• 지역사회간호학회지
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• 제27권3호
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• pp.272-283
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• 2016

Purpose: This is a comparative study using secondary data from the Korean national long term care (LTC) insurance. Methods: Visiting nursing (VN) service users (n=666) and non-users (n=4,375) were extracted and compared in terms of medical expenditures, length of hospitalization, and annual number of ambulatory care visits to investigate effects of VN services in LTC. Results: Total health care expenditures were compared between the two groups and it was found that VN service users spent about $ 1700 than non-users for their medical costs between 2009 and 2011. The average length of in-hospital stay for VN service users was 19.4 days shorter than that of non-users. However, using VN services did not significantly influence the annual number of ambulatory care visits. Conclusion: The study has found that VN services are effective ways of providing community-based LTC services. We recommend LTC policy makers to further utilize VN services to deliver cost effective health care services.

• 한국보건간호학회지
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• 제34권1호
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• pp.5-21
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• 2020

Purpose: This study compared visiting nursing services of Denmark, Sweden, Japan, and the United States to provide baseline data for the development of models for community care nursing services in South Korea. Methods: A review of the literature was performed that include journal articles, government reports, institutional reports, and national/international statistics. Site visits were performed to explore the visiting nursing services of Denmark. Results: Government centered visiting nursing services were provided in Denmark and Sweden mostly by public organizations, while private services prevailed in the United States and Japan. Nursing services included case management or care coordination services, while nurse practitioners or nurse specialists provided visiting nursing services in all of the four countries and the services were provided 24 hour a day. Conclusions: Based on the review of visiting nursing services in foreign countries, the development of models is needed to provide integrated visiting nursing services in Korea that encompass home care nursing, visiting nursing, and visiting health care services.

• 지역사회간호학회지
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• 제16권2호
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• pp.127-136
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• 2005

Purpose: The purpose of this study was to present the outcomes of the district visiting nursing services. Method: We analyzed nursing records and inspected public health center data for evaluating nursing tasks. and conducted a telephone survey of 651 district inhabitants. Results: According to the result, the coverage of the district population, the rate of new registration and overall program activities increased. Meanwhile, accessibility of visiting health care, the level of health problem management, personal cognition and satisfaction concerning visiting nursing care increased, but there was little change in personal perception of health improvement. Furthermore, the status of client management was improved. In the analysis of participation in national cancer screening program, we found that there was twice higher participation in the district than others. Conclusion: We suggest that this district visiting nursing system takes responsibility for district inhabitant health management. Based on the study, we also suggest that the government and local autonomous entities should increase administrative and financial supports to execute the district-based visiting nursing system in wider areas.

• 한국보건간호학회지
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• 제29권2호
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• pp.203-218
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• 2015

Purpose: The purpose of this study is to find and suggest ways to invigorate operation of visiting nursing centers. Methods: SWOT analysis was performed based on the status of use of visiting nursing centers and opinion survey on the centers' nursing experts. Results: SO strategy was drawn to improve service satisfaction, develop standardized manuals, and improve the areas of visiting nursing services, and WO strategy was drawn to establish reliability, strengthen promotion or marketing strategy, strengthen management ability, and reinforce the governmental support of visiting nursing services. ST strategy was drawn to recover the functionality of health management, secure competitive advantage, and simplify the issuance of visiting nursing directions, and WT strategy was drawn to provide customized service, establish the cooperative system of related agencies, and adjust fees. Conclusion: For invigoration of visiting nursing centers, people must recognize the importance of the visiting nursing service and institutional standards should be established so that visiting nursing service, which is currently provided as an option according to Standard Long-Term Care Plan, can be provided on a mandatory basis.

