• Title/Summary/Keyword: Home and Community Based Care

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Policy Implications for Home-Visit Nursing(HVN) of the Korean Long Term Care Insurance through the implications of the Japanese HVN (한국 장기요양 방문간호의 정책적 함의와 일본 방문간호의 시사점)

  • Ryu, Hosihn;Arita, Kumi
    • Journal of Korean Public Health Nursing
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    • v.29 no.3
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    • pp.403-411
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    • 2015
  • Due to lack of an information system regarding the status of using home-visit nursing (HVN), it has barriers of providing improvement of the HVN for management of elderly health care in Korea. The twofold aims of the current review are to expose the existing agendas for HVN and to suggest the political implications for HVN of Korea based on the transition process and revised HVN system of Japan. This review suggests that an information evaluation system has to precede for HVN services in detail. And, the service provided per manpower should be assessed by separating the code of manpower (registered nurse, nurse aide, dental hygienist) as well as securing detailed and precise information on the HVN services. The other suggestion, development of a community-based home health care nursing model in order to provide necessary services for long-term health insurance beneficiaries. In addition, a master plan for health care for elderly should be established at the national level in order to establish an effective home health nursing delivery system.

Comparative Analysis of Differences in Health Condition with Elderly Age Using the Customized Home Modification : Focusing on Community Care Projects (맞춤형 주거환경수정을 이용한 노인의 건강상태 차이비교 분석: 커뮤니티케어 사업을 중심으로)

  • Han, Sang-Woo
    • Journal of Convergence for Information Technology
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    • v.11 no.8
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    • pp.176-184
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    • 2021
  • The purpose of this study was to investigate the effects of home modification in the community care project on the fall risk environment and the health condition in elderly people aged 65 and over. HOME FAST and WHODAS-K 2.0 were used to evaluate, and it was conducted as a group pre-post experimental study. As a result of implementing the home modification service based on the assessment, the fall risk level showed a statistically significant decrease (p<.01), and in the case of health condition, mobility (p<.01) and social participation (p<.05) was confirmed that it was statistically significantly improved in the domain, showing a positive change in the overall health condition (p<.05). In the future, research using a comprehensive home assessment is needed for more subjects. and a process of selecting subjects prior, expansion of professional manpower infrastructure to providing a quality service is required.

Introduce and Promote the Home-based Hospice and Palliative Care (가정호스피스·완화의료 제도 도입을 위한 국민 인식도 조사)

  • Choi, Jung-Kyu;Tae, Yoon-Hee;Choi, Young-Soon
    • Journal of Hospice and Palliative Care
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    • v.18 no.3
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    • pp.219-226
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    • 2015
  • Purpose: This study was conducted to understand public perception of home-based hospice and identify related factors. Methods: Between August 19, 2014 and August 30, 2014, data were collected using an E-mail questionnaire that was filled by 1,500 adults who were over 20 years of age. Data were analyzed using descriptive statistics, ${\chi}^2$-test and logistic regression. Results: Among the respondents, 15.9% were aware of home-based hospice care, and 61.3% were willing to receive home-based hospice care. The factors that influenced the participants' willingness to use home-based hospice services included residential district, religion and private health insurance. Respondents who lived in Seoul (OR: 1.56, 95% CI: 1.04~2.33), Gwangju/Jeolla province (OR: 2.02, 95% CI: 1.23~3.32), Busan/Ulsan/South Gyeongsang province (OR: 1.81, 95% CI: 1.17~2.82) were more well-aware of home-based hospice care than those who lived in Incheon/Gyeonggi province. The faithful were more informed about the services than those without non-faithful participants (Roman Catholics (OR: 2.03, 95% CI: 1.30~3.17), Protestants (OR: 1.76, 95% CI: 1.22~2.53). Participants who had a private health insurance plan knew more about the services than those without one (OR: 1.45, 95% CI: 1.03~2.04). Conclusion: First, it is necessary to improve perception of the public and healthcare providers regarding home-based hospice care. The government should review a measure to institutionalize operation of a palliative care team at hospitals and community home-based hospice care centers.

A Need Analysis for Medical Supporting Service as a Part of Community-based Hospice Palliative Care (지역사회기반 호스피스완화케어에서의 의료지원서비스 요구분석)

  • Kwon, So-Hi;Kim, Sook-Nam;Choi, Soon-Ock;Kim, Jung-Rim;Ryu, Ji-Seon;Baik, Jeong-Won
    • The Korean Journal of Health Service Management
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    • v.10 no.4
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    • pp.109-121
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    • 2016
  • Objectives : This study was conducted to investigate the need of medical supporting service (MSS) as a part of community-based hospice palliative care from the view point of beneficiaries and providers. Methods : This study adopted a methodological triangulation design. A questionnaire regarding intention to use MSS was completed by 175 patients under home-based cancer patient management program. And three focus groups consisted of hospice nurses, public health physicians, and public officials were interviewed to obtain the perceived needs, obstacles, and solutions of MSS. Results : Mean age of home-based cancer patient was 70.18 year old, 48.0% of them were living alone. Only 53.7% of them were treated pain and 93.7% intend to take pain medication prescribed by public health physician. All participants of focus group interviews agreed necessity and importance of MSS. Physicians' lack of confidence and unwillingness to prescribe opioid to terminal patients was the biggest obstacle to provide MSS in the public health center. Conclusions : The necessity and demand of MSS for community-dwelling cancer patients were verified. MSS is urgent issue to meet their needs.

