• 가정∙방문간호학회지
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• 제2권
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• pp.5-18
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• 1995

While the socioeonomic status of Koreas has been dramatically increasing in recent years, chronic and geriatric diseases have also been on the rise, bringing about many changes in our health care system. The basic goals of the home health care are to reduce health care costs, to increase the attrition rate in general hospitals, and to care for patients effectively and conveniontly at home. The purpose of this paper is to review and examine the current status of the home health care in Korea throughout the reports, surveys, other informations and education system of home health nurse. We identified the various types of home health care services programs, such as hospital-based home health care operated in public sector(demonstration project) and community-based home health care in health centers or in private sector, that is, Korean Nurse Association. Hospital based home heatlh care model was established as an alternative to traditional in-patiet services. Quality assurance and client satisfaction is an important measure of care received and establishment of payment and reimbursement for home health care services is important in promotng the home health care. We found out a fee-per-visit system composed of three kinds of fees : a basic service fee(16,000 Won), a travel fee(5,000 Won), and per-service fees (variables). Like fees paid for in-patient care, insureds pay 20% and insurers pay 80% of the basic and per-service fee. The travel fee is borne totally by the insured. Home health care continues to be viewed as not only the most preferred way to provide care to clients, but also the most cost effective. Home health care is that component of a continuum of comprehensive health care whereby health services are provided to individuals and families in their places of residence for the purpose of promoting, maintaining, or restoring health, or of maximizing the level of independence, while minimizing illness. Services appropriate to the needs of the individual patient and family should be planned and provided, nursing is to be a force for positive change and enhanced the nursing professionalism. Whatever type of involvement of home health care, it is essential to remember that home health care is highly service-oriented and highly touch health car deilvery system.

• 가정∙방문간호학회지
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• 제7권1호
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• pp.15-25
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• 2000

This article was trying to suggest an agenda and alternatives of home health care policy for the future home care growth and development and examine the significance of new health care law and regulations. In addition. It was to analyze and drive the home care system problems. of which was made an announcement on the 11th of April. that home health care project must be centered from the nationwide general hospital. As we have learned from the developed countries, the home health care have been closely related health care policy among the field of nursing area. Therefore. we need to understand our national health care policy and need to predict the future direction and goal of our home health care policy in order to enhance the growth and activation of health care system. Additionally. we also need to have a vision and ability to develop under our own health care policy with systematic and rational home care business escaping from past perspective and standpoint. We must create a master plan of home care system to fulfill one part of system of the function and an important role in order to pursue an advanced health care plan under our system. For instance. in the 21th century as we establish a master plan for the growth of our country home care plan with improving plan systematically and also we need to produce many highly qualified researching and good personal who can develop and maintain the system efficiently. Specially. based on the unique characteristics of our health care system and the direction of development of plan, we need to find and correct the problems which we have faced the present time, so that we can provide and reach the goal of advanced health care system which our government want to pursue. Finally. we have to strive our best effort to make our home health care system can be positioned and stand the right direction to have the benefit for every individual citizen in our country.

• 가정∙방문간호학회지
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• 제20권1호
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• pp.5-15
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• 2013

Purpose: This study aimed to investigate the self-care education experience, self-care performance, and home care service needs of patients with rare and incurable diseases who use a home ventilator. Methods: From2 ventilator rental companies and 5 hospitals, records of 162 subjects were collected to obtain data regarding self-care education experience (23 items) and home care service needs (25 items). Results: Of the subjects, 65.4% were male and 55.6% had a myotrophic lateral sclerosis. The items with the highest and lowest levels of self-care education experience were "using the ventilator"(94.0%) and "community-available resource information"(27.0%), respectively. Meanwhile, self-care was performed well in terms of "personal hygiene"(59.6%) but not performed well in "community-available resource information"(23.7%). "Health status assessment" had the highest need(88.2%) of home care services. Generally, the need of home care services was higher for the patients using invasive ventilators than that for those using non-invasive ventilators. Conclusion: Home care nurses need to not only provide physical care for the patients but also strengthen their roles of enhancing patient access to and utilization of various community resources to provide systematic and individualized training and care.