• 대한간호학회지
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• 제34권1호
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• pp.191-201
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• 2004

Purpose: This study aimed to evaluate economic viability of public health center visiting nurse services for the low-income elderly with long-term care needs. Method: The sample consisted of 252 community dwelling elderly who enrolled in public health center visiting nurse services for three months or more. Data was collected on physical (ADL and IADL) and cognitive impairments of the elderly, contents and frequency of visiting nurse services, cost per visit, and costs of alternative services for long-term care. Result: The mean score of ADL and IADL levels of the elderly was 2.80.4904, which indicated these patients were mostly independent. Eighty four percent of the elderly subjects were cognitively intact. Among visiting nurse services supplied, providing assessment was 34%, followed by education and counseling 26%, medication 22%, and referral. The mean cost per visit was 17,824.1 won, which transformed into a total cost per person per year of 161,130.2 won. Comparing the cost of a visiting nurse service with those of other long-term care alternatives, the visiting nurse service was the least costly alternative, followed by an outpatient clinic, hospital based home care, and nursing home. Conclusion: Overall, the results of the study provide evidence of the economic viability of visiting nurse services for the low-income elderly among long-term care alternatives.

• 지역사회간호학회지
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• 제21권4호
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• pp.448-457
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• 2010

Purpose: This study attempted to identify differences in elders' health status, quality of life, and satisfaction with customized home visiting health service depending on connection to volunteerism. Methods: A total of 400 subjects participated in this research. Data were collected from May to August of 2009 and the measurement tool used for this study was the house visiting health service recording sheet recommended by the Ministry of Health. Results: According to the results of this research on elders' health status in customized home visiting health service depending on connection to volunteerism, elders' connected to volunteerism positively showed a high level in functional health status areas such as daily life performance ability, instrumental daily life performance ability and Joint exercise capacity, and in the quality of life area. Conclusion: The results of this study can be utilized as complementary information when resources and networks are used for the effective management of house visiting health service subjects.

• 한국노년학
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• 제29권3호
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• pp.1043-1061
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• 2009

본 연구의 목적은 현재 실시되고 있는 장기요양보호서비스에 대하여 유형별로 비용측면에서 경제성을 분석하고 정책적 함의를 논의하는 것이다. 조사대상자는 2008년 7월부터 시행되고 있는 노인장기요양제도의 적용대상자로 인정받은 65세 이상 노인과 그 부양가족이었고, 주부양자를 대상으로 요양보호서비스유형별로 구분하여 설문조사하였다. 회수된 설문지 중에서 방문요양 155부, 방문간호 67부, 요양시설 108부, 요양병원 92부 총 422부가 본 연구의 분석 표본으로 사용되었다. 조사결과 다음과 같은 사실을 확인할 수 있었다. 첫째, 부양 가계의 가계소득이 높지 않았다. 둘째, 장기요양보험제도가 실시되고 있음에도 불구하고 노인부양가계가 노인을 위하여 직접 지불하는 금액이 여전히 높은 편이다. 셋째, 부양가계가 노인을 위하여 수발하는 데 소요되는 간접비용이 아주 높은 편이다. 특히 재가서비스인 방문요양의 경우엔 평균 756,947원, 방문간호인 경우 594,807원으로 시설서비스에 비하여 간접비용이 상대적으로 아주 더 높았다. 넷째, 장기요양보호 노인에 대한 사회적 비용이 아주 높다. 이 금액은 본 조사에서 확인한 부양가계의 평균가계소득과 비슷한 수준이다. 다섯째, 요양보호서비스 유형별로 부양가계가 부담하는 서비스 비용에서 유의한 차이를 보였다. 여섯째, 부양가계의 직접 비용에서도 요양보호서비스 유형별로 유의한 차이를 보였지만 서비스이용비용보다는 그 차이가 작았다. 일곱째, 사회적 직접 비용은 요양보호서비스 유형별로 아주 유의한 차이를 보였다. 여덟째, 요양보호서비스를 이용하는 노인에 대한 사회적 비용금액이 아주 크고 서비스 유형별 총 사회적 비용이 전체 서비스 이용노인의 평균적인 사회적 비용에 수렴하는 경향을 보였다.

