• Journal of Korean Academy of Nursing
• /
• v.34 no.3
• /
• pp.449-457
• /
• 2004

Purpose: The aim of this study was to analyze economical efficiency of home care service by comparing a cost-utility ratio(CUR) between home care and hospitalization. Method: The analytic framework of this study was constructed in 5 stages: Identifying the analytic perspectives, measurement of costs, measurement of utility, analysis of CUR, and sensitivity test. Data was collected by reviewing medical records, home care service records, medical fee claims, and other related research. Result: The mean of the annual total cost was 23,317,636 Won in home care and 73,739,352 Won in hospital care. QALY was 0.389 in home care and 0.474 in hospital care, so CUR was 299,712,545 QALY in home care and 777,841,266 QALY in hospital care. Conclusion: The findings affirmed that home care had an economical efficiency in the aspect of utility compared to hospitalization. Therefore, the findings of this study can be used to develop a governmental health policy or to expand the home care system. In addition, the cost-utility analysis framework and process of this study will be an example model for cost-utility analysis in nursing research. Therefore, it will be used as a guideline for future research related to cost-utility analysis in nursing.

• Journal of Korean Academy of Nursing
• /
• v.30 no.6
• /
• pp.1580-1591
• /
• 2000

This study was conducted to assess the amount of nursing services for psychiatric inpatients and to estimate psychiatric nursing costs by using the RBRVS. Full details of medical services, including physician and nursing services, for psychiatric inpatients were surveyed and data of general characteristics of hospitals and patients were also collected. The cost of nursing activities was estimated by the multiple conversion factor which was drawn from the Korean RBRVS Development Project to the RBRVS score of each nursing activities, which was drawn from the results of Korean Nurses Association (KNA)'s projects about nursing RBRVS development and cost of nursing activities. The data about 89 inpatients from 3 general hospitals with psychiatric departments were analyzed. The total cost of nursing activities for each patient per admission day was from KRW 22,185 to KRW 27,954 by hospital, and KRW 25,220 in average. The percent of nursing cost to the total cost of medical services was from 36% to 48% by characteristics of patients and 41.4% in average. The cost of nursing activities estimated in this study was between the existing NHI fee schedule and the one suggested by KNA. It is considered as appropriate and acceptable level compared to the total amount of medical services. In the process of KNA's activities to get nursing fee in NHI fee schedule, results of additional studies to estimate the cost of nursing activities balanced with total cost of medical services in every departments should be found and utilized.

• Research in Community and Public Health Nursing
• /
• v.27 no.3
• /
• pp.272-283
• /
• 2016

Purpose: This is a comparative study using secondary data from the Korean national long term care (LTC) insurance. Methods: Visiting nursing (VN) service users (n=666) and non-users (n=4,375) were extracted and compared in terms of medical expenditures, length of hospitalization, and annual number of ambulatory care visits to investigate effects of VN services in LTC. Results: Total health care expenditures were compared between the two groups and it was found that VN service users spent about $ 1700 than non-users for their medical costs between 2009 and 2011. The average length of in-hospital stay for VN service users was 19.4 days shorter than that of non-users. However, using VN services did not significantly influence the annual number of ambulatory care visits. Conclusion: The study has found that VN services are effective ways of providing community-based LTC services. We recommend LTC policy makers to further utilize VN services to deliver cost effective health care services.

• Research in Community and Public Health Nursing
• /
• v.12 no.3
• /
• pp.589-599
• /
• 2001

The purpose of this study was to analyze the relation amongst health status, health care costs. health service utilization among the low income elderly who were 60 years of age or older, earning a half of the average Korean family income. The cross-sectional descriptive survey research we conducted used families randomly sampled nationwide. The data were collected from July 12 to August 7, 1999 and the total sample was 1.259 household members (421 households). These were the major findings. 1. As for the health status. 72.4% of respondents fell ill in the last 1 month; 54% of respondents had chronic disease. 2. As for the health care cost. the cost of hospitalization and the medical treatment were 1.069,000 won and 226.000won. respectively. 59.3% of respondents experienced a burden from the monthly health care expenses. 3. As for the health service utilization for the last 3months. 28.5% of respondents didn't utilize the health service. In addition, 22.2% of respondents gave up a medical treatment because of economic situation (88.8%). 4. The statistically significant determinants of health service utilization are old age, female, living with a spouse, unemployed state, medicare, and more days sick. 5. It is shown conclusively that equity and efficacy of the health care policy are to be considered for lower income older adult.

