• 한국보건간호학회지
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• 제24권1호
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• pp.61-70
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• 2010

Purpose: This study analyzed outcomes of a Telecare case management service pilot project for Korean Medicaid Program Clients in Seoul. Outcome data for provided services and medical aid cost data were analyzed. Methods: Case management services were delivered by 10 medical aid managers. The period of the project was from July to December 2007. Results: The total number of the objects was 9714, representing 43.4% of the total medical aid clients in the area. The average number of consults was 2.58. Consults were most frequently via letter and telephone, with in- person visits being least common. Of the total, 213 cases were referred to community services, 87.8% were transacted successfully. The medical expenditure was less than that from January-June, 2007. Conclusion: Telecare service via mail or telephone allows contact with many clients in a short time which can enable the discover and monitoring of high risk clients. This can be accomplished at a cost savings to the Korean Medicaid Program.

• 가정∙방문간호학회지
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• 제10권1호
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• pp.52-57
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• 2003

The purpose of this study was to evaluate appropriateness of home health care travel cost. For the evaluation, investigated the operating costs of vehicles used by home care nurses and then were components of home care nurses's annual salaries. Travel costs were then calculated based on actual travel expenses of home health care service. Actual data of 23 hospital-based home care agencies between July, 2002 to December, 2002 were collected for the analysis of the travel costs. The results of this study are : 1) For home visit, 65% of home care agencies turned out to be using only hospital owned cars, and 17.1% be depending purely on home care nurses' cars. On average, 1.9 cars used for home visit. 2) Out of 89 agencies, 23 agencies responded to the travel cost survey. Total maintenance cost of a car per month was 381,457 won. 3) Average per visit personal expenses of home care nurses during travel time turned out to be 7,124won assuming 8 working hours per day, 4 visits per day, and 30 minuets of travel time for each visit. 4) Total home health care travel cost per visit was 12,069 won, which was the sum of actually paid travel cost of 4,945 won and personal expenses during travel time of 7,124. In conclusion. we reckon that current compensation price of home care nurses' travel is inappropriate because total home health care travel costs of 12,069 won per visit turned out to be 2.1 times of currently prevailing standard compensation price of 5,830 per visit.

• Perspectives in Nursing Science
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• 제6권1호
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• pp.77-83
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• 2009

The number of nurses per bed at acute-stage hospitals is quite low in Korea compared with other OECD countries. In order to prevent the degradation of the quality of inpatient nursing services due to insufficient nurse staffs, the national health insurance introduced the differentiated nursing care fee system. This did not work as a motive for inducing the employment of nursing staff due to insufficient cost compensation. Because of insufficient nursing staff, family members have to stay with the patient or patients have to hire a personal care attendant. This increases the burden and cost to families. For the activation of hospitals without guardians, there should be policies for raising additional nursing staff such as standardizing jobs among nursing staff, particularly between nurses and nursing assistants, setting adequate standards of staffing in nursing according to medical service, substantiating the cost of nursing under the differentiated nursing care fee system, improving the medical fee system of hospitals without guardians including health insurance payment, supplying nursing staff stably through improving their working conditions such as providing child rearing services and salary increase, clarifying the qualification of personal care attendants working at acute.stage hospitals, developing indexes for assessing the quality of nursing care services, and monitoring for the management of uniform quality.

• 기본간호학회지
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• 제10권3호
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• pp.300-306
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• 2003

Purpose: This study was done to help provide patients with information on medical insurance cost through medical insurance education for nurses, to increase effective management, check on omissions in treatment and appropriateness and accuracy of fees, and to contribute to the economic growth of hospital by providing nurses with necessary knowledge about medical insurance cost. Method: The participants in this study were clinical nurses in general hospitals. The study instrument was a questionnaire developed by the researcher through reference to data for medical insurance education. The data were analyzed with percentages, means, ANOVA, and Duncan method using SPSS PC+10. Result: The results on knowledge of medical insurance according to general characteristics of the nurses showed that there were significant differences according to age: (p=.0036) highest level of education (p=.0007), position (p=.0010) and place where education on medical insurance was received (p=.0093). Conclusion: Continuous in-service education for clinical nurses is reflected in increased knowledge about medical insurance costs but special attention needs to be given to younger nurses and nurses with less education, as well as staff nurses, and those nurses who only received education on medical insurance during their schooling. Accordingly, in-service education is necessary for nurses at the time of orientation so that they have knowledge on standards for recuperation allowance, guidelines to calculate material costs, and guidelines to calculate drug rates. In addition, as medical insurance cost frequently change, all nurses need continuous in-service education.

