Research in Community and Public Health Nursing (지역사회간호학회지)

Korean Academy of Community Health Nursing (한국지역사회간호학회)
권호 표지
DOI QR코드

DOI QR Code

Economic Evaluation of Hospital-based Home Care Services for the Breast Cancer Surgery Patients

유방암 수술 환자에 대한 가정간호서비스의 경제성 평가

  • Ko, Jeong Yeon (Health Insurance Review & Assessment Service) ;
  • Yoon, Ju Young (College of Nursing.Research Institute of Nursing Science, Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) Four Project, Seoul National University)
  • 고정연 (건강보험심사평가원) ;
  • 윤주영 (서울대학교 간호대학 BK21 4단계 사업(미래간호인재양성사업단).간호과학연구소)
  • Received : 2021.03.09
  • Accepted : 2021.08.09
  • Published : 2021.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: This study conducted an economic evaluation of hospital-based home care services for the patients who had undergone breast cancer surgery. Methods: A total of 12,483 patients over 18 years of age who had received breast cancer surgery in 26 tertiary hospitals in 2018 were analyzed with the claim data from the Health Insurance Review & Assessment Service using cost-minimization analysis and societal perspectives. Results: There were 156 patients who utilized hospital-based home care services within 30 days after breast cancer surgery, and they received 2.17 (SD=1.17) hospital-based home care service on average. The average total cost was 5,250,028 KRW (SD=1,905,428) for the group receiving continuous hospital-based home care and 6,113,402 KRW (SD=2,033,739) for the group not receiving continuous hospital-based home care (p<.001). The results of the economic evaluation of continuous hospital-based home care services in patients who had undergone breast cancer surgery indicated a total benefit of 953,691,000 KRW, a total cost of 819,004,000 KRW, and a benefit-cost ratio of 1.16 in 2018. Conclusion: Continuous hospital-based home care was considered economically feasible as the total costs for the group receiving continuous hospital-based home care were lower than those of the group not receiving continuous hospital-based home care. Therefore, policy modification and financial incentives are recommended to increase the utilization of hospital-based home care services for patients who had undergone breast cancer surgery.

Keywords

Acknowledgement

본 논문은 교육부 및 한국연구재단의 BK21 4단계 사업(미래간호인재양성사업단)의 지원을 받았음.

