• Title/Summary/Keyword: Home nursing services

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Visiting Nursing Activities Provided by Public Health Nurses in a Health Center (서울시 일부 보건소 방문간호 활동내용)

  • Kim, Soon-Lae;Lee, Kyeong-Yeao
    • Journal of Home Health Care Nursing
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    • v.6
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    • pp.59-65
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    • 1999
  • In oder to investigate the basic data for the standard of visiting nursing activities and educational program for Public Health Nurses in Health Center in Korea. the health record review carried out regard to visiting nursing services of 131 subjects with visiting nursing care. The results were as follows: 1. Rates of visiting nursing services offered by Public Health Nurse of Health Center(in decreasing order)were health education and disease management(98.5%), activity assess-ment(94.7%), counseling(90.8%), dietary care (61.1%), exercise treatment(60.3%), examination(58.8%), medication(48.9%), referral to hospital(32.8%, vaccination against flu and hepatitis(29.8%), support for welfare and administration(24.4%), position change(9.9%), connection to voluntary services(9.9%), wound dressing(7.6%) and referral for home health care nursing(3.1%). 2. The subjects consisted of 38.2% in male and 61.8% in female. 77.1% of the subjects had no job.

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A Consideration on the Instituting Home Health Care in Korea (우리나라 가정간호제도화 방안에 관한 고찰)

  • Yun, Soon-Nyoung;Hwang, Na-Mi;Hyun, Hye-Jin;Choi, Joung-Myoung;Kwon, Mi-Kyung
    • Journal of Home Health Care Nursing
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    • v.2
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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.

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Survey of Home Healthcare Nursing Services to Establish Quality Assessment Standards (가정간호 서비스 질 평가기준 설정을 위한 조사연구)

  • Kim, Su-Ol;Shin, Hye-Sun;Kim, Gwang-Suk
    • Journal of Home Health Care Nursing
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    • v.17 no.2
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    • pp.85-94
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    • 2010
  • Purpose: The study aimedto provide basic data to improve the quality of home healthcare nursing services by evaluating quality of care in representative nationwide sites. Method: The current quality of home care service in 104 nationwide sites was evaluated in terms of structures, processes, and outcomes based on published standards of the Joint Commission on Accreditation of healthcare Organizations. Results: The mean score for three dimensions of quality of home care service was as follows in descending order: structures (77.6), outcomes (60.4), and processes (38.7). Additionally, by specific item compared level of quality of home care servicein each site, the highest score was 97.3 and the lowest score was 42.3 out of 100, with a mean score of 74.7. Conclusions: These findings provide a base for establishing the quality management system and to develop a tool for evaluating the quality of home healthcare nursing. The result should be continuous management and improvement of home healthcare nursing quality.

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A Study on the Change of Area Resulted of Welfare Facilities on the High-Care degree Elderly in Japan - Focused on the Geriatric Health Services Facility and Special Nursing Home for the elderly - (일본 요개호노인 거주시설의 면적변화에 관한 연구 - 개호노인보건시설과 개호노인복지시설을 중심으로 -)

  • Park, Yeongchol;Park, Jaeseung
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.16 no.2
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    • pp.55-64
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    • 2010
  • The Japanese elderly welfare policy has focused on facility policy for the aged and preventive care service for healthy elderly people. This paper has conducted a comparative analysis on Geriatric Gealth Services Facility and Special Nursing Home for the Elderly. For this, each service function has been divided into six categories; daily life / nursing and caring / medical service / management / supply / miscellaneous. Then the change in real structure by category has been analyzed through a plan analysis on case facilities. In the Geriatric Health Services Facility, the biggest change was observed in 'livelihood' among six categories. In the Special Nursing Home for the Elderly, 'the nursing and care parts' and 'medical service part' are decreased since 1999. At that time, the facilities started to be individualized and divided into a unit. To pursue home-like care instead of unit care, there was a change in construction planning to help the aged with dementia live a self-sufficient life.

Economic Evaluation of Hospital-based Home Care Services for the Breast Cancer Surgery Patients (유방암 수술 환자에 대한 가정간호서비스의 경제성 평가)

  • Ko, Jeong Yeon;Yoon, Ju Young
    • Research in Community and Public Health Nursing
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    • v.32 no.3
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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.

