• Title/Summary/Keyword: Home-care service

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The of Perception Types of Related Subjects on the Residential Care Hhome for Disabled People : Application of Q-methodology (장애인거주시설에 대한 관련 집단들의 인식유형 연구: Q 방법론의 적용)

  • Kim, Yong-Deug;Kang, Hee-Seol
    • Korean Journal of Social Welfare
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    • v.60 no.1
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    • pp.29-51
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    • 2008
  • The purpose of this study is to find out perception types of related groups - service providers, welfare public servants and advocates of disabled people - on the residential care home for disabled people. For this purpose, this study adopted Q-methodology which is developed mainly to study on the subjective conceptualization of related people on research theme. This study found out four major types of perception on residential care home for disabled people, which are the types of focusing specialization and professionalization of care home, valuing on user participation on daily decision making, requesting similar style of care home with normal family home. insisting on abolishment of all kinds of residential care home. This research finding can be used to make clear understanding on diverse voices of related groups about residential care home for disabled people. This kind of understanding would contribute to mutual understanding and clear communication to arrive positive consensus related to the matters of residential care services for the disabled people.

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An Analysis of Referrals, Nursing Diagnosis, and Nursing Interventions in Home Care - Wonju Christian Hospital Community Health Nursing Service - (가정간호 기록지 분석 - 원주기독병원 가정간호 보건활동을 중심으로 -)

  • Suh, Mi-Hae;Huh, Hae-Kyung
    • Journal of Home Health Care Nursing
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    • v.3
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    • pp.53-66
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    • 1996
  • Home Health Care is one part of the total health care system. It includes health care services that link the hospital to the community. While it is important for early discharge patients, home care is also important for people with chronic illnesses or handicapping conditions. In 1989 the Korean government passed a law that opened the way for formal development of home health care services beginning with education programs to certify nurses for home care, and then demonstration home care services. Part of the mandate of the demonstration projects was evaluation of home care services. This study was done in order to provide basic data that would contribute to the development of records that could be used for evaluation through a retrospective audit and to examine the care that had been given in Home Care at Wonju Christian Hospital over a twenty year period from 1974 to 1994. The purposes of the study were : to identify to characteristics of the clients who had received home care, to identify the reasons for client referrals, to identify the nursing problems of these clients, to identify the nursing care provided to these clients, and to identify differences in these areas over the twenty year period. The study was a descriptive study involving a retrospective audit of the client records. Demographic data on all clients were included : 4,171 clients from 2,564 families. Data on referrals, nursing diagnosis and nursing interventions were from even numbered records which had a patient problem list included in the record, 2,801 clients, Frequencies and ANOVA were used in the analysis. The results of the study showed that the majority of the clients were from Wonju city /county. There were more women than men related to the high number of postpartum clients(1,300). The high number of postparttum clients and newborns was also evident in the age distribution. An the number of maternal-child clients decreased over the 20 years, the mean age of the clients increased significantly. Other factors also contributed to this change ; as increasing number of clients with brain injuries or with cancer, and fewer children with burns, osteomyelitis and tuberculosis. There was a decrease in the mean number of visits and mean length of coverage, reflecting a movement towards a short term acute care model. The number of new clents dropped sharply after 1985. The reasons for this are : the development of other treatment alternatives for clients, the establishment of an active wellbaby clinic, many more options plus a decreasing number of new cases of Hansen's Disase, and insurance that allows people with burns to be kept in hospital until skin grafts are healed. Socioeconomic changes have resulted in an increase in the number of cases of cancer, stroke, head injuries following car accidents, and of diabetes. Of the 2,801 client records, 2,541(60.9%) contained a written referral but for 1,802 it contained only the medical diagnosis. The number of records with a referral requesting specific nursing care was 739(29.1%). Many family members who were identified as in need of nursing care had no written referral. Analysis of the patient problem list showed that 41.9% of the enteries were nursing diagnoses. Others incuded medical diagnosis, symptoms, and plans. The most frequently used diagnoses were alteration in nutrition, less than body requirements(115 entries), alteration in skin integrity(114), knowledge deficit(111), pain(78), self-care deficit(66), and alteration in pattern of urinary elimination(50). These are reflected in the NANDA categories for which the highest number of diagnosis was in the Exchanging pattern(446), followed by Moving(178), Feeling(136) and Knowing (115). Analysis of the frequency of interventions showed that exercise and teaching about exercise was the most frequent intervention, followed by teaching concering the need for follow-up care, checking vital signs, managing nutritional problems, managing catheters, giving emotional support, changing dressings, teaching about medication, teaching (subject not specified), teaching about diet, IM and IV medications or fluid, and skin care, in that order. Recommendations included: development of a record that would allow for efficient recording of frequently used nursing diagnoses and nursing interventions: expansion of the catchment area for Home Care at Wonju Christian Hospital ; expansion of the service to provide complication prevention, rehabilitation services, and support to increase the health maintenance /health promotion of the people being served as well as providing client dentered care ; and development of a clinical record that will allow efficient data collection from records, even though the recording is done by a variety of health care providers.

