• 간호행정학회지
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• 제5권3호
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• pp.415-424
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• 1999

The purpose of this study was to estimate the population requiring nursing home services for frail elders who received home care nursing services. This study identified the need of nursing home services and the proportion of elders over 60 years of age requiring nursing home services according to the admission eligibility including items with intensity of home care nursing services and the criteria for screening of patients requiring home care nursing services. In this study, survey research design was conducted. A total of 49 home care nurses were collected. They were asked to assess the need of nursing home services based on items with intensity of home care nursing services and the criteria for screening of patients requiring home care nursing services. Using secondary data analysis from the survey on 'The Evaluation of Home Care Nursing Service Program in 1994 in Korea', the proportion of elders requiring nursing home services was estimated. The estimated numbers and proportion of frail elders requiring nursing home services were 169 (86.2%) aged persons among community dwelling elders based on admission eligibility. However, the proportion of aged persons was 68% using the only criteria for screening of patients requiring for screening home care nursing services.

• 지역사회간호학회지
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• 제19권4호
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• pp.660-672
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• 2008

Purpose: To analyze the home care services provided to the elderly aged 65 and older by a hospital-based home care agencies and to investigate the effects of long-term care insurance for the elderly. Method: The subjects were the home care service recipients aged 65 and older in 172 hospital-based, home care agencies registered in Health Insurance Review & Assessment Service in January, 2007. The data were collected using a questionnaire from March 16 to April 15, 2007. The questionnaire return rate was 43.8%. Result: The hospital-based home care agencies were able to visit 66.5% of the national administrative districts. Of the home care service recipients, over 50% were 65 years old and older. About 43% of the agencies reported that over 50% of their patients would be subject to the long-term care insurance. They expressed concern that home care services would be withdrawn once the insurance system is initiated. Conclusion: This study suggests that hospital-based home care agencies need to manage home care services with long-term care insurance. It also recommends developing guidelines for the use of services and referrals.

• 대한간호학회지
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• 제36권3호
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• pp.503-513
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• 2006

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.

• 가정간호학회지
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• 제6권
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• pp.78-87
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• 1999

From 1990 to 1997 Home Care Education Programs have been offered at 11 Home Care Education Institutes. But there have been no revisions in the program. Especially in the clinical practicum, the Ministry of Health and Welfare proposed 248 hours as 'Family Nursing and Practice'. But each of institutes has developed their own program, and the clinical practicum is very different. Institutions for home care practice have been very limited and even now only 40 hospitals started home care in the second demonstration project. A few community-based institutions have also been offering home care services. This study was conducted to analyze home care clinical practicum offered at Y university, and plan for a revised home care clinical practicum. Y university clinical practicum was revised to include 'visits to community institutions', 'laboratory practice', 'hospital practice', 'discharge planning and home care practice', and 'home care specialty practice'. The results of the evaluation and plan for a revision are as follows: 'Visits to community institutions' is a practice that helps the students understand community resources which are available to home care nurses, and as an orientation to institutions for practice. 'Laboratory practice' is to used to improve nursing skills that are applicable to home care. Problems that the students identified in the laboratory practice were 'lack of opportunity for individual practice', and 'inadequate theoretical preparation for practice'. To address these problems the basic nursing skills laboratory was open and could be used freely by the home care students, and practice could be done after the theoretical lectures. 'Hospital practice' is a practicum in which the students apply nursing skills to patients and to obtain assessment skills for discharge planning. Using a preceptorship, five days for hospital practice should be offered. 'Discharge planning and home care practice' was done at Wonju Christian Hospital. This institute is too far away that this practice should be provided at different institutions as soon as it is possible to contract with home care institutions. Patients groups in different home care institutions are very different, so the 'Home care specialty practice' should be done after analyzing patient groups and choosing specialty areas. These areas are' care of patients with respiratory dysfunction', 'care of patients with neurologic dysfunction', 'care of cancer patients', 'care of patients on dialysis', and 'wound care'. This practice should be offered with a preceptorship, so preceptors, clinical directors, and students should meet for home visit orientation.

