• Journal of Korean Academic Society of Home Health Care Nursing
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• v.7 no.1
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• pp.26-38
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• 2000

The purpose of this study was to estimate home care nursing cost for the patient with Cerebrovascular Disease based on a bundle of home care nursing services This study was conducted through four steps. The first step was to investigate home care nursing activities that were offered to the patient with Cerebrovascular Disease(CD) by home care nurse. The second step was to investigate the time spent on home care nursing service and to calculate labor and manufacturing cost. The third step was to calculate home care nursing cost per minute. And at the fourth step, home care nursing cost for a patient with Cerebrovascular Disease based on a bundle of home care nursing service was calculated. The results of the study were as follows: 1) The number of direct home care nursing activities for the patient with CD was 108, and the time of each activity was spent from 1 to 10 minutes. 2) Average time per visit was 51 minute, and the firs visit time were spent 1.6 times higher than 2nd visit time. 3) Nursing cost per minute(cost per visit ${\\}\;22,565\;\div\;$ average time per visit 51 minutes) was ${\\}\;442$. The cost per visit was calculated on Basic visiting cost(nurse's labor cost ${\\}\;15,760$ + management cost ${\\}\;6,805$) divided by average time per visit(51 minutes). 4) Home care nursing cost to the patient with CD based on bundle of home care nursing service was consisted of basic home care nursing cost, the cost of a bundle of service practiced on visit. and transportation fee. Basic home nursing cost(the time spent on basic home nursing service 20 minutes ${\times}$ nursing cost per minute ${\\}\;442$) was ${\\}\;8,840$. The cost of the bundle of home care nursing services to the patient with CD was calculated as self care ${\\}\;2.898$, Tracheostomy care ${\\}\;10,166$, immobility care ${\\}\;6,188$, sore care ${\\}\;6,188$. Foley care ${\\}\;6,630$, and Levin tube or Gastrostomy care ${\\}\;7.514$. Transportation fee which was composed of the labor cost for transportation(${\\}\;5,122$) and the car management cost(${\\}\;3.876$) was ${\\}\;8,998$. Home care nursing cost to the patient with CD based on bundle of home care nursing services consisted of basic home care nursing cost, the cost of a bundle of service practiced on visit, and transportation fee. It will contribute to improve quality of home care service, because of giving appreciate incentives to home care nurses. And it will be more efficient than current cost of hospital based home care. But it need to management than calculation of the current fee-for-services of home care.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.8 no.1
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• pp.74-84
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• 2001

This descriptive study was conducted to determine the awareness by doctors and patients of the hospital based home nursing service, and the willingness of the patients as well as the doctors to use the service if provided. The convenience samples consisted of 240 hospitalized medical-surgical patients, and 64 doctors from one' hospital. The data was collected from June 1 to June 30, 2000, by questionnairs and interviews. The results of the study were as follows: 1. 57.4% of the subjects were male patients. 35.8% were over 60 years old. and incomes ranged from 1.000,000 to 1.990,000 Won per month in 33.2% of the subjects. 2. 61.3% were unaware of home nursing. 52.7% of the subjects got information about home nursing via TV, magazines, and newspapers, and 83.4% of them showed a willingness to use the service if available. For doctors, 87%, of them said that they were aware of home nursing, and 84.4% viewed the service as necessary. However, only 39.1% responded that they are willing to refer their patients to the home nursing service if it is available. 3. Those who know about the service perceived it more advantageous; however, many do not know about it. Based on the above findings, the following suggestions are made: (1) It is necessary to hold a workshop or a seminar about hospital based home nursing service to draw attention of hospital personnel. (2) There is a need to publicize home nursing service to patients and their family members. (3) Further research is necessary to analyze cost/effectiveness of a hospital based home nursing service for the hospital.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.10 no.2
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• pp.132-140
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• 2003

This study was to identify the utilization of home care service and home care nursing satisfaction for clients with cancer who had completed secondary and tertiary chemotherapy session. Raw data was collected by reviewing charts and questionnaire of 23 clients with cancer between September, 2002 and November 2002 at an university hospital located in Seoul. Korea. The result are as follows: 1. Characteristics in the use of home care: After applying for home care service, patients were visiting an average of 1.88 days later. The major purpose of using home care service was to help recovery after hospitalization or to maintain present health. The average period for home care service was 14.6 days, with 4 visits over this period, for 35.78 minutes per visit. 2. Content of home care service: A total of 47 items of service were provided - basic nursing care, education and counseling, and therapeutic nursing care. On every visit, an average of 19 items of home care service were provided, and the majority (7 items) were therapeutic nursing care. 3. Satisfaction with home care services: Satisfaction was very high, an average of 3.88 on a scale of 4 points. Both patients and families expressed high satisfaction with all sub-domains of nursing care: guidance by the home care nurses, knowledge, skill, attitude, interpersonal relationships, emotional support, and accessibility. In conclusion, home care served basic nursing care, teaching and counseling, and therapeutic nursing to clients with cancer going through secondary or tertiary chemotherapy. Therefore they changed knowledge and attitude to disease and treatment which were difficult to change.