• Health Policy and Management
• /
• v.24 no.3
• /
• pp.283-290
• /
• 2014

Background: This study aimed to examine the relationship between home-visit nursing services and health care utilization under the public long-term care insurance program in Korea. Methods: We analyzed the long-term care need assessment database and the long-term care and the health insurance claim databases of National Health Insurance Service between July 2011 and June 2012. The sample includes a total of 20,065 home-visit nursing recommended-older beneficiaries who use home-visit nursing and/or home-visit care, based on a standard benefit model developed by the Health Insurance Policy Institute of National Health Insurance Service. The beneficiaries were categorized into home-visit nursing use and non-use groups, and the home-visit nursing use group was again divided into high-use and low-use groups home-visit nursing, based on their total annual home-visit nursing expenditure. Two-part models and negative-binomial regression models were used for the statistical analysis. Results: The home-visit nursing use was negatively associated with the number of outpatient visit and cost, while adjusting for all covariates. The home-visit nursing use was also negatively associated with the inpatient cost among the high home-visit nursing use group. Conclusion: The findings implies home-visit nursing use prevents health care utilization. Further studies and policy strategies that can promote and strengthen home-visit nursing services under the public long-term care insurance are necessary in Korea.

• Journal of Home Health Care Nursing
• /
• v.8 no.1
• /
• pp.74-84
• /
• 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.

• Research in Community and Public Health Nursing
• /
• v.32 no.3
• /
• pp.356-367
• /
• 2021

Purpose: This study conducted an economic evaluation of hospital-based home care services for the patients who had undergone breast cancer surgery. Methods: A total of 12,483 patients over 18 years of age who had received breast cancer surgery in 26 tertiary hospitals in 2018 were analyzed with the claim data from the Health Insurance Review & Assessment Service using cost-minimization analysis and societal perspectives. Results: There were 156 patients who utilized hospital-based home care services within 30 days after breast cancer surgery, and they received 2.17 (SD=1.17) hospital-based home care service on average. The average total cost was 5,250,028 KRW (SD=1,905,428) for the group receiving continuous hospital-based home care and 6,113,402 KRW (SD=2,033,739) for the group not receiving continuous hospital-based home care (p<.001). The results of the economic evaluation of continuous hospital-based home care services in patients who had undergone breast cancer surgery indicated a total benefit of 953,691,000 KRW, a total cost of 819,004,000 KRW, and a benefit-cost ratio of 1.16 in 2018. Conclusion: Continuous hospital-based home care was considered economically feasible as the total costs for the group receiving continuous hospital-based home care were lower than those of the group not receiving continuous hospital-based home care. Therefore, policy modification and financial incentives are recommended to increase the utilization of hospital-based home care services for patients who had undergone breast cancer surgery.

• Journal of Home Health Care Nursing
• /
• v.20 no.2
• /
• pp.141-151
• /
• 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.

• Journal of Korean Academy of Nursing
• /
• v.24 no.2
• /
• pp.216-225
• /
• 1994

The cost of hospice care should be covered by the insurance system if it is to be promoted in our country and this, in turn, requires a proper method to the estimate of this cost. The purpose of this study was to set up the method to estimate the cost of hospice care. First the cost effectiveness of hospice care were studied. By tracing the activities of hospice nurses for a given period, all the relevant data such as the scope and load of activities as well as the cost were collected. Then these were analysed and compared with the data obtained from hospice and home care. The results showed that the cost of hospice care was the most economic, and indicate its qualification as .1n in-dependent system. The main part of the cost of hospice care was found to be the labor cost which was up to 83% of the total. Therefore a method to estimate the cost should reflect the real labor cost. Several methods have been proposed in the study in terms of unit labor cost, service time, material cost, and the weight of the labor cost. All variables, including the service time surveyed in this study, can easily be translated into numerical values and it would not difficult to estmate the cost of hospice care. Hence by letting the hospice care be insured, hospice care can be expected to function as a good alternative to the present medical system.

• The Korean Journal of Health Service Management
• /
• v.10 no.2
• /
• pp.49-58
• /
• 2016

Objectives : The purpose of this study was to find factors affecting the cost-reduction practice of clinical nurses. Methods : The Data were collected from Feb. 25, to Mar. 15, 2015.the Total subjects were 201 nurses working in secondary-care hospitals located in Busan Results : The Meaningful variables that explain the cost-reduction practice in clinical nurses were psychological ownership, religion, and marital status in that order. Total explanation power was 22.1.% and psychological ownership has most explanation power. Conclusions : Psychological ownership and economic consciousness need to improve to develop cost-reduction practices. Additionally, nurses with and low concern about finances need to receive financial-related education.