Purpose: This study examined the characteristics and service utilization of home nursing care beneficiaries under the Korean Long-Term Care Insurance (LTCI). Methods: We used assessment data and claim data of National Health Insurance Corporation from July to August 2008. Data were composed of subjects who were the beneficiaries of home nursing care. Results; A total of 634 subjects were analyzed. Of the subjects, 57.1% were 75 years and over. The average score of nursing care need was only 0.71 and the percentage of those whose nursing care need score was zero was 58.0%. More than half of the subjects had partially dependent musculoskeletal conditions, and 75.5% had two or more comorbidities. A third of them usedonly home nursing care, and another third used both home nursing care and general home care at the same time. Those who needed sore care used the largest home nursing care benefits. Conclusion: Home nursing care of LTCI performs community-based healthcare services under LTCI. Throughout the past two years, however, it has not been active. Understanding the characteristics of its users is important in order to develop effective strategies for activating home nursing care.
Purpose: The purpose of this study was to compare the costs and benefits of home nursing care services between public health centers (PHC) and private hospitals. Method: Participants were 105 patients who had received home nursing care services from a private hospital or public health center. From a societal perspective, the researcher identified the costs and benefits of the services using performance data and calculated the net benefit and benefit/cost ratio. Result: The net benefit of the home nursing care service based in the PHC was 165.9 million won and benefit/cost ratio was 2.0, while the net benefit of the home nursing care services by the private hospital was 141.1 million won and benefit/cost ratio was 1.7. Both types of programs were economically validated. Conclusion: Home nursing care services were basically efficient as the results showed a positive net benefit. A cost-benefit analysis indicated that the PHC-based home nursing care services were more efficient than that of the private hospital. With limited human resources and management standards in public health centers, results suggest the need for a more systematic management of the home nursing care service to improve the health of this vulnerable community population.
This Study was done to examine the home health care service provided by home care nurses and the level of client satisfaction. Data were collected from 60 clients who received services from a home care center. The tool for measurement of satisfaction was composed 13 items and was 3 score scale. The results of this study are summarized as follows ; 1. By the disease pattern, subjects were distributed into cardiovascuvr disease(73.5%), digestire disease(10.2%), endocrine disease (6.1%), Senile dementia(6.1%) and the others(4.0%). 2. By the disease pattern, provided home health care services were follows; In cardiovascular disease and digestire disease, direct nursing service, education and physical assessment were provided every time. In senile dementia, direct nursing services were mainly provided and transfer and medication were rarely provided. 3. The level of satisfaction on provided home health services was high; mean score was 2.4 out of 3.
본 연구는 가정간호사의 표준간호중재를 개발하여 이를 근거로 각각의 진단과 연결된 중재를 분류하고 프로토콜을 전산화하여 사용함으로써 의료기관간, 또한 의료인간의 격차를 없애고 서비스의 질 개선에 도움을 주고자 시행하였다. 연구방법은 크게 가정간호 표준중재 개발과정과 개발된 가정간호 표준중재 프로토콜을 전산화하는 과정으로 나누었는데, 가정간호 표준중재를 개발하기 위하여 먼저, 국내외 가정간호사의 직무분석, 대상자 사정 프로토콜 개발, 대상자 진단 프로토콜 개발, 대상자 중재 프로토콜 개발의 4가지 연구내용으로 구성하였다. 개발된 가정간호 표준 중재 프로토콜을 전산화하는 과정으로, 크게 가정간호 정보시스템을 위한 전략수립과 가정간호 정보시스템의 분석, 설계, 운영 및 평가 등의 4개 연구내용으로 구성하였다. 개발된 프로그램은 P시에서 가정간호사업 실시 기관에 근무하는 가정간호사를 대상으로, 가정간호 정보시스템 매뉴얼을 사용하여 직접 시범, 교육하였다. 따라서 본 연구에서는 표준 가정간호중재에 속하는 구성요소를 가정간호정보조사지, 가정간호경과기록지, 가정간호경과요약서, 가정간호종결 요약서 양식에 포함될 수 있도록 개발하였으며, 표준 가정간호중재가 개발됨으로써 가정간호사업부서 간의 정보교환이 용이하고 기록의 누락 및 중복을 막을 수 있으며 EMR, HMR 개발시 병원용어의 표준화에 기여할 수 있을 것이다.