• 지역사회간호학회지
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• 제19권2호
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• pp.196-204
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• 2008

Purpose: To examine factors affecting long-term care hospital patients' intention of transfer to a nursing home. Method: A questionnaire survey was conducted in Aug. 2007 that included 655 patients from 49 long-term care hospitals. The survey aimed to assess the patients' health status, family status, cost and intention of transfer to a nursing home. Institutional characteristics were analyzed from the nationwide database of Health Insurance Review & Assessment Service. The affecting factors were examined by employing chi-square test and logistic regression using SAS 8.2. Result: Of the subjects, 32.4% had intention of transfer to a nursing home. The intention of transfer to a nursing home was affected by moderate or severe pain, living together with the primary carer, high cost uncovered by insurance, and recognition of nursing home. Conclusion; For appropriate service utilization. a higher level of care is needed to satisfy patients at nursing homes and a balanced fee schedule is needed between long term care hospitals and nursing homes. It is desirable to encourage transfer to a nursing home at which nurses support patients and their families by giving information, coordination, and to make efforts to establish a reference system.

• 지역사회간호학회지
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• 제12권3호
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• pp.620-626
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• 2001

Purpose: This study was aimed at investigating the recognition and attitude of inpatients for the purpose of facilitating the implementation of the home health care program in relation to the opening of the Home Care Department in P University Hospital in Pusan. Method: Data were collected from the questionnaires returned by 293 patients, who were admitted at P University Hospital. from May 1 to May 15, 2001 and analyzed using descriptive statistics and the Fisher exact test. Results: In regard to the previous information about the home health care program, 55.6% of the inpatients heard about the name through the advertisement in the hospital. the mass communication, and from acquaintances. The percentage of right answers regarding the knowledge of home health care program was 43.9%. In regard to the acceptance of the home health care program, 97.1 % of patients agreed with the implementation of the home care program. The reasons for acceptance were: the maintenance of the continuity of care, the alleviation of the family burden of time. Conclusion: For the stabilization and successful implementation of a home health care system, it should be accompanied not only by advertisement but also education for patients about the home health care program, and a post-evaluative study after the implementation.

• 가정∙방문간호학회지
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• 제2권
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• pp.52-59
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• 1995

This Study was done to examine the home health care service provided by home care nurses and the level of client satisfaction. Data were collected from 60 clients who received services from a home care center. The tool for measurement of satisfaction was composed 13 items and was 3 score scale. The results of this study are summarized as follows ; 1. By the disease pattern, subjects were distributed into cardiovascuvr disease(73.5%), digestire disease(10.2%), endocrine disease (6.1%), Senile dementia(6.1%) and the others(4.0%). 2. By the disease pattern, provided home health care services were follows; In cardiovascular disease and digestire disease, direct nursing service, education and physical assessment were provided every time. In senile dementia, direct nursing services were mainly provided and transfer and medication were rarely provided. 3. The level of satisfaction on provided home health services was high; mean score was 2.4 out of 3.

• 가정∙방문간호학회지
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• 제23권2호
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• pp.243-252
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• 2016

Purpose: This study aims to classify multiple forms of home care services from a service user's perspective. By comparing the German system to the Korean one, this study seeks to find better ways of enhancing client-centered care. Methods: The data of 121 home care users were collected from six home care centers that had under the management of nursing managers for more than five years. The researcher used a German instrument to estimate the level of care. Results: High correlation was found between German and Korean assessment criteria (r=0.81, p<.001). However, compared to their German counterparts, Korean home care providers allocated more time towards provision of domestic help per daily visit. German home care providers allocated more time towards services relating to provision of support for physical activities, including personal hygiene. It was confirmed that the level of care in Korea does not correlate with either the categories of home care services and duration. Conclusion: Therefore, care services should be offered according to long-term care needs. This study suggests a need for systematic care aimed at strengthening the client's autonomy which should be properly planned, implemented, and managed.

• 가정∙방문간호학회지
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• 제8권2호
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• pp.121-134
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• 2001

