• Title/Summary/Keyword: daily average medical expenses

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A Study on Effectiveness of the Hospital-based Home Nursing Care of the Early Discharged Surgical Patients and its Cost Analysis (조기퇴원 수술환자의 병원중심 가정간호 효과 및 비용분석에 관한 연구)

  • 박경숙;정연강
    • Journal of Korean Academy of Nursing
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    • v.24 no.4
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    • pp.545-556
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    • 1994
  • Medical insurance and health care delivery system enabled Korean people to get the necessary medical service, but it caused increased needs for medical service, and resulted in the occurence of some problems such as a lack of manpower and medical facilities. In order to solve these problems, many countries, which already had medical insurance system had developed home care system and it has been regarded effective both in reducing costs and in increasing the rates of turnover of bed. Recently, Korea has included home nursing care in its health care delivery system, and some models of the hospital based home nursing care had been tried and its effects had been evaluated. So, author tried to run a home nursing care for the Cesarean section mothers and evaluate Its effects both in the mother's health and costs. This study was designed as a Quasi-experimental study. Subjects were thirty mothers who got Cesarean section operation in hospital in Seoul. Experimental group consisted of 15 volunteers, and control group were selected by means of matching technique. Data were gathered from February 1st to March 26th by two assistants who were trained by author. Experimental group were discharged on the 4th day after their operation, and got nursing care and assessment about their home three times on the 5th, 6th, and 7th day. Control group stayed in the hospital until 7th day as usual and were checked on the same day as above mentioned To evaluate the state of physiological recovery, vital signs, H.O.F, presence of edema in the legs, bathing, appetite, sleep, presence of pain or discomfort in the breasts, amount of lochia, color of lochia, defecation urination. To compare incidence of complication in experimental group with that in control group, specific assessment was done such variables as smell of lochia, presence of inflammation of operation wound, dizziness, and presence of immobilization in the extremities. The activities of daily living were checked Satisfaction of nursing were checked To calculate costs, author asked subjects to specify expenditure including hospital charge, traffic enpenses, and food expenses. The results were as fellows. 1. On effectiveness of home nursing careThere were n significant differences between experimental and control group in incidence of abnormal symptoms and any complication. The number of taking a bath [POD #5 P=0.001, #6 P=0.0003, #7 P=0.001] and the degree of appetite [POD #5 P=0.03, #6 P=0.02, #7 P=0.013] were significantly higher in experimental group than in control group. Contrary to author's expectation, the degree of the activities of daily living in experimental group was not higher than that of control group. All of the experimental group said they were satisfied with the home nursing care. 2. Cost analysis 1) Hospital charge of experimental group was lower than that of control group. [P=0.009] By taking home nursing care, average period of hospitalization was shortened to 3.1 days, and family members could save 22.8 hours. Total amount of money saved by early discharge was 3,443,093 Won. It is estimated that total amount of money saved by early discharge in a year will be 40,398,956 Won. 2) Home nursing care charge of 15 mothers was 1,781,633 Won. It is estimated that total amount of money Saved by it in a year Will be 20,904,493 Won. It was lower altogether than hospital charge of the three days which is 5th, 6th, 7th day of operation. The average cost of single home visit was calculated 10,940 Won. It took 87 minutes per round and it costed 1,017.3 Won. The average hour of home care was 39.0 minutes. 3) It is expected that early discharge can bring forth the increase of hospital income. On the condition that the rate of running bed is 100%, the expected increase of hospital income will be 202,374, 026 Won in a year. Suggestions for further study and nursing practice are as follows : 1. For the welfare of patients and the increased rates of running bed, home nursing care system should be included in the hospital nursing care system. 2. Studies to test effect of home nursing care on the patients with other diseases are needed. 3. Establishment of law on the practice of home nursing care is strongly recommended.

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Nutritional Survey of Physically Handicapped Children - An Ecological approach - (지체(肢體) 부자유(不自由) 아동(兒童)의 영양실태(營養實態) 조사(調査) - 생태학적(生態學的) 접근(接近) -)

  • Lyu, Eun-Soon;Moon, Soo-Jae
    • Journal of Nutrition and Health
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    • v.15 no.2
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    • pp.98-106
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    • 1982
  • This study was carried out to investigate the nutritional status of physically handicapped children with cerebral palsy in order to contribute to their welfare by studying their healthy status, nutrient intake, daily energy expenditure, and living environment. The survey was conducted at two rehabilitation institutions from May 25 to June 30, 1981. A special questionnaire was designed to investigate the living environment. The 24 hr. recall method was used in evaluation the nutrient intake of 67 children. Anthropometric measurement was made of height, weight, chestgirth, upper-arm circumference, and triceps skinfold thickness. The biochemical status of the children with cerebral palsy was assessed with measurement of hemoglobin and hematocrit. The results may be summarized as follows : 1. The children with cerebral palsy, the intakes of all nutrients except vitamin A, thiamin, and ascorbic acid were lower than Korean recommend dietary allowances (1980). They had significantly higher intakes of vitamin A and calcium than the normal children, but the calcium intake was low as 62% of the Korea RDA. 2. All the children with cerebral palsy were very short and low weight in comparison with the accepted standards, but chestgirth was above the accepted standards for Korean school children. 3. The average hemoglobin value was 12.2gm%, hematocrit 39.3%, and mean corpuscular hemoglobin concentration (MCHC) 31.1%. 4. The possible etiological factors of cerebral palsy were, prenatal factors 16%, natal 44.9%, postnatal 27.5%, and unknown 11.6%. Eighty four percent of the children showed their first symptoms within the first year after birth. 5. Thirty percent of the parents said that the handicapped children lead to marital problems, and 84.1% of the parents mentioned that medical expenses for the children influenced their family finances.

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