• 가정간호학회지
• /
• 제29권1호
• /
• pp.5-17
• /
• 2022

Purpose: This study aimed to investigate the role of hospital-based home health nursing in community care by examining the institutional progress of hospital-based home health nursing and the current status of home health nursing in Korea. Methods: Korean research data, national statistical data, government press releases, and related laws were investigated to clarify the role of hospital-based home health nursing in community care. Results: Korean visiting medical care services, including hospital-based home health nursing, was not found to be sufficient nationwide. The supply of home health nursing did not increase due to the nature of the visiting services that required transportation time, poor profitability due to insufficient insurance fees, and increase in acute beds. Conclusion: The nature of the Korean medical environment and visiting medical care makes it challenging to establish a visiting medical supply system for community care. Therefore, hospital-based home health nursing is an important infrastructure for visiting medical care, and will be a valuable resource to link discharged patients returning to the community when moving health care services. Hence, laws and institutional supplementation to expand the role of home health nursing agencies nationwide are needed along with addressing the limitations in the supply of home health nurses.

• 가정간호학회지
• /
• 제10권1호
• /
• pp.5-14
• /
• 2003

Recently, there has been an increasing need for long-term care and comprehensive health care services in community settings. The Ministry of Health and Welfare introduced the Hospital-Based Home Nursing Care Program in 2000. Before this initiative, there was a Home Nursing Demonstration Center, affiliated with the Seoul Nurse Association, had offered home nursing services with the financial support from the local government. since 1993, the Center's nursing staff has been engaged in a general hospital in an effort to provide home nursing care services within Korea's health care system. The purpose of this study was to analyze and identify characteristics of community-based home nursing care supplied by a community-based home nursing team engaged in a general hospital. Also. visit nursing care services provided by public health centers were evaluated in terms of accessibility and supply versus demand, to enhance the accessibility of low-income patients living in Seoul to home nursing care services. Data were collected from home nursing insurance reimbursement claims submitted by the community-based home nursing care team from March 1 to October 30 in 2001 and a questionnaire survey on home-visit nursing services of 25 public health centers in Seoul. The subjects consisted of 197 patients and 12 public health centers. The result were as follows. First, medical institution's community-based home nursing care program was better in technical quality than health-center-based home-visit nursing care. In addition. the pattern of the subject patients was similar to that of hospital-based home nursing care program. Second, there was a high demand for community-based home nursing care while only a small number of home-visiting nurses served at public health centers in Seoul. As a result, many patients could not receive adequate care. Finally, we suggest that community-based home nursing care program should be introduced in the national health system to meet the at-home care needs of severely ill low-income patients. Furthermore, to better utilize home nursing and visit-nursing care resources and offer continued care for patients in community settings, an efficient referral network should be built among related institutions. This would require improvement of reimbursement system and amendment of the law related to health insurance system and community-based home nursing care services.

• 지역사회간호학회지
• /
• 제32권3호
• /
• pp.356-367
• /
• 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.

• 지역사회간호학회지
• /
• 제20권4호
• /
• pp.443-452
• /
• 2009

Purpose: The purpose of this study were to examine the need of community care services and the influencing factors of the need in the family care givers of hospital-based home care patients. Methods: Data were collected from 256 family caregivers, who were recruited from 10 hospitals in a metropolitan city. A structured questionnaire on the characteristics of caregivers, resources, and patients was administered. Also, questions on the need of community care services were added. Logistic regression analysis was used to identify the influencing factors of the need for community care services. Results: The participant needed more transportation service, lease of health care devices, visiting bath, caring, visiting hair dressing than that of housekeeping, short-term care, and day care service. Various variables from the three factors were found to be influenced on the need of community care services. Conclusion: The accessibility of the higher need of community care services should be increased for hospital-based home care users. Also, the factors of Family care giver, Resource, and Patient might be considered to provide community care services of hospital-based home care users.

• 대한간호학회지
• /
• 제31권4호
• /
• pp.619-630
• /
• 2001

Purpose: The purpose of this study was to analyze the differences in terms of services and cost between CVA without typical diseases (Group I), and CVA with typical diseases (Group II), in their Hospital-based home health care. Method: The subjects of this study were 308 CVA patients who used home care nursing during the second phase demonstration project of their hospital-based home health care. Results: The results of the study was as follows 1. Group II had more home visit (15.3/12.7) (p>0.05), and cases of death when home care (16.8/11.4) (p<0.05). 2. Group II needed more services than Group I such as bladder irrigation, skin care, bed sore care, glycerin enema, finger enema, lung care, urine sugar test, monitoring and surveillance of fluid infusion and R.O.M exercise (p<0.05). 3. The variables that showed statistical significance in the regression analysis were family style, OPD visit, level of consciousness, patient's state on termination of home care, and some extend of home health care services (R2=0.373, 0.205). Conclusion: Home nursing care needs to be planned by severity in Hospital-based home health care for CVA patients.