Effects of Home Care Services Use by Older Adults on Family Caregiver Distress (재가 장기요양 서비스 이용과 노인 가족돌봄제공자의 돌봄 스트레스: 방문간호 서비스의 영향)

  • Kim, Jiyeon;Kim, Hongsoo
    • Journal of Korean Academy of Nursing
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    • v.46 no.6
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    • pp.836-847
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    • 2016
  • Purpose: The purpose of this study was to examine the association between utilization of home care services under the national long-term care insurance system and family caregiver distress. Methods: A secondary data analysis was conducted in this study using data collected in 2011 and 2012 from the Korean version of International Resident Assessment Instrument (interRAI) Home Care assessment system. The study sample included 228 clients receiving community based home care and their family caregivers in Korea. Descriptive statistics, $x^2$ test, t-test, and Heckman selection model analysis were conducted using SAS 9.3. Results: Presence of family caregiver distress was significantly associated with days of nurse visits (${\beta}$=-.89, p=<.001) and home helper visits (${\beta}$=-.53, p=.014). Level of caregiver distress was also significantly associated with days of nurse visits (${\beta}$=-.66, p=.028). Other factors which were significantly associated with caregiver distress were depression, cognitive function, inadequate pain control, social support for older adult, and caregiver relationship to the older adult. Conclusion: The results of this study show that visiting nurse service and appropriate support programs for Older Adults and family caregivers experiencing caregiver distress should be developed and provided to families based on the health care needs of older adults and their family caregivers for effective and sustainable home care.

Is the Legal Basis for Physical Therapist's Home-Based Rehabilitation Appropriately Prepared?

  • Kim, Won-Su;Shin, Jun-Bum;Yun, Hye-Lyeong
    • The Journal of Korean Physical Therapy
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    • v.32 no.4
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    • pp.258-265
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    • 2020
  • Purpose: This study examined the legal basis related to a physical therapist's home-based rehabilitation. Methods: The policy data were referenced to the comprehensive plan for national health promotion and the guidebook Community Health Promotion Project issued by the Korea Health Promotion Institute and other institutes. The legal data were referenced to the Bill information system on the National Assembly website. Results: The physical therapist's home-based rehabilitation did not have a legal basis in the community-based rehabilitation project (CBR) of the HP 2020 project. On the other hand, according to the Home health care part of the community health promotion project that began in 2013, physical therapists were allowed to play a role from 2020 under Article 16-2 (Public Officials in Exclusive Charge of Visiting Health Management) of the REGIONAL PUBLIC HEALTH ACT. Conclusion: Policies and laws are being developed in the field of healthcare, but the necessary policies and laws in the field of rehabilitation are still insufficient. A bill to rehabilitate in a variety of fields and spaces by modifying the scope of work of physical therapists will be needed.

A Study on the Recognition of Client Home Visit Nursing Care Services in Public Health Centers (방문간호사업에 대한 대상자의 인식에 관한 연구)

  • Min, Young-Sun;Chung, Yeoun-Kang;Han, Seung-Eui
    • Research in Community and Public Health Nursing
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    • v.11 no.2
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    • pp.399-410
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    • 2000
  • In this, analyzing the type of subjectivity in which people would have about home visit nursing services originating from public health care centers. I tried to research more effective ways to improve home visit nursing care services. and later. for the development of home visit nursing care. to supply basic data. The method for this study was the Q-method. created by William Stephenson. and was adequate for the study of subjectivity. For this study. through the deep interview. literature inquiry, and the discussion course. 206 Q-statement sentences were abstracted. and based on them, after Q-sample-selection. I then collected the Q-categorized-result from 32 subjects from Mar. 10. 2000 to Mar. 25. 2000. Through the statistic a analysis of PC-Qunal program. the subjectivity species were categorized and analyzed. The study results show that there are 3 sorts of recognition types. and they are analyzed in the following; The first type: the positively receiving type shows that they feel thankful and a trusting feeling about home visit nursing. The second type: the negatively mistrusting type shows that they had doubtful attitudes about the specialty of home visit nursing: they wanted medicine or nutrition remedies rather than health education and concerning the their own health care, they prefered the hospitals or clinics. The third type: the conditional receiving type shows that even though they had a positive receiving attitude about home visit nursing wanting to consult with the home visit nurses about the difficult problem which could not easily be settled, hoping that the home visit nurses could visit them more often, in their actual lives. they strongly indicated their attitudes concerning money as more important than home visits. The subjects in these 3 types commonly had a good feeling about the kindness of the home visit nurses: the first and third types also had a positive recognition about home visit nursing; however. in aspects of the evaluation and receiving attitudes, they showed a big difference. When all the above results are integrated. in the case of the first type the home visit nursing service, which satisfied the demand for health care of the medically weak people. should be continuously supplied. Additionally in case of the second type (negatively mistrust). continuous education and support should be supplied with enough interest to lead their concerns about their own health care as well as lead medical spending in a productive and effective direction in order to change their impressions. Through this study. I learned that the recognition of the objectives of home visit nursing services can be categorized in to 3 types and could be analyzed. Thus I wish that this study helps to present basic data which contributes to the development of the home visit nursing field.