Purpose: The purpose of this research was to address the working conditions of home health nurses through a nationwide home health agency survey conducted at hospitals. Method: The mail surveys were sent to 303 home health nurses nation wide and returned with a response rate of $71.8\%$. Result: (a) Seventy-five percent of home health agencies were established within the past5 years and half of home health nurses are over 40 years old. (b) Working conditions were considered as follows: Seventy-one percent of respondents were full-time employees, sixty-sixpercent of home health nurses had unscheduled visits on a regular day of duty and forty-eight percent were on vacation. Fifty-one percent of home health nurses have experienced traffic accidents and paid. penalties ($65.9\%$). Self-reported monthly income level per year was an average of 28,364,000 won. (c) Rates were significantly higher for shoulder pain ($61.5\%$), lower back pain ($54.1\%$), knee pain ($39.4\%$), and gastrointestinal problems ($33.0\%$). Conclusion: These baseline results show the importance of improving home health nursing working conditions, a comprehensive prevention system and safeguards from physical discomfort.
This study was carried out during the month of September 1976 to analyse and compare the health complaints of two groups of the university women, those who lived at home and those who lived in the university dormitory. The purpose of the study was to provide basic data required by the university health program for planning related to the health need of women students. The study sample consisted of 434 students living in the dormitory and 381 students living at home enrolled for the fall semester 1976 in a womens university in Seoul. The instrument used for the collection of data was an abridged version of a modified Cornell Medical Index. The questionarre included 35 items related to physical health complaint and 22 items related to mental health complaints. The data was treated by a computer (SPSS) using one way analysis, the Fishers' ratio and Chi-Square test at the 5% level were used for the test for statistical significance. The interpretation of this study is limited due to the sample which was restricted to one university and not randomly selected. To guide the direction of the study, it was hypothesized that the rate of expressed health problems of students living in the dormitory would be Venter than that of students living at home. The hypothesis was tested and rejected. The following is a summary of the findings; 1. Total health (physical and mental) complaints a. There was no statistically significant difference between the home and dormitory groups with regard to total health complaints expressed. b. The rate of total complaints expressed by the home group significantly higher than dormitory group only among third year students. c. There was no statistically significant between the home and dormitory groups in their satisfaction with their economic situation. d. The home group showed a significantly higher rate of complaints related to the Nervous System compared to that of the dormitory group. 2. Physical health complaints a. Students living at home showed a significantly higher rate of physical complaints than the dormitory group. b. When the year variable was controlled, the third year was the only group which showed a different rate between home and dormitory groups; the home group presented a higher rate. c. Since the year variable seemed to affect the physical complaints those data were further analysed to see whether the specific system areas were operating as variables in each year. The results were as follow: Among the home group, First year students showed a higher rate in Family History of Disease, while the third year students more Nervous System and Cardiovascular System complaints. Among the dormitory group, only fourth year students showed a higher rate in the Skeletal-Muscular System. This was the only area the dormitory group though only for the fourth year students supported the hypothesis. d. When the economic satisfaction variable was controlled, the satisfied group was the only group which showed a different rate between home and dormitory groups; the home group presented higher rate. e. Since the economic satisfaction variable seemed to affect the physical complaints those data were further analyzed to see whether the specific system areas were operating as variables in each economic satisfaction level, but there was no statistically significant difference between home and dormitory groups. 3. Mental health complaints a. There was no significantly difference between home and dormitory groups with regard to mental health complaints expressed. b. When the year variable was controlled the third year group was the only group which showed a different rate between home and dormitory groups; the home group presented a higher rate. c. Since the year variable seemed to affect the mental complaints, those data were further analyzed to see whether the specific system areas were operatings variables in each economic satisfaction level. The result were as follows: Among the home group, the third year students showed higher rates in Inadequacy and Anxiety. d. When the economic satisfaction variable was controlled, the very satisfied group was the only group which showed a different rate between home and dormitory groups: the home group presented a higher rate. Since the economic satisfaction variable seemed to affect the mental complaints, those data were further analysed to see whether the specific system areas were operating as variables in each economic satisfaction level, but there was no statistical significant difference between the home and dormitory groups. Although the social environment of dormitory life differs from family life, there was no difference in the rate of total health problem complaints between the home and dormitory groups but the home group showed a higher rate of physical health complaints than the dormitory group. Possible positive factors influencing dormitory life and negative factors influencing family life affecting health complaints must be explored in order to relate to the health needs of the university health program. This study could not define the causes for the fewer physical complaints of dormitory students living at home. Further study of such causal factors recommended in order to provide the data needed to contribute to a more effective health program.