• 간호행정학회지
• /
• 제16권4호
• /
• pp.409-418
• /
• 2010

Purpose: The purpose of this study was to compare the costs and benefits of home nursing care services between public health centers (PHC) and private hospitals. Method: Participants were 105 patients who had received home nursing care services from a private hospital or public health center. From a societal perspective, the researcher identified the costs and benefits of the services using performance data and calculated the net benefit and benefit/cost ratio. Result: The net benefit of the home nursing care service based in the PHC was 165.9 million won and benefit/cost ratio was 2.0, while the net benefit of the home nursing care services by the private hospital was 141.1 million won and benefit/cost ratio was 1.7. Both types of programs were economically validated. Conclusion: Home nursing care services were basically efficient as the results showed a positive net benefit. A cost-benefit analysis indicated that the PHC-based home nursing care services were more efficient than that of the private hospital. With limited human resources and management standards in public health centers, results suggest the need for a more systematic management of the home nursing care service to improve the health of this vulnerable community population.

• 가정간호학회지
• /
• 제16권1호
• /
• pp.49-58
• /
• 2009

Purpose: This study aimed to clarify the needs for hospital-based home care nursing medical services in elder care institutions by analyzing the details and frequency of medical services provided by, and the needs for, hospital based home care nursing in select institutions in Korea. Methods: Seventy-seven staffs at elderly care institutions located throughout the country completed self-report questionnaires between February 1 and May 31, 2009. SPSS ver. 14.0 was used for data analysis regarding frequency and percentage, mean and standard deviation. Results: Forty-eight hospital-based home care nursing medical services in eight domains were identified as being needed in elderly care institutions. The most commonly used medical services were providing instruction in oral drug administration, checking drug beneficial/adverse effects, and administering blood glucose test, while the most needed medical services requiring hospital based home care nursing were complex pressure ulcer care, followed by diabetic foot ulcer management and nutrient injection. Conclusion: The present results should provide fundamental data for better healthcare services with hospital based home care nursing at elderly care institutions as part of a 'win-win' strategy through which medical expenses are reduced, insurance costs are kept stable, and safe and high-quality medical services are provided for residents of elder care institutions. Political decisions intended to promote visits by hospital based home care nurses to elder care institutions would be a prudent course.

• 지역사회간호학회지
• /
• 제19권4호
• /
• pp.660-672
• /
• 2008

Purpose: To analyze the home care services provided to the elderly aged 65 and older by a hospital-based home care agencies and to investigate the effects of long-term care insurance for the elderly. Method: The subjects were the home care service recipients aged 65 and older in 172 hospital-based, home care agencies registered in Health Insurance Review & Assessment Service in January, 2007. The data were collected using a questionnaire from March 16 to April 15, 2007. The questionnaire return rate was 43.8%. Result: The hospital-based home care agencies were able to visit 66.5% of the national administrative districts. Of the home care service recipients, over 50% were 65 years old and older. About 43% of the agencies reported that over 50% of their patients would be subject to the long-term care insurance. They expressed concern that home care services would be withdrawn once the insurance system is initiated. Conclusion: This study suggests that hospital-based home care agencies need to manage home care services with long-term care insurance. It also recommends developing guidelines for the use of services and referrals.

• 보건교육건강증진학회지
• /
• 제7권2호
• /
• pp.78-88
• /
• 1990

The subject of this study is to review the practical approaches of Home Care Services. Included is a brief overview of its nature, providers of Home Care Services, recent history of Home Care Services, and the impact of the national movement toward cost containment in health care. The data used in this study are obtained from the Elderly Program of the Medical Services and other data on the Home Care Services in Japan. With the growing elderly population in Japan, it is to be expected that the medical care expenditure for this sector will continue to increase. With the aim of keeping expenditure for medical care within reasonable bounds, it is essential that this increasing expenditure on the elderly be used effectively. With the Health and Medical Services Law for the Aged was enforced, therefore, remuneration for medical treatment of the elderly and what is known as the staff placement standard at hospital for the elderly were rationalized. In addition to rationalization from the point of view of medical care supply, it is necessary to guarantee the appropriate treatment within the community and at home for those elderly who are bedridden but not in need of hospital care. For this it is required that Home Care Services, such as health services like visiting guidance by public health nurse in hospital of Health Center. So that the elderly can feel secure in receiving treatment within the community and at home, allowances for guidance on leaving hospital and for intermittent nursing and guidance thereafter are to be newly introduced. Home care Services in one aspect of comprehensive health care, it is comprised of health services provided to individuals and families in their homes. Its purposes include promoting, maintaining and restoring health, specifically maximazing independent functioning and minimizing the disabling effects of illness, including terminal illness. Services appropriate to the needs of clients and their families are planned, coordinated, and delivered by providers organized for the delivery of home health care through the use of contractual arrangement, employed staff, or a combination of the two.

• 한국보건간호학회지
• /
• 제35권1호
• /
• pp.5-18
• /
• 2021

Purpose: This study aimed to develop a client-centered integrated home nursing care model for rural areas by analyzing public health nursing, hospital-based home care services, and long-term nursing care in Korea. Methods: The literature review performed included data from the National Assembly Library, DBpia, RISS, and KISS, Google Scholar, the Ministry of Government Legislation, Statistics Korea, and the Ministry of Health and Welfare. Results: The client-centered and integrated home nursing care model in a rural area was opened as the Home Nursing Care Center in a public health center operating directly or on consignment. This model provides both a hospital-based home care services as well as long-term care, in accordance with the health status of the client and difficulty of nursing services. Moreover, the nurse who worked in a sub-organization (Centers for Supporting Healthy Living, Public Health Units, and etc.) of the public health center as care coordinator and case manager facilitates to connect home nursing care services and social welfare services. Conclusions: Our data indicates that the client-centered integrated home nursing care model in rural areas effectively combines professional services, regional accessibility, and social welfare services.