The purpose of this study were to analyze the home care services and to evaluate the client's satisfaction with the home care services provided by home care service center in the C hospital. The data were collected by reviewing charts of 128 home care clients who were receiving home care services at C hospital from October 1997 to September 2000. The subjects for satisfaction of home care service were 20 clients from July 10 to September 30, 2000. The tool for measurement of present condition of home care service was developed by the researchers. The satisfactions of the home care services were measured by using the instrument developed by Im(997). The data were analyzed by using the SPSS/PC+. The results of this study were as followings : 1. Majority of the subjects was female(61.7%). The average of age was 63.5 years. The service has been used mostly by the elderly 60 years of age or older(71.1%). The economic level of most of subjects was in middle class(94.5%). 2. Majority of the subject had a cancer(55.4%), following stroke(25.0%). The average duration of disease for the subjects was 31 months. The average time of hospitalization for the subjects was 3.3 times. The duration of hospitalization was 10$\sim$30 days(26.6%), 30$\sim$60 days(23.4%) and above of the 210 days(9.4%). 3. Most of the subjects used his/her doctor (47.7%), as a consultant, following his/her nurse (28.1%), other patients or their family (21.9%). Most of reasons for a consultation were supportive management(Infusion or medication, 60.94%), following tube management(L-tube or T-tube, 25%), Foley catheter management (15.63%) etc. 4. 28 types of nursing diagnoses were used by the home care service. The nursing diagnosis altered nutrition: less than body requirement were used mostly by the home care service, following risk for infection, impaired skin integrity, impaired swallowing, ineffective airway clearance altered comfort: pain, impaired physical mobility. By the human-response pattern, exchanging(63.2%), moving(7.5%), feeling(10.4%), knowing(5.2%), communicating (2.6%), relating(0.5%) perceiving(0.4%) and choosing(0.3%). There were 42 nursing intervention types were performed by the home care service. By the NIC(nursing intervention classification. McCloskey. Bulech. 1996). physiologic: complex (30.3%) was the most, safety(28.3%), behavioral(20.0%), physiologic: basic(10.8%) and health system(1.7%). Observation or assessment was the most nursing intervention performed by the home care service. following IV infusion. vital sign observation. infusion management and fluid-electrolyte balance management. 5. The level of client's satisfaction with provided home care services showed considerably high(2.67/ 3).

• Asian Pacific Journal of Cancer Prevention
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• 제16권9호
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• pp.4089-4094
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• 2015

The purpose of the research was to determine the effect of home care service on the quality of life in patients with gynecological cancer. This randomized case control study was carried out in a womans hospital between September 2011 and February 2012. Women undergoing gynecological cancer treatment were separated into intervention and control groups, of 35 patients each. The intervention group was provided with nursing care service through hospital and home visits ($1^{st}$, $12^{th}$ weeks) within the framework of a specifically developed nursing care plan. The control group was monitored without any intervention through the hospital routine protocols ($1^{st}$, $12^{th}$ weeks). Data were collected using An Interview Form, Home Visit Monitoring Form and Quality of Life Scale/Cancer Survivors. Effects of home care service on the quality of life in gynecological cancer patients were investigated using chi-square tests, McNemar's test, independent t-test and ANOVA. This study found that the intervention group receiving home care service had a moderately high quality of life (average mean: $6.01{\pm}0.64$), while the control group had comparatively lower quality (average mean: $4.35{\pm}0.79$) within the 12 week post-discharge period (p<0.05). This study found home care services to be efficient in improving the quality of life in patients with gynecological cancer.

• 한국보건간호학회지
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• 제19권1호
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• pp.108-116
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• 2005

The purpose of this study is to determine the level of recognition of home care services and to provide basic data for implementation of home care services. Data collection was carried out between December 2004 and January 2005 by surveying 88 nurses and 40 physicians working at a general hospital and 28 physicians working at different clinics in the Seoul metropolitan city area. The results of this study were as follows: 1. Home care services were recognized by $94.2\%$ of nurses, $77.5\%$ of physicians and $92.9\%$ of clinic physicians. The main sources of information for most of them were medical and nursing journals. 2. The percentages of staff regarding find home care services as necessary for the institutions were $88.6\%$ of nurses, $74.4\%$ of physicians and $57.1\%$ of clinic physicians. All of them anticipated that home care services would maintain 'continuous care' and 'long-term patient care'. 3. The percentages of staff willing to refer their patients to home care were $95.5\%$ of nurses, $100\%$ of physicians and $87.1\%$of clinic physicians. However, only $7.1\%$ of clinic physicians were willing to refer actively. 4. Most nurses and physicians replied that a majority of test-related services is suitable for home care services. However, among medication-related services, intravenous injections were not suitable for home care services. Among treatment-related services, most nurses and physicians replied that Levin tube feeding, oral and nasal suction, simple dressing, perineal care, and enema were suitable for home care services, but incision and drainage, and tracheostomy tube change were not suitable for home care services. In conclusion, for the implementation of hospital-based home care services, it is necessary to educate nurses and physicians on the present condition and precedent at other hospitals.