• Health Policy and Management
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• v.31 no.4
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• pp.387-398
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• 2021

Moon Jae-in Care can be seen as a 2.0 version of Roh Moo-Hyun Care. Just as Roh Care failed to achieve its coverage rate goal and 30% share of public beds, Moon Care also failed to achieve its expected goal. The reason is that it followed Roh Care's failed strategy. Failure to control non-covered services has led to a long way to achieve a 70% coverage rate and induced the expansion of voluntary indemnity insurance, resulting in increased public burden. The universal coverage of non-covered services caused an immediate backlash from doctors. And Moon government also failed to control the private insurance market. The expansion of publicly owned beds has not become realized and has not obtained public support. Above all, it failed to overcome the resistance of doctors and failed to obtain consent from budget power groups in the cabinet for public investment. It was also insufficient to win the support of civic groups. Communication with interested groups failed and the role of private health care providers was neglected. The next government should also continue to strengthen health care coverage, but it should prioritize preventing medical poor and create a consensus with both medical providers and consumers for the control of non-covered services. Ahead of the super-aged society, the establishment of linkage between medical services and long-term care and visiting health care or welfare services is an important task. All public and private provisions and resources should be utilized in the view of a comprehensive public health perspective, and public investment should be input in sectors where public medical institutions can perform more effective functions. The next government, which will be launched in 2022, should design a new paradigm for health care in the face of a period of transformation, such as the coming super-aged society in 2026 and the Fourth Industrial Revolution, and recognize that the capabilities of the health care system represent the nation's overall capacity.

• Research in Community and Public Health Nursing
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• v.15 no.2
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• pp.177-186
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• 2004

Purpose: The purpose of this study is to analyse time taken for visiting nursing activities by visiting nurses in health centers. Method: A questionnaire was developed by a research team for the technological support of visiting nursing activities and visiting nurses. A total of 481 questionnaires were recovered by five visiting nurses from May to October 2003. Result: A visiting nurse's total length of time for visiting activities was 532.2 minutes per day and the number of households a visiting nurse visits a day was 4.5. A visiting nurse spent 133.3 minutes for actual nursing services and 119.1 minutes for travelling. Time for actual nursing activities was more than half of the total working hours. Time for travelling was 42.9 minutes on the average when using public transportation means and 25.6 minutes when using a car. Conclusion: The results of this study is expected to be used as basic data in establishing plans for the adequate supply of visiting nurses based on demands for visiting nursing services.

• Journal of Home Health Care Nursing
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• v.26 no.3
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• pp.253-264
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• 2019

The aim of this review is to present a German system of an outpatient care center under the German Health Insurance Act and home care (integration of medical care, basic care, bathing) under the Long-Term Care Insurance Act. This idea of a German integrated home care system should contribute to the development of a Korean home care model. Prior the introduction of long-term care insurance (1995), and with the of the health insurance law (1989), German outpatient care centers already provided medical and basic care services for patients with acute and chronic symptoms. Since 1995, patients with acute symptoms and rehabilitation periods under the Health Insurance Act have been eligible for home care. The Long-Term Care Insurance Act is intended for all citizens who are unable to carry out their daily activities for more than six months. In 2017, 13,657 (97%) of 14,050 outpatient care centers provided home care services after long-term care and health insurance. In other words, patients in Germany can use home care in both the acute and chronic phase at the same home care center, or 'integrated home-care center'.