• 대한간호학회지
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• 제32권3호
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• pp.344-354
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• 2002

This study is a fact-finding research to understand the status of visiting nursing services operated by health centers in Korea and it aims to provide basic information for policy development on operation and management of visiting nursing services in health centers. Method: This study investigates the results of visiting nursing services in 242 health centers from Jan. 10 through Dec. 30, 2000, where 3,106 visiting nurses were employed by the public work program. Result: In 2000, 129,401 new household as service recipients was identified and that was 0.9% of Koreas total households (15,137,000), and 5.8% of low income households (2,242,000). The highest high risk group was dementia patients(aver. 55.2/1,000 person). Average number of households visited by visiting nurse were 4.5 households per day and the first-visited houses per visiting nurse were 1.1 households per day. The re-visiting rate was 71.3%. Total 4,059,130 service items were provided and assessment ranked the highest with 33.7%. The satisfaction level of clients on the nurses was an average of 3.17 points in the scale of 4 and the nursing service was a 2.60 points in a scale of 3. Conclusion: Visiting nursing service should continue to provide comprehensive healthcare services in cost-effective ways while cooperating with others

• 지역사회간호학회지
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• 제12권1호
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• pp.22-31
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• 2001

Purpose of this study is to compare the cost effectiveness of home care services for the cerebrovascular accident patients by the type of institution. The method is the secondary analysis using the patients' charts. 107 subjects and 1.417 visits were sampled from each type of home care institution such as one hospital based home care center. one KNA home care center, one urban health center, one rural health center and one health care post. Result: There were differences in the functional status of patients and the service contents and frequencies provided by the type of home care institution, The cost per visit for one unit of ADL by the hospital based home care was higher than by the community-based home care. Conclusion: It was suggested that the referral system among the home care institutions would be developed to improve the cost-effectiveness.

• 대한간호학회지
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• 제43권4호
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• pp.507-516
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• 2013

Purpose: The purpose of this study was to use cost-benefit analysis of activity to clarify the economic effect of prepared nurses versus atmospheric environment managing engineers as healthcare managers. Methods: For the study 111 workplaces were surveyed, workplaces in which nurses or atmospheric environment managing engineers were employed as healthcare managers. The survey content included annual gross salaries, participation in external job training, costs in joining association covered by the company, location and year of construction of the healthcare office, various kinds of healthcare expenditures, costs in operating healthcare office, health education, and activity performance in the work of environment management. Results: In the case of the healthcare manager being a nurse, benefit was larger than input costs at a ratio of 2.31. On the other hand, in the case of healthcare manager being an atmospheric environment managing engineer, input costs were larger than benefits (benefit-cost ratio 0.88). Conclusion: Results indicate that nurses are an effective healthcare human resource and can offer good quality healthcare service. Therefore companies should hire nurses and actively promote the economic efficiency of nurses in workplace.

• 여성건강간호학회지
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• 제24권1호
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• pp.24-32
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• 2018

Purpose: To determine traits related to pregnancy and delivery, length of stay, health care cost, postpartum discomfort, and satisfaction with medical service of puerperas giving birth in midwifery clinic and hospitals. Methods: This study used a comparative survey design. Data were collected from a total of 140 postpartum mothers composed of 70 mothers who gave births in two hospitals and another 70 mothers who delivered in one midwifery clinic. Results: Delivery in midwifery clinic had higher Apgar score at 1 minute and 5 minutes after birth than hospital. Those who delivered in midwifery clinic had shorter stay in the clinic, fewer health care cost, less postpartum discomfort in physical, environmental, social, and cultural areas, higher satisfaction with medical services than those who delivered in hospitals. Conclusion: Results of this study can be used as a basis for studies on giving birth in midwifery clinic and hospitals. They might increase the autonomy of women in giving birth with positive effect on the delivery experience of the mother and her spouse.

• 간호행정학회지
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• 제11권4호
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• pp.449-467
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• 2005

Purpose: This study aims to offer the fundamental data in order to cost the nursing service on the basis of the NIC and a close examination of the interventions that are contained in the health insurance cost list under the system of the current health insurance. Methods: The data is handled with the SPSS 10.0 program. The participants' general peculiarity is calculated in terms of the real number and the percentage, and the performing frequency of the nursing interventions is calculated in terms of the mean and the standard deviation. the correlation between the participants' general peculiarity and the performing frequency of the nursing interventions is analysed with t-test or one way ANOVA of SPSS. Results: In the performing frequency of the nursing interventions, the domain of "the physiological: basic" was the highest as 2.69${\pm}$1.21, the domain of "the behavioral" was the lowest as 2.11${\pm}$1.12. There were 50 core interventions in the medical unit, 48 in the surgical unit, 24 in the MICU and 33 in the SICU. The health insurance cost items contained commonly in the core interventions of each unit were 12, and the health insurance cost items except 12 items contained commonly in the core interventions of each unit were appeared 14 items in the medical unit, 6 in the surgical unit, 7 in the MICU and 2 in the SICU. The core interventions contained commonly in four units of the medical unit, the surgical unit, the MICU & the SICU are 18. And among these, the core interventions contained in the health insurance cost items are 10; pain management, hyperglycemia management, analgegic administration, medication administration: intravenous, oxygen therapy, pressure ulcer prevention, fluid management, fluide monitoring, intravenous(IV) insertion, intravenous(IV) therapy. As the result of the comparison & analysis between the core interventions of the NIC and the health insurance cost items, the core interventions contained in the health insurance cost list are 21(29 as the health insurance cost items). Conclusion: In the performing frequency of the nursing interventions, the domain of "the physiological: basic" is being performed most frequently, and in the performing frequency of the core interventions, the interventions of the domain of "the physiological: complex" is being performed most frequently. On the basis of these results, the writer hopes that the attempts to interlink the nursing interventions into the nursing cost by using of standard terms and the efforts to cost the nursing services would also be made in the future constantly.

• 대한간호학회지
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• 제34권1호
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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.