• Research in Community and Public Health Nursing
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• v.12 no.1
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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.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.10 no.2
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• pp.123-131
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• 2003

This study was to compare the functional status. complication and readmission rates. and client satisfaction with nursing care of home-based care and hospital-based care for clients with Coronary Artery Bypass Graft. Raw data were collected by interviewing and reviewing charts of 41 clients with Coronary Artery Bypass Graft between June 2001 and July 2002 at an university hospital located in Seoul. Korea. Out of 41 clients. 15 were in home care group and 26 were in hospitalization group. The baseline characteristics of the groups were almost identical. Mean age was 61.7 and 75.6% of clients being male. For home care group. the data collection was made at discharge and at termination of home care. and for hospitalization group. at discharge and at the first visit of outpatient department. Complication and readmission rates were investigated at one month after operation. Collected data were then analysed by conducting Chi-square test. Wilcoxon rank sum test. and Wilcoxon signed ranks test with SPSS program. The level of significance was .05. The results of the study are summarized as follows: 1. Postoperative length of stay of the home care group was shorter than that of hospitalization group by 1. 14 days(8.45 days vs. 9.59 days). On average. 1.8 home visits per client were observed. 2. The functional status (Barthel Index) at the termination of home care was significantly increased from that at discharge. For hospitalization group. a significant increase was observed between the functional status at the discharge and that at the first visit of outpatient department. The differencies in incremental of the scores. between the groups. were however not significant. 3. Complication and readmission rates; no statistically significant difference between the groups was observed. 4. The client satisfaction with nursing care (CSS) at termination of home care was significantly higher than that at hospital discharge. In conclusion. the outcomes of the analysis suggest that the home care benefits clients with Coronary Artery Bypass Graft. Client satisfaction with nursing care rises at termination of home care as compare to that measured at hospital discharge. Meanwhile. there was no significant differences in functional status. and complication and readmission rates. Further. home care reduced the length of stay in hospital.

• Journal of Korean Academy of Nursing
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• v.31 no.4
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• pp.619-630
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• 2001

Purpose: The purpose of this study was to analyze the differences in terms of services and cost between CVA without typical diseases (Group I), and CVA with typical diseases (Group II), in their Hospital-based home health care. Method: The subjects of this study were 308 CVA patients who used home care nursing during the second phase demonstration project of their hospital-based home health care. Results: The results of the study was as follows 1. Group II had more home visit (15.3/12.7) (p>0.05), and cases of death when home care (16.8/11.4) (p<0.05). 2. Group II needed more services than Group I such as bladder irrigation, skin care, bed sore care, glycerin enema, finger enema, lung care, urine sugar test, monitoring and surveillance of fluid infusion and R.O.M exercise (p<0.05). 3. The variables that showed statistical significance in the regression analysis were family style, OPD visit, level of consciousness, patient's state on termination of home care, and some extend of home health care services (R2=0.373, 0.205). Conclusion: Home nursing care needs to be planned by severity in Hospital-based home health care for CVA patients.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.8 no.1
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• pp.38-49
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• 2001

The purpose of this study was to evaluate the self care focused home nursing' care outcomes of parturient women following Cesarean sections, The subjects included 56 parturient women following a cesarean section, and they were randomly assigned to an experimental group or a control group, The experimental group included women who were discharged early from the hospital. 4-5 days after having a cesarean section. Home nursing care for the experimental group consisted of stitch removal. wound care and education for parturient women. Home nursing care was provided for 2-3 days after early discharge. The outcomes of self care focused home nursing care were measured by self-care competency. Data collection was done by a self-reported questionnaire and by a telephone interview 2-3 days after discharge from the hospital(control) or after home care (experimental) from December, 20, 1998 to June, 10, 1999. The questionnaire consisted of 25 items on 9 self-care domains. Data was analyzed by a t-test. and as $x^2$-test. The study results were as follows: 1. The general characteristics of both groups were similar except for the total number of pregnancies, and whether or not they wanted the pregnancy at this time. 2. The self-care competency scores for the experimental group receiving self care focused home nursing care were higher than the scores for the control group(t=2.361. $p{\le}.05$). 3. There was no significant difference in the rate of OPD visiting, readmission, or emergency room use between the two groups. We concluded that self care focused home nursing care is effective in promoting the self-care competency of parturient women following Cesarean sections. It is suggested that further study is needed with a larger sample to be able to generalize these results.

• Journal of Information Technology Services
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• v.21 no.6
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• pp.21-37
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• 2022

Due to the development of technology and medical care following the 4th industrial revolution, the medical paradigm is shifting towards patient-centered medical services. Based on the development of smart home technology, the residential environment is changing into a residential space that cares for and heals the lifestyles and the healthcare of families. As lifestyle changes, the concept of supporting smart home care based on the residential environment is making it possible to build a smart home IoT service design with enhanced accessibility and convenience for medical appointments and well-being lifestyle care. This paper is a study on user-centered health care smart home IoT service design suitable for family members based on the health care, beauty care, exercise care, and customized diet care beyond the conventional concept of health care monitoring. Based on the analysis, this paper proposes a personal care coordinate smart home service design in a human-centered wellness clinic care smart home service design environment. Human-centered wellness clinic smart home IoT service design is meaningful in presenting a vision for research on smart home service design that links hospital-linked and care-linked service industries, which should be considered from the smart home construction planning stage.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.4
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• pp.65-75
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• 1997

