efficiency score among them. The lowest efficiency score was 57.56%. Conclusion: According to these results, we found that, generally, outpatient clinics were operated very efficiently. However, some outpatient clinics had low efficiency and they needed specialized outcome improvement strategies. To increase the efficiency of inefficient outpatient clinics, we will recommend using results of DEA, as a benchmark point of the most efficient outpatient clinics.

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Nurses' Happiness: Integrative Literature Review and Meta-analysis (간호사의 행복: 통합적 문헌고찰 및 메타분석)

  • Kim, Eun Joo;Kim, Seong Kwang
    • Journal of Home Health Care Nursing
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    • v.28 no.3
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    • pp.243-255
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    • 2021
  • Purpose: This study was conducted to explore research trends on hospital nurses' happiness. Methods: Studies published from January 1, 2000 to December 31, 2020 were searched. At the first search, 1,898 articles were extracted from academic databases. Twenty-eight articles were used in the systematic review, and 20 included meta-analysis. Results: There were 38 variables explored in relation to nurses' happiness. The variables with the highest meta-analysis value were resilience, positive psychological capabilities, quality of nursing work life, and perceived stress on nursing performance measurement. Among the areas classified based on the nurses' happiness theoretical framework, personal factors (r=.60) and work environment factors (r=.51) showed high meta-correlation values. Conclusion: The relationship between the hospital nurses' happiness and work-related factor in various dimensions has been confirmed. Considering variables related to hospital nurses' happiness in the future, various programs at the individual level and organizational level should be developed.

Influence of Perception of Importance of Patient Safety Management and Culture on of Small and Medium-sized Hospital Employees' Safety Performance (중소병원 종사자의 환자안전관리 중요성과 환자안전문화 인식이 안전수행에 미치는 영향)

  • Kwag, Hee Jung;Yang, Nam Young
    • Journal of Home Health Care Nursing
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    • v.29 no.2
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    • pp.216-224
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    • 2022
  • Purpose: This study aimed to investigate the influence of the perception of the importance of patient safety management and culture on employees' safety performance in small and medium -sized hospitals. Methods: The participants comprised 119 hospital employees, including nurses, doctors, and medical technicians. Data were analyzed through descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients, and multiple regression analysis using the SPSS program. Results: The mean safety performance was 4.09±0.34, mean safety compliance was 4.12±0.44, and safety participation was 4.06±0.38. There were significant differences in safety performance by gender and job. Safety performance and its assocation with both perception of importance on patient safety management and, perception of patient safety culture showed a positive correlation. Safety performance was influenced by the perception of patient safety culture. The explanatory power was 15.7%. Conclusion: Based on these results, improving the perception of patient safety culture is necessary to increase safety performance. To this end developing and applying an interprofessional safety performance education program for employees in small and medium-sized hospitals is vital.

Long-term Policy Development for the Aged on Medical and Health Care Security (노인의료보장 및 건강관리를 위한 장$cdot$단기 대책)

  • Rhee Seonja;Lee Yoon Sook
    • Journal of Korean Public Health Nursing
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    • v.5 no.1
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    • pp.70-95
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    • 1991
  • The ageing problem of the population has been emerging in Korea since 1970's so that it is expecting the elderly 65 years and over among the total population from $4.5\%$ in 1988 to be $6.3\%$ in year 2000. This study was conducted to provide secure policy development in coming years for the aged on medical and health care aspects based on the examining current status of the aged problems and health care policies and systems. The study divided into four parts; The first part examined the medical insurance program and public assistance program of the health services in relation to the aged. The second part emphasized on reduction of medical care cost for the aged. The third part studied the regular health check-up program and health education for the aged. The fourth part examined the chronic disease management programs for the aged and strategies of the health care service quality improvement and specialized programs. The following recommendations made as the results of the study. 1. At present, the medical insurance program and public assistance program for the medically indigent is not appropriate to the elderly because it is a part of general medical insurance program so that Health Security Law for the Aged is proposed. 2. Medical cost will be increased due to the high occupancy rate of hospital beds and long stay of the elderly so that it is recommended to develop an early discharge program, home health care program, Health hospice and an althernative programs. 3. At present, a regular health check-ups for the elderly is not included in medical insurance program so that it is recommended to be included in the insurance program and at the same time health education program thoroughly developed for the aged. 4. To make proper medical and nursing services on chronic diseases for the elderly, it is recommended manpower development, specialized clinics or hospitals, nursing homes and an equivalent long term care facilitices should be established on the community based and a research institutions also to be related to supper the care programs.

