Test on the Cost and Development on the Payment System of Home Health Care Nursing

가정간호수가 적정성 검증 및 수가체계 개선 방안

  • Published : 2006.06.01

Abstract

Purpose: This study focused on analysing costs per home health care nursing visit based on home health care nursing activities in medical institutes. Method: The data was collected in three stages. First, the cost elements of home health care nursing services were collected and 31 home care nurses participated. Second, the workload and caseload of home care nursing activities were measured by the Easley-Storfjell Instrument(1997). Third, the opinions on improving the home health care nursing reimbursement system were collected by a nation-wide mailing survey from a total of 125 home care agencies. Result: The cost of home health care nursing per visit was calculated as 50,626\. This was composed of a basic visiting fee of $35,090{\\}({\fallingdotseq}355$)$ and travel fee of $15,536{\\}({\fallingdotseq}15$)$. The major problems of the home care nursing payment system were the low level of the cost per visit, no distinction between first visit and revisits, and the limitations in health insurance coverage for home health care nursing services. Conclusion: This study's results will contribute as a baseline for establishing policies for improvement of the home health care nursing cost and for applying a community-based visiting nursing service cost.

Keywords

References

  1. Chiu, L., Shyu, W., & Liu, Y. (2001). Comparisons of the cost-effectiveness among hospital chronic care, nursing home placement, home nursing care and family care for severe stroke patients. J Korean Acad Nurs, 33(3), 380-386
  2. Chiu, L., Tang, K., Shyu, W., Huang, C., & Wang, S. (2000). Cost analysis of home care and nursing home services in the southern Taiwan area. Pub Health Nurs, 17(5), 325-335 https://doi.org/10.1046/j.1525-1446.2000.00325.x
  3. Finkler, S. A. (1982). The distinction between cost and charges. Ann Intern Med, 96, 102-109 https://doi.org/10.7326/0003-4819-96-1-102
  4. Korea Institute Health And Social Affairs (1994). A study on development of a model and payment system for home health care nursing in Korea
  5. Korea Institute Health And Social Affairs (1999). An evaluation study on home health care nursing in Korea
  6. Kim, M. J. (2000). Cost analysis of community-based home health care versus hospital-based home health care. Unpublished master thesis, Yonsei University, Seoul
  7. Jung, K. S. (2003). Hospital financial management, 5th Edi. Jungwoo co
  8. Lee, T. H., Park, J. S., & Kim, I. S. (2000). Workload measurement of home health care nurses services using relative value units. J Korean Acad Nurs, 30(6), 1543-1555 https://doi.org/10.4040/jkan.2000.30.6.1543
  9. Lee, S. J. (2003). Cost analysis of home health care with activity-based costing(ABC). Unpublished doctoral dissertation, Yonsei University, Seoul
  10. Lee, S. J., Lee, S. H., & Seo, J. H. (2001). Hospital accounting. Seoul: Imagination
  11. Ministry of Health and Welfare (2004). 2004 Guide on the Institution base home health agency management
  12. Park, J. S. (1999). An evaluation research of home health care payment system, Unpublished master's thesis, Yonsei University, Seoul
  13. Ryu, S. H. (1998). Hospital management - Theory and practice. Seoul: Soomoonsa
  14. Ryu, H. S. (1994). A study on development of a model and payment system for home health care nursing in Korea, Unpublished doctoral dissertation, Yonsei University, Seoul
  15. Ryu, H., An, J., & Koabyashi, M. (2005). Home health nursing care agenda based on health policy in Korea, Nurs Health Sci, 7(2), 92-98 https://doi.org/10.1111/j.1442-2018.2005.00215.x
  16. Storfjell, J. L., Allen, C. E., & Easley, C. E. (1997). Analysis and management of home health nursing caseloads and workloads. J Nurs Admin, 27(9), 24-33
  17. Whang, N. M. (1998). Current status and policy agenda on home health care payment system, Health and Welfare Forum, 98(1)