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.

The Cost of Long-Term Care Alternatives for the Elderly (미국 노인환자들의 만성질환관리형태에 대한 비용분석)

  • Lee, Tae-Wha
    • Journal of Korean Academy of Nursing Administration
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    • v.4 no.2
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    • pp.351-361
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    • 1998
  • The purpose of this study was to explore whether there is a point within the range of physical impairment after which the cost of home care exceeds the cost of nursing home care among the elderly who require long-term care. The provision of long-term care for the elderly is a major health policy issue, in part due to the aging of the American population and dramatic increase in health care costs. The framework for this study was guided by Pollak's(1973)model of costs of alternative care settings for the elderly. This study used a retrospective, descriptive correlational design. Physical impairment was measured by the modified Index of Activities of Daily Living(Katz et al. 1963). Cost of care was measured by the average cost per patient per day. The sample for this study included 67 patients receiving long-term care at home from the Long-term Home Health Care Programs (LTHHCPs) and 67 patients receiving long-term care in nursing homes. Data were collected on patient characteristics. including activities of daily living and cognitive impairment. and on the number of physician visits. emergency room visits. and hospitalization from the patient records. For each patient. Medicaid cost data for home care services/or nursing home services were collected from the financial department of each home care agency or nursing home. The living costs and informal care costs were estimated for home care patients. The results indicated that the home care sample and the nursing home sample were similar in terms of gender. ethnic background. and marital status. The elderly patients in the home care sample were: however. younger and less physically impaired than those in the nursing home sample. The hypotheses of this study were supported: For elderly persons with physical impairment scores below 12(possible range of 0 to 14), cost of care was lower in home care than in the nursing home care setting. However, for elderly persons with physical impairment scores above 12. the cost of care was higher in home care than in the nursing home care setting. Thus. in this sample for elderly patients with extreme physical impairment, the cost of home care exceeded the cost of nursing home care.

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Functional Status Evaluation of Disabled Persons in Urban and Rural Areas (도농복합지역 재가복지대상자의 기능상태평가)

  • Mun, Mi-Seung
    • Journal of Korean Academy of Rural Health Nursing
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    • v.2 no.2
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    • pp.127-132
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    • 2007
  • Purpose: The purpose of this study was to provide the basic techniques in utilizing the systematic home-rehabilitation service with a Minimum Data Set for Home Care (MDS-HC) 2.0 navigator system. Methods: The present study was conducted with 50 persons receiving home-care services from a Welfare Center. Respondents were selected from urban and rural areas in and around the Wonju area. Results: The results showed that MDS-HC2.0 was useful to evaluate the functional status of disabled persons in the fields of health and home-care services. Furthermore, this navigator system provided basic information about the functional health problems of respondents and therefore can provide guidance for health and home care services for disabled persons. Conclusions: Through the present study, a comprehensive model for health and home-rehabilitation was developed. The author believes that respondents will have the satisfaction of high quality service if the developed model is used as the standard in planning and providing home-rehabilitation services.

A Study on the Expressed Desire at Discharge of Patients to Use Home Nursing and Affecting Factors of the Desire (퇴원환자의 가정간호 이용의사와 관련 요인)