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Cost Analysis of Home Care with Activity-Based Costing(ABC) (활동기준원가계산[ABC]을 적용한 가정 간호 원가 분석)

  • Lee Su-Jeong
    • Journal of Korean Academy of Nursing
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    • v.34 no.6
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    • pp.1117-1128
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    • 2004
  • Purpose: This study was carried out to substantiate the application process of activity-based costing on the current cost of hospital home care (HHC) service. The study materials were documents, 120 client charts, health insurance demand bills, salary of 215 HHC nurses, operating expense, 6 HHC agencies, and 31 HHC nurses. Method: The research was carried out by analyzing the HHC activities and then collecting labor and operating expenses. For resource drivers, HHC activity performance time and workload were studied. For activity drivers, the number of HHC activity performances and the activity number of visits were studied. Result: The HHC activities were classified into 70 activities. In resource, the labor cost was 245₩per minute, operating cost was 9,570₩ per visit and traffic expense was an average of 12,750₩. In resource drivers, education and training had the longest time of 67 minutes. Average length of performance for activities was 13.7 minutes. The workload was applied as a relative value. The average cost of HHC was 62,741₩ and the cost ranged from 55,560₩ to 74,016₩. Conclusion: The fixed base rate for a visit in the current HHC medical fee should be increased. Exclusion from the current fee structure or flexible operation of traveling expenses should be reviewed.

A Study of Hospital-based Home-Visit Nutrition Education Needs of Patients at Discharge (퇴원환자의 병원중심 방문영양지도 요구도 조사)

  • Ahn, Su Mi
    • Korean Journal of Community Nutrition
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    • v.19 no.4
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    • pp.386-400
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    • 2014
  • Objectives: The purpose of this study was to provide a basic data of nutrition services in home health care by analyzing hospital-based home-visit nutrition education needs of patients at discharge. Methods: Data was collected from September 11 to October 12, 2012 by administering questionnaires to 289 chronic disease patients to be discharged from a university hospital in Pusan. The home-visit nutrition education instruments used for collecting data were developed by the researcher. Results: Regarding the demands of home-visit nutrition education, 62.3% of subjects were willing to use home-visit nutrition education and 37.7% weren't. The main reason for using the home-visit nutrition education was "the effective nutrient management in consultation with an individual's doctor", 38.9% and 31.2% of patients who did not wish to use the service gave the reason for their decision as, "Just by managing the nutritional requirements of a family's diet and, the patient will be able to fully recover", respectively. As for the demand, classified with the areas of home-visit nutrition education, the demand for the area of basic nutrition (3.75/5.00) was the highest followed by, the area of educational nutrition (3.74/5.00), therapeutic nutrition (3.67/5.00), and dietary nutrition (3.55/5.00). The demand for the area of educational nutrition was high "Considering the state of dietary management, such as disease status and drugs", 73.7%. As for the relation between the characteristics of the study subjects and analysis of demand home-visit nutrition education, the characteristic of subjects, that is, "regular home-visit nutrition education", "practice of diet therapy after discharge" had a significant difference statistically (p < 0.01). As for the relation between the needs for fundamental home-visit nutrition education and the demand of home-visit nutrition education, basic nutrition, educational nutrition, therapeutic nutrition, and dietary nutrition had a significant difference statistically (p < 0.01).

