• 제목/요약/키워드: 방문간호서비스

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가정간호사업의 활동기준원가관리시스템 설계 (Design of Activity Based Costing Management System in Home Care)

  • 이수정;임정은
    • 한국정보과학회:학술대회논문집
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    • 한국정보과학회 2004년도 가을 학술발표논문집 Vol.31 No.2 (2)
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    • pp.427-429
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    • 2004
  • 진료 및 간호서비스는 다른 제조업과는 달리 무형의 서비스에 대한 간접비의 비율이 두드러지는 특성을 지니며, 이러한 특성으로 인해 의료기관의 전략적 계획수립, 수익성 분석, 경제성 분석, 의료서비스 제공의 질 관리 등의 의사결정에 적극 활용되어야 하는 원가 분석에 어려움을 겪어왔다. 전문 간호 분야인 가정간호는 1회 방문 시에 다양한 활동들이 모여서 가정간호서비스가 수행되므로 가정간호의 원가분석에는 각 행위들이 모인 활동에 대한 분석에 근거한 정확한 원가 정보가 요구되고 있다. 활동기준원가의 기본 요소는 자원, 활동, 자원 동인, 활동 동인, 원가 대상이며 이에 따라 가정간호사업에서 활동기준원가의 각 요소를 정의하고 전통적 원가 계산이 아닌 활동을 중심으로 가정간호사업의 업무 알고리즘을 분석하여 활동기준원가관리시스템을 설계한다. 가정간호사업의 활동기준원가관리시스템은 가정간호의 효율적 운영과 의료기관의 경영 개선과 항께 실질적 원가계산을 통해 정부가 건강 보험 수가를 결정하고, 보험 수가의 적절성을 평가하는데 중요한 기초 자료를 제공하게 될 것으로 기대한다.

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대도시지역 동단위 지역담당 방문간호소서비스 효과분석 - 뇌졸중 환자를 대상으로 - (An Evaluation of the Visiting Nursing Service Model Based on the District Management System - focused on stroke patients -)

  • 유호신;황라일;진달래;석민현
    • 지역사회간호학회지
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    • 제16권1호
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    • pp.5-12
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    • 2005
  • Purpose: This study was conducted to examine the effect of visiting nursing of the visiting nursing services based on the district management system on the subjects of stroke patients. Method: A nonequivalent control group pretest-posttest design was applied to 50 stroke patients (31 from the experimental group, 19 from the control group). To evaluate the effects of visiting nursing services. health status(SF-36) and activity daily living(ADL/IADL) were measured from June 2003 to November 2004. Result: Health condition and the activities of daily living (ADL/IADL) of the subjects who received visiting nursing service were shown to be improved. Conclusion: Visiting health service model based on the district management system in public health center is considered to be an effective measure of visiting nursing services in large cities.

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노인장기요양보험 재가방문간호 서비스 개발과 확대 방안 (Expansion Strategy of Home Visit Nursing Services of Long-Term Care Insurance)

  • 임지영;김주행
    • 가정간호학회지
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    • 제27권3호
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    • pp.241-249
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    • 2020
  • Purpose: This study aimed to investigate possible ways to expand the services of home-visit nursing through a review of the progress, achievements, and obstacles of home-visit nursing; a pilot project of an integrated home-service; the application of the Omaha System; as well as a case analysis of providing home-visit nursing services. Method: An integrated review was conducted using various source materials, including laws, previous studies, and a case analysis. Results: In case analysis of providing visiting nursing service, rehabilitation nursing, end-of-life nursing, and dementia care showed high nursing needs. It was necessary that the various home visit nursing services in the intervention area of the Omaha System, administrative services, case management, and center operation activities were all included in the payment systems of long-term care insurance. Conclusion: In the future, home visit nursing services of long-term care insurance should be reborn in the form of a center for integrated case management in the community, which would set long-term goals until the time of a client's death and encompass the realm of human rights for health, quality of daily life, and a dignity of life.

노인장기요양 방문간호서비스의 소요시간별 방문당 원가 분석 (Estimation of Nursing Costs Based on Nurse Visit Time for Long-Term Care Services)

  • 김은경;김윤미;김명애
    • 대한간호학회지
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    • 제40권3호
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    • pp.349-358
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    • 2010
  • Purpose: The purpose of this study was to estimate nursing costs and to establish appropriate nursing fees for long-term care services for community elders. Methods: Seven nurses participated in data collection related to visiting time by nurses for 1,100 elders. Data on material costs and management costs were collected from 5 visiting nursing agencies. The nursing costs were classified into 3 groups based on the nurse's visit time under the current reimbursement system of long-term care insurance. Results: The average nursing cost per minute was 246 won. The material costs were 3,214 won, management costs, 10,707 won, transportation costs, 7,605 won, and capital costs, 5,635 won per visit. As a result, the average cost of nursing services per visit by classification of nursing time were 41,036 won (care time <30 min), 46,005 won (care time 30-59 min), and 57,321 won (care time over 60 min). Conclusion: The results of the study indicate that the fees for nurse visits currently being charged for long-term care insurance should be increased. Also these results will contribute to baseline data for establishing appropriate nursing fees for long-term care services to maintain quality nursing and management in visiting nursing agencies.