  • Lee, Ji-Hyun;Lee, Young-Eun;Lee, Myung-Hwa;Sohn, Sue-Kyung
    • The Korean Journal of Rehabilitation Nursing
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    • v.2 no.2
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    • pp.257-270
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    • 1999
  • The purpose of this study is to investigate factors related to the intent of using home nursing of chronic disease patients who got out of a university hospital. For the purpose, the study selected 153 patients who were hospitalized and left K university hospital with diagnoses of cancer, hypertension, diabetes and cerebral vascular accident and ordered to be discharged and performed interviews with them and surveys on their medical records to obtain the following results. For this study a direct-interview survey and medical record review was conducted from June 28 to Aug. 30, 1998. The frequency and mean values were computed to find the characteristics of the study subjects, and $X^2$-test, t-test, factor analysis and multiple logistic regession analysis were applied for the analysis of the data. The following results were obtained. 1) When characteristics of the subjects were examined, men and women occupied for 58.8% and 41.2%, respectively. The subjects were 41.3 years old in aver age and had the monthly aver age earning of 0.99 million won or below, which was the most out of the total subjects at 34.6%. Among the total, 87.6% resided in cities and 12.4 in counties. The most left the hospital with diagnosis of cancer at 51.6%, followed by hyper tension at 24.2%, diabetes at 13.7% and cerebral vascular accident at 7.2%. 2) 93.5% of the selected patients had the intent of using home nursing and 6.5%, didn't. Among those patients having the intent, 85.6% had the intent of paying for home nursing and 14.4%, didn't. The subjects expected that the nursing would be paid 9,143 won in aver age and 47.7% of them preferred national authorities as the main servers. 86.3% of the subjects thought that home nursing business had the main advantage of making it possible to learn nursing methods at home and thereby contributing to improving the ability of patients and their facilities to solve health problems. 3) Relations between the intent of use and characteristics of the subjects such as demography-related social, home environment, disease and physical function characteristics did not show statistically significant differences among one another. Compared to those who had no intent of using home nursing, the group having the intent had more cases of male patients, the age of 39 or below, residence in cities, 5 family member s or more, no existence of home nursing servers, leaving the hospital from a non-hospitalized building, disease development for five months or below, hospitalization for ten days or more, non-hospitalization with in the recent one month, two times or over of hospitalization, leaving the hospital with no demand of special treatment, operation underwent, poor results of treatment, leaving the hospital with demand of rehabilitation services, physical disablement and high evaluation point of daily life. 4) Among those patients having the intent of using home nursing, 47.6% demanded technical nursing and 55.9%, supportive nursing. As technical nursing,' inject into a blood vessel ' and 'treat pustule and teach basic prevention methods occupied for 57.4%, respectively, topping the list. Among demands of supportive nursing, 'observe patients 'status and refer them to hospitals or community resources as available, if necessary' was the most with percent age point of 59.5. Regarding the intent of paying for home nursing, 39.2% of those patients wishing to use the nursing responded paying for technical services and 20.2, supportive services. In detail, 70.0% wanted to pay for a service stated as 'inject into a blood vessel', highest among the former services and 30.7%, a service referred to as 'teaching exercises needed to make the body of patients move', highest among the latter. When this was analyzed in terms of a relation between the need(the need for home nursing) and the demand(the intent of paying for home nursing), The rate of the need to the demand was found two or three times higher in technical nursing(0.82) than in supportive nursing(0.35). In aspects of tech ical nursing, muscle injection(1.26, the 1st rank) was highest in the rate while among aspects of supportive nursing, a service referred to as 'teach exercises needed for making patients move their bodies normally'(0.58, the 1st rank). 5) factors I(satisfaction with hospital services), II(recognition of disease state), III(economy) and IV(period of disease) occupied for 34.4, 13.8, 11.9 and 9.2 percents, respectively among factors related to the intent by the subjects of using home nursing, totaled 59.3%. In conclusion, most of chronic disease patients have the intent of using hospital-based home nursing and satisfaction with hospital services is a factor affecting the intent most. Thus a post-management system is needed to continue providing health management to those patients after they leave the hospital. Further, supportive services should be provided in order that those who are satisfied with hospital services return to their community and live their in dependent lives. Based on these results, the researcher would make the following recommendation. 1) Because home nursing becomes more and more needed due to a sharp increase in chronic disease patients and elderly people, related rules and regulations should be made and implemented. 2) Hospital nurses specializing in home nursing should be cultivated.

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Self-care Education Experience, Self-care Performance, and Home Care Service Needs of Patients With Rare and Incurable Diseases Who Use a Home Ventilator (가정형 인공호흡기를 적용하고 있는 희귀, 난치성 질환자의 자가관리 교육 경험과 수행정도, 가정간호 요구도)

  • Hwang, Moon Sook;Chang, Soo Jung
    • Journal of Home Health Care Nursing
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    • v.20 no.1
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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.

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