• Research in Community and Public Health Nursing
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• v.30 no.4
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• pp.528-538
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• 2019

Purpose: The purpose of this study was to follow-up the frailty of the old who received home health care by Registered Nurse in Public Health Center over 8 years. Methods: We used the second wave data which was a comprehensive longitudinal data set, Public Health Information System of a public health center located in Seoul from 2010 to 2018. For statistical analysis, a mixed model of repeated measures by R program was used. Results: Frailty (range: 0~31) was getting worse significantly from 5.38 on registration to 6.54 on 4th year, 7.40 on 7th year, 7.69 on 8th year with adjustment for age, sex, economic status, the number of family, and the number diseases. The coefficient of parameters with frailty change was serviced year (β=0.29, p<.001), age (70~79 to 60~69; β=0.98, p=.018) and sex (female to male; β=2.55, p<.001). Conclusion: This study showed that the home visiting health service needs to take attention to aged 70s and over, female. The home health care of public health center need to be extended more practical and effective services in terms of 'community care'and 'ageing in place'.

• Research in Community and Public Health Nursing
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• v.15 no.1
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• pp.56-66
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• 2004

Objectives: The purpose of this study was to verify a change for family nursing phenomena and satisfaction of clients of vulnerable families in an urban community. Methods: The study subjects were 711 families, randomly selected, who had chronic diseases(arthritis diabetes, stroke, hypertension, mental disease, cancer, dementia) with basic social welfare services from the nation and had disabled persons in an urban community, South Korea. The instruments used were the family nursing phenomena in Korea by ICNP and client satisfaction. Client satisfaction consisted of client satisfaction on home visiting nurses(4 Likert scales) and home visiting services(3 Likert scales). Results: The average visiting number is 3.82. The service number of education and counseling is 3.16, patient and symptom management 3.08, assessment and diagnosis 3.08, test 2.02, medication service 1.71회, dressing 1.01, referral to social welfare institute 1.00회, referral to medical service institute 0.21. In both, pre home visiting and post home visiting, the highest rated phenomenon was the 'lack of social support system' and following that 'deficit of financial management skill and support'. 'lack of family interaction in community', and 'social isolation' 'unhealthy life style' and 'inadequate care management of sick member', in that order. The percentages of phenomena besides 'deficit of financial management skill and support' decreased. The satisfaction level of clients towards the nurses was 3.27 points on a scale of 4, and the nursing services was 2.70 points on a scale of 3. Conclusion: Home visiting nursing services should continue to provide comprehensive healthcare services and support for vulnerable families, in urban communities.

• Physical Therapy Korea
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• v.29 no.2
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• pp.94-105
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• 2022

Background: As South Korea enters an aged society, the government has emphasized the need for a soft landing of the older adults into the community after the acute and recovery periods under a national policy of "community care." However, the institutionalization of community rehabilitation services to implement this is insufficient. Japan had already entered an aged society when the Long-Term Care Insurance System was introduced in 2000. Thus, the case of Japan's institutionalization of the system is expected to have implications for us in supplementing a suitable system for the aged society. Objects: This study compared the institutionalization process of the Long-Term Care Insurance System in South Korea and Japan and the services currently being implemented in each country. Methods: To examine the institutionalization process and services of the system, related legal rules and regulations, government reports, and articles were reviewed. To examine the operation status of the system, statistical data provided by each country's government were analyzed. Results: Japan recognized the importance of community rehabilitation even before the enactment of Long-Term Care Insurance. Thus, community rehabilitation services, such as home-visit rehabilitation and health facilities, were already stipulated in the law. Under such institutional legacy, Long-Term Care Insurance was able to establish a service system, which balanced welfare and health-related services, including various types of services with enhanced rehabilitation functions. In South Korea, rehabilitation policies were not much considered in the process of institutionalizing the system; thus, it was composed mainly of services focusing on care and recuperation. Conclusion: In order to realize community care, rehabilitation services need to be developed in Long-Term Care Insurance System in various forms such as home-visit services, daily services, short stay, and facility services.