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A Study on Home Care and Home Visiting Nursing in Japan (일본의 재가간호 및 방문간호 -새로운 개호보험제도의 실시를 앞두고-)

  • Kim, Jeung-Im
    • Research in Community and Public Health Nursing
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    • v.10 no.1
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    • pp.106-120
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    • 1999
  • Japan has been prepared for aging society from 1970. In 1970, the percentage of distribution of population of 65 years old and over was 7.1%. It is similar to present percentile of the elderly in Korea. Therefore, it will be needed to study about home care and home visiting nursing in Japan at present. This study was aimed to prepare the fundamental documents for home care nursing in Korea and to know the background of new health care system of Long-term Care Insurance in Japan, by studying home care and home visiting nursing in Japan. With the continuing aging of the population, especially the increase in the number of latter stage elderly, it is predicted that there will be an increase in the number of the elderly who are bedridden and suffering senile dementia. To ensure that these people will be able to continue living in the communities and homes they are accustomed to, surrounded by their families and neighbors, Japan substantially improve and expand in-home services. There were also long-term effort to reach the level of services outlined in the Gold Plan and the New Gold Plan within the decade between FY 1991 and FY 1999 in the field of health care and welfare. Under this plan, the most noticeable change was occurred in home care, home was permitted as the field of care and visiting nursing was established in law. Through this 10- Year Strategy for Promotion of Health and Welfare Services for the Aged, many problems have been improved and solved, but some problems remained such as inadequate service supply and consumption of medical insurance for the elderly. Japan will be a society composed 25% of elderly people of total population in 2020, and it will be soon faced with a shortage of welfare and medical facilities and manpower. As for equalizing the benefits and cost burdens, and other future arrangements for health care and welfare, Long-term Care insurance system was established in 1994. This system will be enforced from April 2000 and use present facilities and services. To know home care and home visiting nursing in Japan, we need to consider present conditions well and to take notice of changes and measures to cope with an aging society continuously.

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A Cost Benefit Analysis of Visiting Health Care for People 65 Years and Over Using Total Medical Expense from Health Insurance Claims Data (국민건강보험공단 진료비 자료를 활용한 65세 이상 방문건강관리사업 대상자의 비용-편익분석)

  • Kim, Jinhyun;Ko, Young;Kwon, Hyun-Jeong;Yim, Eunshil
    • Journal of muscle and joint health
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    • v.27 no.3
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    • pp.238-246
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    • 2020
  • Purpose: This study aimed to investigate the effect of home visiting care service and to evaluate the effect from the cost-benefit among older people. Methods: The target participants were enrolled in 2007 and they were classified into 1 year, 2 years, 3 years, and 4 years according to their service provision period. We analyzed health insurance claims data and entitlement data from the National Health Insurance Service databases between 2006 and 2010. This study examined the participants' social-economic and health status factors related to total medical expense. Cost-benefit analysis was done using the net benefit and benefit/cost ratio. Results: Based on the use of home visiting service, the effect was reduced by 223,914 won. The cost for 952,109 people aged 65 or older was 39,891,462,882 won and the benefit was 213,190,534,626 won. The net benefit was 173,299,071,744 won and the benefit/cost ratio was 5.34 times, which was very economical. Conclusion: Home visiting health care should continue to expand as a means of economically effective health care for people aged 65 and older and to ensure health equity for vulnerable groups.