References

  1. Ministry of Health and Welfare. Community care promotion plan[Internet]. Sejong: Ministry of Health and Welfare. 2018 [cited 2018 December 1]. Available from: http://www.mohw.go.kr/react/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&CONT_SEQ=346683&page=1
  2. Ko JY, Yoon JY. Analysis of hospital-based home care service utilization using national health insurance claim data from 2008 to 2017. Journal of Korean Academy Society Home Care Nursing. 2019;26(1):36-50. https://doi.org/10.22705/jkashcn.2019.26.1.36
  3. Ministry of Health and Welfare. Hospital-based home care nursing manual. Seoul: Ministry of Health and Welfare; 2010. 181 p.
  4. Lim JY. A comparison of cost between home care and hospital care-according to subject's general characteristics. Journal of Korean Academy of Nursing. 2003;33(2):246-255. https://doi.org/10.4040/jkan.2003.33.2.246
  5. Park JY. Cost-benefit analysis of the community-based home health care program for cerebrovascular disease patients [master's thesis]. [Seoul]: Seoul National University; 2000. 107p.
  6. Lee E, Kim J. Economic effect of home health care services for community-dwelling vulnerable populations. Journal of Korean Academy of Nursing. 2016;46(4):562-571. https://doi.org/10.4040/jkan.2016.46.4.562
  7. National Cancer Information Center. Breast cancer information [Internet]. Goyang City, Gyeonggi-do: National Cancer Information Center. 2019[cited 2020 March 1]. Available from: https://www.cancer.go.kr/lay1/S1T639C641/contents.do
  8. Health Insurance Review & Assessment Service. Breast cancer 6th adequacy evaluation result [Internet]. Wonju City, Gangwon-do: Health Insurance Review & Assessment Service. 2019[cited 2020 March 1]. Available from: http://www.hira.or.kr/re/diag/getDiagEvlList.do?pgmid=HIRAA030004000100
  9. Chadha NK, Cumming S, O'Connor R, Burke M. Is discharge home with drains after breast surgery producing satisfactory outcomes?. Annals of the Royal College of Surgeons of England. 2004;86(5):353-357. https://doi.org/10.1308/147870804263
  10. Bundred N, Maguire P, Reynolds J, Grimshaw J, Morris J, Thomson L, et al. Randomised controlled trial of effects of early discharge after surgery for breast cancer. British Medical Journal. 1998;317(7168):1275-1279. https://doi.org/10.1136/bmj.317.7168.1275
  11. Health Insurance Review & Assessment Service. Understanding evidence-based health care. Wonju, Gangwon-do: Health Insurance Review & Assessment Service; 2017. 215 p.
  12. Health Insurance Review & Assessment Service. Manuals for medical expense claims, forms and instruction. Wonju, Gangwon-do: Health Insurance Review & Assessment Service; 2019. 711 p.
  13. Choi SM, Lee OH, Choi DS, Lee MJ, Park GH, Kim JH, et al. 2018 Survey data for medical costs for insured patients. Policy Research Report. Wonju, Gangwon-do: National Health Insurance Service; 2019 December. Report No.: 350005.
  14. Moon SW, Gang TW, Oh HR, Seo NG, Kim SS. 2017 Korea health panel study. Policy Research Report. Wonju, Gangwondo: National Health Insurance Service; 2019 December. Report No.: 2019-1-0006.
  15. Lee TJ, Kim YH, Shin SJ, Song HJ, Park JY, Jeong YJ, et al. Cost calculation bar in health care field. Policy Research Report. Seoul: National Evidence-based Healthcare Collaborating Agency; 2011 December.
  16. Ministry of Employment and Labor. 2018 Survey report on labor conditions by employment type. Sejong: Ministry of Employment and Labor; 2019. 236 p.
  17. Statistics Korea. Economically active population survey [Internet]. Daejeon: Statistics Korea. 2019[cited 2020 March 1]. Available from: http://kostat.go.kr/portal/korea/kor_nw/1/1/index.board?bmode=read&aSeq=372640
  18. Drummond MF, Sculpher MJ, Torrance GW, O'Brien BJ, Stoddart GL. Methods for the economic evaluation of health care programmes. 4rd ed. New York: Oxford university press; 2015. 464 p.
  19. Yang BM, Kim JH, Lee TJ, Bae EY. Health Economics. 2nd ed. Seoul Special City: Nanam press; 2015. 476 p.
  20. Seoul Caregiver Association. Caregiver cost [Internet]. Seoul: Seoul Caregiver Association. 2020 [cited 2020 March 1]. Available from: https://7hr.modoo.at/
  21. Health Josun. Breast cancer treatment skills are basic, hospitalization period is short, and the cost is low [Internet]. Seoul: Health Josun. 2018[cited 2020 March 1]. Available from: http://health.chosun.com/site/data/html_dir/2018/08/19/2018081901125.html
  22. Evans WK, Phyllis Will B, Berthelot JM, Logan DM, Mirsky DJ, Kelly N. Breast cancer: Better care for less cost. International Journal of Technology Assessment in Health Care. 2000;16(4):1168-1178. https://doi.org/10.1017/s0266462300103204
  23. Mander BJ, Cunnick C, Daultrey M, Wishart GC. Medical and psychological effects of early discharge after surgery for breast cancer. Patients can be discharged on second postoperative morning. BMJ. 1998;317:1081. https://doi.org/10.1136/bmj.317.7165.1081a
  24. Korean Nursing Association. Become a professional nurse [Internet]. Seoul: Korean Nursing Association. 2020 [cited 2020 March 1]. Available from: http://www.koreanurse.or.kr/resources/be_specialist.php
  25. National Law Information Center. Rules on the qualification of professional nurses, etc [Internet]. Sejong: National Law Information Center. 2020 [cited 2020 March 1]. Available from: http://www.law.go.kr/lumLsLinkPop.do?lspttninfSeq=61761&chrClsCd=010202&ancYnChk=0
  26. Kim KR. Advanced practice nurse system and unlicensed medical practice. Medical Law. 2010;11(1):173-198.
  27. National Law Information Center. Article 24 of the enforcement regulations of the medical law (Hospital-based home care) [Internet]. Sejong: National Law Information Center. 2020 [cited 2020 March 1]. Available from: http://www.law.go.kr/lsInfoP.do?lsiSeq=217729&efYd=20200424#0000
  28. Leem CS, Choi SJ, Lim KC, Yi YH, Jeong JS, Shin YA, et al. Common scope of practice for advanced practice nurses in Korea derived from expert agreement. Journal of Korean Critical Care Nursing. 2019;12(3):35-49. https://doi.org/10.34250/jkccn.2019.12.3.35
  29. Park SG, Ji JG, Park WS, Shin JY, Seo SW, Seo JS, et al. A study for the standardization of healthcare statistics terms. Policy Research Report. Seoul: Ministry of Health and Welfare; 2002 May. Report No.: 02-PJ1-PG5-P02-0001.
  30. Lee HJ, Kim YH, Lee EP, Kim SW, Jun BH. An analysis on the effectiveness of hospital revenues per bed by shortening length of stay. Journal of Hospital Management Association. 1998;3(1):100-120.