The needs for the home care of postpartum mothers and their infants are increasing, but the quality control of home care nurses is not developed yet. The objective of this study is to develop assessment - intervention algorithms for the home care of postpartum mothers and their infants. We can use these algorithms when we assess the client's condition, and find appropriate nursing interventions. Also, these algorithms can offer guidelines for home care nurses, so that standardization of home care can be attained. Common problems for postpartum mothers are postpartum hemorrhage, abnormal vaginal discharge(endometritis), episiotomy pain, breast problems, breastfeeding difficulty, edema, urinary dysfunction and defecation difficulties. Also, commom problems for infants are abnormal body temperature, tarchycardia, respiratory problem, neonatal jaundice, cord problem, abnormal stool, breast feeding, and bathing. These algorithms can be used as a basis for the development of computerized infomation system for the home health care.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.10 no.1
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• pp.73-84
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• 2003

This study was done to examine the home care service provided by home care nurses and the level of client satisfaction. Data were collected from 110 clients who received the home care service at the P-hospital in Pusan from 23th April, 2001 to 30th November, 2002. The tool for measurement of satisfaction was composed of 16 items and was 4 score scale. Data was analyzed by using SPSS/WIN 10.5 program, the results of this study are summarized as follows; 1) 77.3% among 110 clients were over sixty years old. By the disease pattern. subjects were distributed into cancer(52.7%), cerebro-vascular disease(22.7%) and the others. 36.4% of clients were received home visits from 10 to 20 times by home care nurse. 2) The total number of home care services was 20,828. And most of the clients received the health education and training. 3) The mean score of satisfaction on provided home care services was $3.36\pm0.45$, out of 4. among 16 items. 'The home care nurses were kind enough' was highest ($3.59\pm0.49$), the total level of satisfaction of home care services was very high. with total mean score $53.84\pm7.16$. As mentioned above. the satisfaction level of home care services was very high. so we can except that the prospect of home care services is very challengeable. Therefore. we should try to expand the service recipients with promotional education to the home care clients under the cooperation with medical staff and make more efforts to develop the management system about clients' information. to improve the quality of the service, to assure close ties with the public health centers for the continuous home care service linking.

• Journal of Korean Academy of Nursing Administration
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• v.12 no.2
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• pp.225-232
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• 2006

Purpose: The purpose of this study was to analyze the services and cost of CVA patients in hospital-based home health care and compare the differences of home health care cost by hospital types. Methods: The subjects of this study were 5,756 home care patients with cerebrovascular disease. Data were collected by using home health care medical expense claims from 127 hospitals in 2004. Results: The home care service 'indewelling catheterization' was the highest(19.28%), and then 'nasogastric tube insertion and change(16.72%)', 'bladder irrigation(15.98)', 'wound management(simple dressing)(10.42%)' followed. Average home health care cost per visit was 39,943 won, and the highest 46,058 won in general hospitals and the lowest 33,922 won in tertiary hospitals, so there were statistically significant among the types of hospitals(F=1112.47, p<0.0001). Conclusions: The number of home health care patients has been rapidly growing with the increase of aged population and demand for home care services is rising. So, it could be urgent to develop a reasonable cost reimbursement system for home health services and to expend scopes of the roles of home care specialist nurses. Amid the demand of more detail understanding the present status of home care, our study can be contributed to provide fundamental information of home care in Korea.

• Research in Community and Public Health Nursing
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• v.22 no.1
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• pp.33-44
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• 2011

Purpose: This study examined the characteristics and service utilization of home nursing care beneficiaries under the Korean Long-Term Care Insurance (LTCI). Methods: We used assessment data and claim data of National Health Insurance Corporation from July to August 2008. Data were composed of subjects who were the beneficiaries of home nursing care. Results; A total of 634 subjects were analyzed. Of the subjects, 57.1% were 75 years and over. The average score of nursing care need was only 0.71 and the percentage of those whose nursing care need score was zero was 58.0%. More than half of the subjects had partially dependent musculoskeletal conditions, and 75.5% had two or more comorbidities. A third of them usedonly home nursing care, and another third used both home nursing care and general home care at the same time. Those who needed sore care used the largest home nursing care benefits. Conclusion: Home nursing care of LTCI performs community-based healthcare services under LTCI. Throughout the past two years, however, it has not been active. Understanding the characteristics of its users is important in order to develop effective strategies for activating home nursing care.

• Research in Community and Public Health Nursing
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• v.13 no.3
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• pp.433-443
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• 2002

Objectives; The purpose of this study was to develop a framework for home care and a Home Care Need Assessment Tool. Method 1. Identifying common domains in the provision of home care. 2. Charts of 253 home care clients were reviewed to obtain a classification of the nursing diagnoses. 3. A focus group methodology was used to develop the domains. 4. The tool was applied to 439 home care clients.(Kappa value=0.460-1.000, sensitivity, 0.444-1.000: specificity, 0.743-1.000). 5. Some refinements and extractions of the defining characteristics and related factors were made based on the results of the focus group. Results Home Care Need Assessment Tool consists of three parts; -Part I : factors related to basic conditions -Part II : a screening component that enables home care nurses to assess 30 multiple domains of 53 nursing diagnoses. -Part III : summative nursing diagnoses and nursing need intensity for the clients. Conclusion This tool provides a comprehensive assessment that helps the recognition of many strengths as well as problems of the clients. It will be usefully utilized in scheduling home care nursing plans and evaluating client outcomes.