A Preliminary Study for Evaluating on Demonstration Project of Community-based Home Health Care Nursing Services by the Seoul Nurses Association (지역사회중심 가정간호 시범사업 성과평가를 위한 기초연구- 서울시 간호사회 주관 -)

  • 유호신;이소우;문희자;황나미;박성애;박정숙;최행지;정기순;한상애
    • 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.

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Aromatherapy of Patients with Chronic Diseases (만성 질환자의 건강문제와 아로마 요법)

  • Kim, Myung-Ja;Park, Hyung-Sook;Song, Hyo-Jeong
    • Journal of Home Health Care Nursing
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    • v.10 no.1
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    • pp.25-33
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    • 2003
  • In this paper, we checked health problems of outpatients who suffered from cancer, apoplexy, and arthritis. After accessing each patients condition, in order to alleviate their sufferings, we introduced several methods of aroma therapy as a holistic approach to these health problems. Aromatherapy, which can be defined as a nature-friendly complementary / alternative method, has its great merit in its easy way of treatment by the family member of patient or patient himself. Recently, it was scientifically proved that aroma therapy has various curative effects. The easiness of applying aroma therapy is full of suggestions concerned with the future of nursing science. Recently, in the domain of home care nursing, there happened a fundamental change in its structure: a change from the supplier/professional-centered to the consumer/patient-centered one. With this change, home care nursing as a cherished desire of nursing science obtained its legal ground in the established medical programs and, in the same context, patients came to have the chance to receive demanded medical services in their home without going through complicated hospital admission procedures. Considering the future status of home care nursing as a major contributor in the consumer-centered structure of medical health service, aroma therapy as a complementary/alternative method is expected to contribute not only to establishing more effective structure of health service supply but also to resolving chronic health problem of outpatients.

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Prediction of Veterans Care Demand and Supply System for Veterans

  • Tae Gyu Yu
    • International journal of advanced smart convergence
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    • v.12 no.1
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    • pp.193-198
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    • 2023
  • The rapid aging of the veterans has reached a level that cannot handle the demand for veterans care through the existing veterans care infrastructure. Therefore, it is urgent to improve the quality of the overall service of veterans due to the deterioration of the quality of nursing services for veterans with various underlying diseases compared to general patients and the long-term waiting for admission to the veterans care center. In this situation, about 640,000 people are admitted to veterans care institutions, but only about 5% of them can enter the veterans care center smoothly. As of June 2020, the number of people waiting to enter the veterans care center exceeds 1,000, including 520 at Suwon Veterans Nursing Home, 1 at Gwangju Veterans Nursing Home, 47 at Gimhae Veterans Nursing Home, 39 at Daegu Veterans Nursing Home, 86 at Namyangju Veterans Nursing Home.. Therefore, in order to predict those who want to enter the Veterans Nursing Home and wait for admission, and to find an important basis for resolving the long-term atmosphere, the ratio of future care providers is predicted in 2022-2050 and 2022-2024 to establish a cooperative system. As a result, 6,988 people in 2022, 6,797 people in 2023, and 6,606 people in 2024 can be admitted when 'preferred linkage', and 12,057 people in 2022 when 'expanded linkage'. It was found that 11,837 people in 2023 and 11,618 people in 2024 could be admitted. This was derived by estimating the percentage of people who wish to enter the Veterans Nursing Home when linking private nursing homes, and eventually "additional acceptance" of 22.5% in 2022, 20.9% in 2023, 19.4% in 2024, and 38.8% in 2023, 36.3% in 2023, and 34.1% in 2024 are most efficiently available.