The purpose of this study was to assess the provided home health care services and to evaluate the patient's satisfaction level of received home health care services. Well trained two home health care nurses interviewed with 138 respondents who received home health care by Keimyung University Hospital from January 1st to August 31st 1999. The results were summarized as follows : 1) Among 138 respondents, $55.8\%$ were mail and $44.2\%$ were female and $70.3\%$ of them were over sixty years old. Respondents main family care givers were spouse$(53.6\%)$, daughters and sons$(36.2\%)$ and parents$(7.2\%)$. 2) $60.2\%$ of cancer patients received home health care services, $23.3\%$ of cerebralcardiovascular patients, $7.5\%$ of endocrine disorder patients, $2.3\%$ of those who have indwelling foley catheter patients, $1.5\%$ of those who have respiratory problems and others$(5.2\%)$. 3) $88.1\%$ of respondents were satisfied with the number of home visits they received. $50.5\%$ of respondents' were received 1 to 3 times of home visits by home health care nurse per month. $48.6\%$ of respondents answered they were introduced by attending doctors or nurses to home health care services. $55.8\%$ of respondents answered registration to home health care services was simple and easy. $97.4\%$ of respondents answered home health care payment system was adequate. $64.9\%$ of respondents answered the cost of home health care per visit was adequate and comfortable. 4) Health education, counselling, physical assessment was provided to most of the patients. Those who suffered with cerebral-cardiovascular disease was needed hands on direct care most of all. The least home health care service provided was medication. 5) The satisfaction measurement tool was composed with 13 items and 3 score scale. The mean score of satisfaction on provided home health care services was 2.67 out of 3. Among 13 items. 'home health care service was kind enough' was highest(2.84). 'nurse use precise word to understand and communicate'. 'nurse gave home visiting notice ahead of time and kept the home visiting promise on time' was 2.83. 'whenever I need home health care nurse I can give a call and meet the nurse' was lowest 2.41. Special Home Health care programs such as comprehensive hospice care programs for elders over sixty years old should be organized. Adequate and standardized home health care payment system should be developed as soon as possible. In korean family situation. when family members are getting sick and stay at home. family members were taking care of the patients. special program such as counselling family members are needed.
Purpose: The purpose of this study was to measure home health resource utilization using a Case-Mix Adjustor Model developed in the U.S. Method: The subjects of this study were 484 patients who had received home health care more than 4 visits during a 60-day episode at 31 home health care institutions. Data on the 484 patients had to be merged onto a. 60-day payment segment. Based on the results, the researcher classified home health resource groups (HHRG). Result: The subjects were classified into 34 HHRGs in Korea. Home health resource utilization according to clinical severity was in order of Minimum (C0) < 'Low (Cl) < 'Moderate (C2) < 'High (C3), according to dependency in daily activities was in order of Minimum (F0) < 'High (F3) < 'Medium (F2) < 'Low (Fl) < 'Maximum (F4). Resource utilization by HHRGs was the highest 564,735 won in group C0F0S2 (clinical severity minimum, dependency in daily activity minimum, service utilization moderate), and the lowest 97,000 won in group C2F3S1, so the former was 5.82 times higher than the latter. Conclusion: Resource utilization in home health care has become an issue of concern due to rising costs for home health care. The results suggest the need for more analytical attention on the utilization and expenditures for home care using a Case-Mix Adjustor Model.
Purpose: The purpose of this study was to describe the current status of utilization and costs of home health nursing care by the levels of medical institutes in Korea. Method: A secondary analysis of existing data was used from the national electronic data information(EDI) of 148 home health agencies for 6 months from May to Oct 2005 in total. Result: The 148 agencies had multiple services in cerebral infaction, essential hypertension, sequoia of cerebrovascular disease, type 2 diabetes mellitus, etc.. The highest 10 rankings of 76 categories of home health nursing services were composed of 96.4% of the total services, such as simple treatment, inflammatory treatment, urethra & bladder irrigation, inserting indwelling catheter etc., in that order. The highest 20 rankings of 226 categories of home examination services were composed of 77.0% of the total home examination services. In addition, the average cost of home health care per visit was 46,088 Won (${\fallingdotseq}$ 48 $, 1 $=960 Won). The costs ranged from 74,523 Won (${\fallingdotseq}$78 $, loss of chronic kidney function, N18) to 32,270 Won (${\fallingdotseq}$34 $, other cerebrovascular diseases, 167). Conclusion: Results suggest that client characteristics of hospital based HHNC are not different from community based HHNC or visiting nursing services for elderly. The national results will contribute to baseline data used to establish a policy for the home health nursing care system and education.
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