• Journal of Korean Academy of Nursing
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• v.30 no.6
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• pp.1488-1502
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• 2000

This study, based on current home nursing services, aims at promoting measures for establishing a community-based home nursing system derived from the pilot home nursing demonstration project conducted by the Seoul Nurses Association. The study was based on an analysis of home nursing records from march 1993 to December 1999. The following is a summary analysis, based on individual characteristics of the patients, the organization, which recommended the service for their patients and personnel services. 1. The service has been used by many elderly people 60years of age or older(66.4%). and married people(60.9%). The average number of visits by service personnel for patients of city government was 23.5. This is 2.5 times as many visits by general patients. General patients(20.2%) had only one visit from service personnel, while 65.5% of patients of city government had 10 or more visits. Particularly, for government recommended patients, 72.7% of the patients were recommended by nurses, while only 21.9% where referred to the services by doctors. The main focus of a home nursing service was to maintain present health status (53.4%), and hospice(11.6%). Also to increase hospital-based home nursing services focused on recovery(55.9%) and maintain present health conditions (19.0%). 2. For general patients, 42.0% of patients were suffering from problems related to CVA, 11.3% from high blood pressure, and for patients referred from city, 21.2% from skeletal muscular disease. Results of home nursing services 29.4% of patients were able to recover or maintain their health status, but 48.9% of the patients died. Another main point of community-based home nursing services is medication(6.7%), other basic nursing services(6.1%), special treatment, instructions on how to use medical devices(5.9%), change of physical posture(4.6%), and training on changing physical positions(4.7%). As mentioned above there were some differences between the characteristics of patients who used the pilot home nursing service conducted by the Seoul Nurses Association and those hospital-based service users. The results are believed to be useful to support a community-based home nursing service model. Particularly, patients under medical supervision and patients recommended by government-run health clinics show a higher frequency and longer use of home nursing services compared to general patients or hospital-based home nursing service users. According to the study, nurses accounted for a large number of recommendations for home nursing services. Many patients with CVA, high blood pressure, skeletal muscular disease and bedsores used community-based home nursing services, while others used the service for minor treatments or maintaining their current health status. Based on the study, the researchers make several suggestions to establish a community- based home nursing service system. First, different ways of setting up a community-based home nursing system have to be mapped out based on the evaluation of the pilot home nursing service conducted by the Seoul Nurses Association. Secondly, a new, community-based, home health care nursing service model, and reimbursement payment system have to be developed. This is based on the outcome of the analysis, and implemented policy. Accordingly, efforts are needed to develop a community- based home nursing system with an intermediary role to promote the visiting nursing services of government-run health centers.

• Research in Community and Public Health Nursing
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• v.33 no.1
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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.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.9
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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.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.8 no.2
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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).

• Journal of Korean Academy of Nursing
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• v.45 no.5
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• pp.742-751
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• 2015

Purpose: The purpose of this study was to examine the current status of home care nursing services provided by community health nurses and to identify barriers to the services. Methods: A cross-sectional survey was conducted with three types of community health care nurses. Participants were 257 nurses, 46 of whom were hospital based home care nurses, 176 were community based visiting nurses, and 35 were long term care insurance based visiting nurses. A structured questionnaire on 7 domains of home care nursing services with a 4-point Likert scale was used to measure activities and barriers to care. Data were analyzed using SPSS WIN 21.0 program. Results: Hospital based home care nurses showed a high level of service performance activity in the domain of clinical laboratory tests, medications and injections, therapeutic nursing, and education. Community based visiting nurses had a high level of service performance in the reference domain. Long term care insurance based visiting nurses showed a high level of performance in the service domains of fundamental nursing and counseling. Conclusion: The results show that although health care service provided by the three types of community health nurse overlapped, the focus of the service is differentiated. Therefore, these results suggest that existing home care services will need to be utilized efficiently in the development of a new nursing care service for patients living in the community after hospital discharge.

• Health Policy and Management
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• v.24 no.3
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• pp.283-290
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• 2014

Background: This study aimed to examine the relationship between home-visit nursing services and health care utilization under the public long-term care insurance program in Korea. Methods: We analyzed the long-term care need assessment database and the long-term care and the health insurance claim databases of National Health Insurance Service between July 2011 and June 2012. The sample includes a total of 20,065 home-visit nursing recommended-older beneficiaries who use home-visit nursing and/or home-visit care, based on a standard benefit model developed by the Health Insurance Policy Institute of National Health Insurance Service. The beneficiaries were categorized into home-visit nursing use and non-use groups, and the home-visit nursing use group was again divided into high-use and low-use groups home-visit nursing, based on their total annual home-visit nursing expenditure. Two-part models and negative-binomial regression models were used for the statistical analysis. Results: The home-visit nursing use was negatively associated with the number of outpatient visit and cost, while adjusting for all covariates. The home-visit nursing use was also negatively associated with the inpatient cost among the high home-visit nursing use group. Conclusion: The findings implies home-visit nursing use prevents health care utilization. Further studies and policy strategies that can promote and strengthen home-visit nursing services under the public long-term care insurance are necessary in Korea.

• Journal of Korean Academy of Nursing Administration
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• v.8 no.2
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• pp.323-334
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• 2002

Purpose: This study was designed to analyse economical efficiency of home care service by comparing a cost-effectiveness ratio(CER) between hospitalization and home care service. Method: The analytic framework of this study was constructed in 5 stages; perspective of the analysis, measurement of costs, measurement of effects, analysis of CER, and sensitivity analysis. The SAS program was utilized for the general characteristics of the subjects, descriptive statistics, homogeneous test, normality test and difference test. Result: The results were as follows; 1) CER was 35,248,256 of ADL, 7,996,026 of nursing satisfaction, 6,144,946,000 of QALY of patients in the hospital and 11,168,863 of ADL, 2,322,239 of nursing satisfaction, 3,674,556,000 of QALY of patients in the home care center. ICER was 438,067,932 of ADL, -190,044,176 of nursing satisfaction, 8,615,336,000 of QALY. 2) In the sensitivity analysis of sex, age and discount rate, the CER of patients in the home care center was lower than the CER of patients in the hospital. Conclusion: With these findings, it affirmed that home care service had an economical efficiency compared with hospitalization in cerebrovascular disease patients. Therefore, these results will be used to develop governmental policy or expansion of the home care service.