Determination of Nursing Price using Willingness to Pay (지불용의접근법을 이용한 간호서비스의 가격결정)

  • Ko, Su-Kyoung;Park, Jeong-Young
    • Journal of Korean Academy of Nursing Administration
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    • v.7 no.2
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    • pp.205-221
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    • 2001
  • It will become more and more popular to use the long-term care facilities and home health care services with the chronic disease increasing. It depends on how much the consumers would pay and purchase the services. They might get more benefits from that kind of services than from ordinary hospitalization. So far, the study of determining the medical service price has focused most often on the efforts from the providers' view. But it must be reasonable to include the consumers' value for the service. This study was performed to assess WTP(Willingness to Pay) for home health care service in order to apply to the determination of nursing price in a reasonable manner. In this study, respondents were asked if they would pay for the service's intangible benefits under the four different types(open-ended minimum WTP, open-ended maximum WTP, bidding WTP, referendum WTP). The contingent valuation method is a potentially useful tool in understanding how people value the benefits of the service. As a result, average open-ended minimum WTP was W16,015 per day among 65 respondents. Average open-ended maximum WTP was W29,154 per day among 65 respondents. Average bidding WTP was W26,300 per day among 65 respondents. Average referendum WTP was W22,200 per day among 70 respondents. The results of regression analyses were also consistent with theoretical prediction, e.g., increasing WTP with consumers' value for the service, state of patients, and household income. This study demonstrated that it was more reasonable to consider the consumers' value in determining the services' price. In addition, a further study is needed to test the validity of this CV method and to determine a proper nursing price based on the consumers' view.

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A Study on the Educational Satisfaction and the Occupational Readiness among the Home-health-care Workers Licensing Program Participants: An Application of Educational Service Quality (SERVQUAL) Model (가족지지 자원인 요양보호사 양성과정 교육프로그램 만족도와 직무수행준비에 관한 연구: SERVQUAL 모델의 적용)

  • Auh, Seong-Yeon;Paik, Sun-Ah;Kim, Yang-Hee
    • Journal of Family Resource Management and Policy Review
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    • v.14 no.3
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    • pp.69-85
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    • 2010
  • The purpose of this study is to investigate the home-health-care workers licensing education course in Seoul, Korea. Based on the previous research, a conceptual model was suggested explaining the dynamics of perceived educational service quality (SERVQUAL), educational satisfaction and the occupational readiness. The data set for this study drawn from the 297 self-administered surveys were analyzed with the suggested conceptual model by utilizing AMOS program. The measurement models and conceptual model fit well with the collected data set. As results of this study, 5 domains of SERVQUAL were produced including accountability, trustiness, responsiveness, sympathy, and assurance. The results of structural modeling with latent variables confirmed that SERVQUAL were influenced perceived educational satisfaction as well as occupational readiness. Among the SERVQUAL domains, accountability, trustiness, responsiveness, and assurance had significant impacts on the educational satisfaction while accountability, trustiness and responsiveness had significant direct effects on the occupational readiness. The trustiness had significant indirect effects on the occupational readiness via the educational satisfaction. Hence, the educational satisfaction had the significant impacts on the occupational readiness. Based on the findings of this study, we suggest to intense the educational program or curricular focusing on the SERVQUAL elements. Those changes will enhance self-confidence among the prospective home-health-care workers as well as public trustiness on the national long-term care program.

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The Follow-up Study of Changes in Frailty in Elderly Receiving Home Health Care of the Public Health Center

  • Lee, Dong Ok;Chin, Young Ran
    • Research in Community and Public Health Nursing
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    • v.30 no.4
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    • pp.528-538
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    • 2019
  • Purpose: The purpose of this study was to follow-up the frailty of the old who received home health care by Registered Nurse in Public Health Center over 8 years. Methods: We used the second wave data which was a comprehensive longitudinal data set, Public Health Information System of a public health center located in Seoul from 2010 to 2018. For statistical analysis, a mixed model of repeated measures by R program was used. Results: Frailty (range: 0~31) was getting worse significantly from 5.38 on registration to 6.54 on 4th year, 7.40 on 7th year, 7.69 on 8th year with adjustment for age, sex, economic status, the number of family, and the number diseases. The coefficient of parameters with frailty change was serviced year (β=0.29, p<.001), age (70~79 to 60~69; β=0.98, p=.018) and sex (female to male; β=2.55, p<.001). Conclusion: This study showed that the home visiting health service needs to take attention to aged 70s and over, female. The home health care of public health center need to be extended more practical and effective services in terms of 'community care'and 'ageing in place'.