• 가정간호학회지
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• 제17권1호
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• pp.45-54
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• 2010

Purpose: This study sought to provide basic information for the establishment of home care nursing system in cancer patients. Methods: Data were collected by the descriptive questionnaires consisting of 42 articles from five fields of nursing services. Patient's symptoms were investigated by the Korean version of EORTC QLQ-C30. Data were analysed using SPSS-PC 12.0. Results: Among the cancer patients (n=182), 40.1% had serious limitations on their usual lives. 74.7% had serious economic burdens. 79.7% agreed strongly with the necessity of home care nursing system, 74.2% were willing to use home care nursing, and 91.2% felt that home care nursing should be mandatory in cancer centers. There was no correlation between the frequency of symptoms or nursing items and the degree of home care nursing requirements. Digestive symptoms, symptoms requiring procedures, and symptoms to meet educational help displayed a high degree of requirement. Conclusion: Home care nursing should be activated for cancer patients as a bridge between hospital-based acute care and community-based chronic care which could increase the quality of care and reduce insurance related payments.

• 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.

• 지역사회간호학회지
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• 제9권1호
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• pp.163-180
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• 1998

The purpose of this study is to evaluate the community based home care service, and make reorientation for better service. The data was collected from the public health center, which was operated for one year, 1997. This case is evaluated and reoriented according to five elements of public health care system; system of resources for public health, organization and administration, health care delivery system of financing, management. In resources for public health, available health personnels are 15 physicians, 17 nurses, 11 nurse aides and 2 other persons. One professional health personnel take care of 609 clients, The equipments used for elderly and the disabled are 6 wheelchairs, 4 walkers, 1 hairwashers and 30 viberations. But these equipments are not enough to deal all clients. In organization and administration, planning and setting goals for community home care are made by the director, supervisor of family department and public health nurse. So there is no regular commitee for home care services in this community. The form of delivery of health care is focused on preventive health care. The important works of public health nurse are health education, preventive care for hypertension, D.M. and vaccination of communicable desease. In finaning system, funds come from central government(8.3%), local goverment(16.7%) and health center itself(3.8%), The services consist of health education, vaccination, clinical test and equipment. There are several local volunteers, which are local hospitals, a college, a christian association, a catholic association, a drivers association and a disabled association. The volunteer groups give physical and mental support to the clients. In management, this health center has three evaluation methods. One is done by local government, one is done by health center itself, and the other is done by clients with questionair. But the evaluation tools are deferent between agency. Home care services must be planned and evaluated. This public health center has to have more personnel, equipments, education for professional kowledge and meetings with community volunteer agencies.

• 가정간호학회지
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• 제9권1호
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• pp.37-45
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• 2002

Purpose: The purpose of this study was to suggest the projected workforce of home health care specialists in Korea. Method: Need model. ratio methods and expert opinion were used for projecting the number of home health care specialists. Result: 1) In 2002. there are 13 programs which offer one year home health specialist training. From those programs. they produced 3860 registered home health care specialists. 2) In 2002. there are 89 hospitalbased home health service units and 220 active home health care specialists. 3) In case of hospital- based home health service. average of 4 services per month for average of 3 months was assumed as workforce standard. 4) In case of community-based home health service. average of 4 services per month for 12 months was assumed as workforce standard. 5) The number of home health care specialists required to meet the demands for home health care population in 2000 and 2005 was estimated at minimum of 20.361 to maximum of 31.360 and 21.989 to 34.080. respectively. Conclusion: Community home health care agencies are needed to meet the demands of home health care.

• 간호행정학회지
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• 제16권4호
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• pp.409-418
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• 2010

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.

• 지역사회간호학회지
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• 제32권3호
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• pp.356-367
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• 2021

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.