도시지역 취약가구의 방문간호서비스 평가 (Evaluation of Visiting Nursing Services for the Vulnerable Family in Urban Community)

  • 박경민
    • 지역사회간호학회지
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    • 제15권1호
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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.

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뇌졸중환자 가정간호 및 방문간호서비스의 비용효과 비교 (Cost-Effectiveness Analysis of Home Health Care Program for Cerebrovascular Accident Patients)

  • 전경자;박정영
    • 지역사회간호학회지
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    • 제12권1호
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    • pp.22-31
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    • 2001
  • Purpose of this study is to compare the cost effectiveness of home care services for the cerebrovascular accident patients by the type of institution. The method is the secondary analysis using the patients' charts. 107 subjects and 1.417 visits were sampled from each type of home care institution such as one hospital based home care center. one KNA home care center, one urban health center, one rural health center and one health care post. Result: There were differences in the functional status of patients and the service contents and frequencies provided by the type of home care institution, The cost per visit for one unit of ADL by the hospital based home care was higher than by the community-based home care. Conclusion: It was suggested that the referral system among the home care institutions would be developed to improve the cost-effectiveness.

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노인장기요양보험제도에서의 방문물리치료 도입에 대한 노인요양시설 물리치료사의 인식조사연구 (Research for the Inclusion of Home-Based Physical Therapy in Long-Term Care Insurance System of Physical Therapists in Elderly Care Facilities)

  • 이광재;노정석
    • 한국콘텐츠학회논문지
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    • 제11권11호
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    • pp.231-240
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    • 2011
  • 본 연구는 앞으로의 노인장기요양보험 서비스의 확대 시 우선적인으로 방문물리치료 서비스 도입의 기초자료를 제공하는데 그 목적이 있으며 그를 위해 노인장기요양보험 하에서 물리치료 서비스를 제공하고 있는 노인시설 물리치료사들의 제도에 대한 인식조사를 실시하였다. 그 결과 노인장기요양보험에 대한 인지도는 88.1%로 높았으며 필요성에서도 높았지만 40세 이상에서 절대 필요하다는 응답이 60.3%로 더 높았다. 또한 수가는 방문간호를 기준으로 높게 책정해야 한다는 의견이 59.7% 가장 높았다. 방문물리치료서비스 중 가장 중요한 치료접근으로는 일상생활 지도가 40%로 가장 높았고, 서비스 주체로는 방문간호센터처럼 방문재활센터로 해야 한다는 의견이 69.4%를 차지했다. 방문물리치료 시행에 따른 기대효과는 50점 만점에 전체 평균 41.44점으로 나타났으며 특히 40세 이상에서 42.48점으로 나타나 전체적인 기대효과가 높은 것으로 나타났다.

취약계층 고혈압 대상자를 위한 방문건강관리사업의 비용편익분석 (Cost-benefit Analysis of Home Visiting Care for Vulnerable Populations with Hypertension)

  • 고영;이인숙
    • 지역사회간호학회지
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    • 제22권4호
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    • pp.438-450
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    • 2011
  • Purpose: This study was to investigate the effect of home visiting care service and to evaluate the effect from the cost-benefit perspective. Methods: Target participants were enrolled in 2007~2008 for home visiting care and provided with a home visiting nursing service for more than 18 months in J Ward of S City. Of 391 participants, 244 who satisfied the inclusion criteria were used in the final analysis. Cost-benefit analysis was done using the net benefit and benefit/cost ratio. Results: After providing the home care nursing service, the blood pressure control rate increased from 50.8% to 75.4%. Of the subjects, 39.8% maintained their blood pressure level within the target range. As a whole, the net benefit of home visiting care per person ranged from 434,964.86 to 447,112.43 won and the benefit/cost ratio ranged from 2.82 to 2.84. Conclusion: Home visiting care for vulnerable populations with hypertension was effective in both maintaining blood pressure and reducing blood pressure to the target range. Therefore these results are especially useful for establishing the value of home visiting services for policy makers as well as for prioritizing vulnerable populations.

농어촌 지역의 대상자 중심 통합방문형 간호서비스 모형 개발 (The Development of Client-centered and Integrated Home Nursing Care Model in Rural Areas)

  • 양숙자;한영란;함옥경;이건아;김서현;하재영
    • 한국보건간호학회지
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    • 제35권1호
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    • pp.5-18
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    • 2021
  • Purpose: This study aimed to develop a client-centered integrated home nursing care model for rural areas by analyzing public health nursing, hospital-based home care services, and long-term nursing care in Korea. Methods: The literature review performed included data from the National Assembly Library, DBpia, RISS, and KISS, Google Scholar, the Ministry of Government Legislation, Statistics Korea, and the Ministry of Health and Welfare. Results: The client-centered and integrated home nursing care model in a rural area was opened as the Home Nursing Care Center in a public health center operating directly or on consignment. This model provides both a hospital-based home care services as well as long-term care, in accordance with the health status of the client and difficulty of nursing services. Moreover, the nurse who worked in a sub-organization (Centers for Supporting Healthy Living, Public Health Units, and etc.) of the public health center as care coordinator and case manager facilitates to connect home nursing care services and social welfare services. Conclusions: Our data indicates that the client-centered integrated home nursing care model in rural areas effectively combines professional services, regional accessibility, and social welfare services.