• 한국노년학
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• 제39권2호
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• pp.213-229
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• 2019

이 연구는 서울시 찾아가는 동주민센터(이하 '찾동') 노인 방문건강관리 서비스를 이용해 본 경험이 있는 노인들을 대상으로, 건강관리 서비스 미충족에 영향을 미치는 요인을 분석하고, 향후 효과적인 커뮤니티케어 정착을 위한 동 단위 방문건강관리 사업의 방향성을 제시하고자 하는 목적으로 수행하였다. 이를 위해 찾동 2단계('16. 7. 1 ~ '17. 6. 30) 사업에 참여한 17개 자치구 만 65세, 만 70세 노인 중 1,000명을 자치구별 비례할당 및 임의 추출하여 대면 설문조사를 실시하였다. 서비스 미충족 영향요인의 경우, 개인 및 자치구 환경적 요인으로 나누어 다수준 회귀분석을 실시했다. 연구결과 서비스 미충족을 높이는 개인적 요인으로 사회경제적 수준(고소득, 독거 및 노인가구), 건강수준(복합만성질환, 건강문해력, 우울), 찾동 경험(간호사 1회 방문, 적은 서비스 제공시간 및 낮은 이해도), 사회신뢰(낮은 정부신뢰)로 나타났으며, 자치구 요인으로는 사업 시행기간이 짧을수록, 재정자주도가 낮을수록 서비스 미충족 확률이 높았다. 이를 통해, 커뮤니티케어의 효율성 제고를 위한 다음의 제언을 하고자 한다. 첫째, 건강관리 서비스 수혜 대상을 현재의 65세 및 70세 노인 전수 방문에서 중장기적으로 경제적 또는 건강 취약가구로 사업의 초점대상을 좁혀서, 제한된 예산 속에서 서비스의 질을 높이는 방안에 대한 고민이 요구된다. 둘째, 방문 대상 연령을 만 65세에서 만 66세로 전환하고 국민건강보험공단 생애주기별 건강검진사업과 결과를 공유하여, 사업의 효율성이 높이는 것을 고려할 필요가 있다. 서울시 찾동 사업은 시군구를 중심으로 운영되던 국민건강관리를 행정동 단위로 낮추어 국민들이 체감도를 높이고, 지역사회 건강관리의 패러다임을 바꾸었다는 점에서 의미가 크다. 이 연구가 향후 커뮤니티케어의 효과적인 정착을 위한 기초자료 및 정책 대안으로 활용되기를 기대한다.

• 지역사회간호학회지
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• 제33권1호
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• pp.1-12
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• 2022

Purpose: This secondary data analysis study evaluated the effects of ICT enhanced home-visit nursing in long-term care insurance on health-related quality of life among community-dwelling older adults. Methods: This study included data of 131 older adults who had experienced a pilot service for ICT enhanced home-visit nursing. ICT enhanced home-visit nursing refers to a method of sharing health records and teleconference between a visiting nurse and a doctor during the home-visit nursing services to community-dwelling older adults. Health-related quality of life and influencing factors were analyzed by t-tests, logistic regression analysis using the Stata 17/SE program. Results: After a pilot service for ICT enhanced home-visit nursing, their health-related quality of life increased. The teleconferencing method had a significant effect on the increase in health-related quality of life. Conclusion: The findings indicate a pilot service for ICT enhanced home-visit nursing can be applied to the domestic community-based healthcare service model in terms of health management. In the future, the advanced service model of a pilot service for ICT enhanced home-visit nursing in which subjects conduct detailed for each health problem, and a well-designed evaluation system should be developed.

• 가정간호학회지
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• 제22권1호
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• pp.22-37
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• 2015

Purpose: This study aimed to compare the health service delivery level and educational needs by work experiences and types of public health center among the nurses who work as visiting health services workers at public health centers. Methods: Data collected from 484 nursing staff for 2 weeks, was analyzed using the SPSS program t-test, ANOVA, and Spearman Rank-Order Correlation. Nurses with more than 2 years experience were 79.1%; and 43.6% of the subjects worked within Gun type public health centers. Results: The health service performance frequency of metropolitan city type public health centers was significantly high in the areas of education, behavior pattern, chronic disease, pregnant women & infants, and multi-cultural family. The health service performance frequency of Gun type public health centers was significantly high in the areas of type of test, fundamental nursing, and basic rehabilitation. In addition, the correlation between the performance frequency and educational needs was positively correlated, and the subjects with greater educational needs performed more. Conclusion: Educational programs should be designed according to the types of public health centers rather than work experiences, especially in systematic training for frequently performed items after reviewing the practice precisely.