Factors Relating to the Quality of Care for Nursing Home Residents in Korea: Using the Delphi Method

  • Shin, Juh Hyun;Kim, Eun Mee;Lee, Ji Yeon
    • Journal of Korean Academy of Nursing
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    • v.49 no.6
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    • pp.783-794
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    • 2019
  • Purpose: This study identified factors related to the quality of care in nursing homes, and elicited consensus opinions from experts on nursing homes. Methods: A Delphi questionnaire was developed based on a review of the literature using the keywords "nursing homes," "workforce," and "quality of care." A total of two Delphi surveys were conducted with 14 experts. The important and urgent factors related to the quality of care for nursing home residents emerged. Results: A consensus was achieved on the important and urgent factors relating to the quality of care. The related factors were grouped into four sections: Organizational Characteristics, Staffing Characteristics, the Long-Term Care Market and Legal and Policy Issues, and Nursing Processes. In total, 23 items were important factors and 26 items were urgent factors relating to the quality of care. In addition, the unanimous advocacy by the experts for increased hours per resident day for registered nurses (RNs, 41 minutes 59 seconds) was much higher than the current hours per resident day of RNs in Korea. Conclusion: To provide optimal care for residents in nursing homes in Korea, the mandatory and essential placement of RNs with professional knowledge and skills is paramount.

Effect of Web-Based Video Self-Management Education Program for Infection Prevention in Patients with Cancer Receiving Chemotherapy: A Preliminary Study (항암화학요법을 받는 환자를 위한 웹기반 동영상 감염예방 자가관리 교육프로그램 효과: 예비연구)

  • Ha, Boo-Young;Lee, Insook;Jeong, Seon-Gyeong;Jang, Chun-sun
    • Journal of Home Health Care Nursing
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    • v.27 no.3
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    • pp.294-305
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    • 2020
  • Purpose: The aim of this study was to examine the preliminary effects of applying a developed web-based video education program in patients with cancer receiving chemotherapy. Methods: A one-group pre-post test design was used. The web-based video education program to prevent infection consisted of 5 subjects. The program was confirmed to be valid by an expert group of doctors and nurses. Convenience sampling of 23 subjects was performed to evaluate the effectiveness of the web-based video education program. Data were analyzed based on nonparametric statistics using SPSS 25.0 software. Results: Per the results of the study, knowledge and self-management behavior of infection prevention significantly improved after application of the program; however, there was no significant difference in self-efficacy. Conclusion: It was confirmed that the web-based video education program is effective to improve the knowledge and self-management behavior of infection prevention. However, as a preliminary study, this study did not have external validity. Therefore, it is necessary to verify the effectiveness of the program through randomized controlled trials and confirm the true infection prevention effect that was not considered in this research design.

Implementation of Low-Power Ubiquitous Health System based on Real-Time Embedded Linux using ZigBee wireless communication (ZigBee를 이용한 실시간 임베디드 리눅스 기반의 저전력형 U-Health 시스템 구현)

  • Kwon, Jong-Won;Ayurzana, Odgerel;Park, Yong-Man;Koo, Sang-Jun;Kim, Hie-Sik
    • Proceedings of the KIEE Conference
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    • 2007.04a
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    • pp.436-438
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    • 2007
  • As the sensors and communication technology get advance, the remote health diagnosis for patients and senior persons at home are possible now without visiting doctors in hospitals. A low-power ubiquitous health check device was developed adapting Real-Time Embedded Linux is developed. This ubiquitous device is consisted of three sensors. The wrist type health checking terminal acquires periodically the health data by using a blood pressure sensor, a pulse sensor and a body temperature sensor. It transmits the health data to the access point located at the home center through the ZigBee wireless communication modem. This health data collector or access point device sends the data again to the main server operated in a hospital or health care organization. The health server control continuously the input data and sends an alarm signal to the assigned. doctor and responsible persons using cellular SMS when any dangerous events occur. This wrist type health check device has an embedded linux OS using Intel PAX255 MPU. The developed U-Health system is applicable for checking patients health in remote at home. And their family or related persons in remote site can check the patients health status at any time. They can be assured by receiving SMS record and alarm of emergency case which is transmitted from the health server.

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