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Development of Health Assessment Tools and Tailored Home Visiting Nursing Service Model for Children in Poverty (신생아-학령전기 대상자의 맞춤형 방문건강관리 기록지 및 모형 개발)

  • Kim, Hee-Ja;Yoo, Jae-Soon;Kim, Hyun-Sook;Tak, Yang-Ju;Bang, Kyung-Sook;Huh, Bo-Yun
    • Korean Parent-Child Health Journal
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    • v.13 no.2
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    • pp.63-77
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    • 2010
  • Purpose: The purpose of this study was to develop child's health assessment tools and tailored home visiting nursing service model in a community. Methods: Based on the literature review and several types of workshops participated with the child health nursing professors and visiting nurses in public health centers from May to December 2009, the standards of child health assessment tools, service model and education materials for visiting nurses were developed. Results: Some record forms were newly developed, including neonatal assessment, breast feeding, mother-infant interaction, oral care, vaccination and safety, and appropriate developmental screening tests in the community were selected. For systematic health care management in the community, problem list, problem criteria, health care plan, outcome criteria were also developed. Conclusion: On the demand of growing need for health promotion and early intervention for children and their association with parenting and socioeconomic status, assessment and control measures are indispensable to the promotion of child health for vulnerable population. Children's health and developmental problems, and safe circumstances can be assessed using this assessment tools, and can be used for tailored home visiting nursing care for children.

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Developing a Visiting Health Care Program at the Public Health Center in Korea (한국의 보건소 방문건강관리시스템 발전 과제)

  • Ryu, Ho-Shin;SeoMun, Gyeong-Ae;Hwang, Won-Sook
    • Journal of Home Health Care Nursing
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    • v.15 no.1
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    • pp.37-43
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    • 2008
  • This paper provides the guidelines from which to develop a visiting health care program at the Public Health Center in Korea and involves an expanded payment compensation system of preventive services based on the new long-term health insurance system in Japan. The function and management methods to achieve the goals practiced in a community contact center for elderly support which have recently been established will guide the specific directions and strategies that the Public Health Center should pursue. That is to say, comprehensive and continuous efforts will be put forth in preventive home visiting care targeting the elderly in certain jurisdictions. At this point in time in which the visiting care nursing program has not yet started, visiting health care provided by the Public Health Center oversees chronic diseases of a vulnerable population. But after it has been developed nationwide, the visiting health care system at the Public Health Center will be distinctive and focused on health promotion and prevention.

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Impact of Community Health Care Resources on the Place of Death of Older Persons with Dementia in South Korea Using Public Administrative Big Data (공공 빅데이터를 이용한 치매 노인 사망장소의 결정요인: 지역보건의료자원의 영향)

  • Lim, Eunok;Kim, Hongsoo
    • Health Policy and Management
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    • v.27 no.2
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    • pp.167-176
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    • 2017
  • Background: This study aimed to analyze the impact of community health care resources on the place of death of older adults with dementia compared to those with cancer in South Korea, using public administrative big data. Methods: Based on a literature review, we selected person- and community-level variables that can affect older people's decisions about where to die. Data on place-of-death and person-level attributes were obtained from the 2013 death certification micro data from Statistics Korea. Data on the population and economic and health care resources in the community where the older deceased resided were obtained from various open public administrative big data including databases on the local tax and resident population statistics, health care resources and infrastructure statistics, and long-term care (LTC) insurance statistics. Community-level data were linked to the death certificate micro data through the town (si-gun-gu) code of the residence of the deceased. Multi-level logistic regression models were used to simultaneously estimate the impacts of community as well as individual-level factors on the place of death. Results: In both the dementia (76.1%) and cancer (87.1%) decedent groups, most older people died in the hospital. Among the older deceased with dementia, hospital death was less likely to occur when the older person resided in a community with a higher supply of LTC facility beds, but hospital death was more likely to occur in communities with a higher supply of LTC hospital beds. Similarly, among the cancer group, the likelihood of a hospital death was significantly lower in communities with a higher supply of LTC facility beds, but was higher in communities with a higher supply of acute care hospital beds. As for individual-level factors, being female and having no spouse were associated with the likelihood of hospital death among older people with dementia. Conclusion: More than three in four older people with dementia die in the hospital, while home is reported to be the place of death preferred by Koreans. To decrease this gap, an increase in the supply of end-of-life (EOL) care at home and in community-based service settings is necessary. EOL care should also be incorporated as an essential part of LTC. Changes in the perception of EOL care by older people and their families are also critical in their decisions about the place of death, and should be supported by public education and other related non-medical, social approaches.