• Journal of Korean Academy of Nursing
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• v.34 no.6
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• pp.983-993
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• 2004

Purpose: This study focused on analysing costs per visiting nursing care based on nursing activities in a public health center. Method: The Easley-Storfjell Instrument(1997) was used for a prospective descriptive analysis of self-records for workload data from 10 visiting nurses during 4 weeks on all nursing activities. In addition, analysis of the 478 visiting nursing records and cost data from 5 home visiting departments in public health centers during one year of 2003 was done. Result: The workload of visiting nurses by the type of model was identified as follows: Type I showed that caseloads made up 32.9 % of all nurse activities, and type II showed that the caseloads made up 45.8 %. Second, The cost per visit in type I was 33,088 won and 31,323 won in type II. Third, the estimated budgets were 1,902,436 won to 12,057,696 won for the type I model. and 4,151,316 won to 17,432,712 won for the type II model for one year. Conclusion: This study's results will contribute to baseline data used to establish on infrastructure for visiting nursing program and visiting nursing agencies based on the budget of visiting nursing services.

• Journal of Korean Public Health Nursing
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• v.35 no.3
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• pp.430-447
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• 2021

Purpose: The purpose of this study was to analyze the role and tasks of nurses who were working for the elderly in the visiting health services at the public health centers. Methods: Literature reviews, two rounds of meetings with 5 experts and a two-round Delphi technique with 15 experts were performed in this study. Results: The nurses' role and job analysis revealed 5 roles, 16 duties and, 71 tasks. The nurses' roles, including discovery and registration of households/groups in visiting health service in the community, case manager, administrative management, program planning, operation and evaluation, and development of job competency. Sixteen duties included client registration and management, need assessment and plan establishment, education, consultation and support, seasonal health care, prevention and monitoring of infectious diseases, basic nursing care, chronic disease management, linkage and utilization of resources, team cooperation and coordination, home environment management, monitoring and support for intervention outcomes, evaluation, administrative management, program planning, operation and evaluation, development of professional competency and, adoption of fourth industrial revolution technology. Conclusions: Based on the results, the government should provide sufficient nursing personnel to provide universal preventive health services for the elderly and a job training program to perform these roles well.

• Journal of Home Health Care Nursing
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• v.22 no.1
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• pp.22-37
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• 2015

Purpose: This study aimed to compare the health service delivery level and educational needs by work experiences and types of public health center among the nurses who work as visiting health services workers at public health centers. Methods: Data collected from 484 nursing staff for 2 weeks, was analyzed using the SPSS program t-test, ANOVA, and Spearman Rank-Order Correlation. Nurses with more than 2 years experience were 79.1%; and 43.6% of the subjects worked within Gun type public health centers. Results: The health service performance frequency of metropolitan city type public health centers was significantly high in the areas of education, behavior pattern, chronic disease, pregnant women & infants, and multi-cultural family. The health service performance frequency of Gun type public health centers was significantly high in the areas of type of test, fundamental nursing, and basic rehabilitation. In addition, the correlation between the performance frequency and educational needs was positively correlated, and the subjects with greater educational needs performed more. Conclusion: Educational programs should be designed according to the types of public health centers rather than work experiences, especially in systematic training for frequently performed items after reviewing the practice precisely.

• Journal of the Korean Geographical Society
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• v.44 no.6
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• pp.813-832
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• 2009

As accessibility to health-care service in less populated rural areas is geographically limited and demand for public health-care by the aging is increasing, a new approach for health-care service such as a home care service is becoming more popular. For a home care service, health-care personnels directly visit to location of health-care clients. Such changes in provision of health services require developing innovative and scientific approaches for efficient allocation of health resources and managing services by public health-care organizations. The purpose of this study is to formulate a location model for visiting health-care districting for the rural elderly and to develop an Automated Zoning Procedure (AZP) to solve this model. Mobility, workload balance and contiguity criteria are considered in the model. Three different objective functions are evaluated; 1) minimizing the sum of network distance between the unit areas in a district, 2) maximizing spatial interaction between the unit areas in a district, and 3) minimizing tour distance that visits each unit area exactly once in a district. The AZP for solving the model is developed and applied to a rural area. The application results demonstrate that the AZP can generate different districting systems for each objective functions.