• Title/Summary/Keyword: In-Home Care Services

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A Study for Reorientation of Home Care Service at Community (일개 보건소 방문간호사업의 업무 분석)

  • Lee, Hong-Ja;Kim, Chun-Mi;Yun, Soon-Nyong
    • Research in Community and Public Health Nursing
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    • v.9 no.1
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    • pp.163-180
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    • 1998
  • The purpose of this study is to evaluate the community based home care service, and make reorientation for better service. The data was collected from the public health center, which was operated for one year, 1997. This case is evaluated and reoriented according to five elements of public health care system; system of resources for public health, organization and administration, health care delivery system of financing, management. In resources for public health, available health personnels are 15 physicians, 17 nurses, 11 nurse aides and 2 other persons. One professional health personnel take care of 609 clients, The equipments used for elderly and the disabled are 6 wheelchairs, 4 walkers, 1 hairwashers and 30 viberations. But these equipments are not enough to deal all clients. In organization and administration, planning and setting goals for community home care are made by the director, supervisor of family department and public health nurse. So there is no regular commitee for home care services in this community. The form of delivery of health care is focused on preventive health care. The important works of public health nurse are health education, preventive care for hypertension, D.M. and vaccination of communicable desease. In finaning system, funds come from central government(8.3%), local goverment(16.7%) and health center itself(3.8%), The services consist of health education, vaccination, clinical test and equipment. There are several local volunteers, which are local hospitals, a college, a christian association, a catholic association, a drivers association and a disabled association. The volunteer groups give physical and mental support to the clients. In management, this health center has three evaluation methods. One is done by local government, one is done by health center itself, and the other is done by clients with questionair. But the evaluation tools are deferent between agency. Home care services must be planned and evaluated. This public health center has to have more personnel, equipments, education for professional kowledge and meetings with community volunteer agencies.

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A Study on the Supply Estimation and Arrangement of In-Home Care Facilities for The Elderly in Seoul (서울시 재가노인복지시설의 공급량 및 시설배치에 관한 연구)

  • Kim, Seok Jun;Lee, Teuk Koo
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.10 no.1
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    • pp.19-28
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    • 2004
  • Recently, as the population of the elderly rapidly increases, the number of the special care facility for the elderly is a big social issue. The services for the elderly are divided two way. One is a facility care, the other is an in-home care. In-home care(day care, short stay care, home help) facility for the elderly in seoul are insufficient now. So this study quantitatively estimate In-home care facility needed in seoul in 2007, 2012 and 2017, propose a arrangement of these facility in seoul.

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Community Care and Visiting Nursing Services in Denmark, Sweden, the United States, and Japan (국외 커뮤니티 케어의 방문간호서비스 사례 분석)

  • Han, Young Ran;Yang, Sook Ja;Ham, Ok Kyung;Lee, Guna;Kim, Seo Hyeon;Ha, Jae Young
    • Journal of Korean Public Health Nursing
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    • v.34 no.1
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    • pp.5-21
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    • 2020
  • Purpose: This study compared visiting nursing services of Denmark, Sweden, Japan, and the United States to provide baseline data for the development of models for community care nursing services in South Korea. Methods: A review of the literature was performed that include journal articles, government reports, institutional reports, and national/international statistics. Site visits were performed to explore the visiting nursing services of Denmark. Results: Government centered visiting nursing services were provided in Denmark and Sweden mostly by public organizations, while private services prevailed in the United States and Japan. Nursing services included case management or care coordination services, while nurse practitioners or nurse specialists provided visiting nursing services in all of the four countries and the services were provided 24 hour a day. Conclusions: Based on the review of visiting nursing services in foreign countries, the development of models is needed to provide integrated visiting nursing services in Korea that encompass home care nursing, visiting nursing, and visiting health care services.

Roles of Visiting Nurses Defined Based on Long-Term Care Insurance Regulation for the Elderly (노인장기요양보험제도에 의한 방문간호사의 역할.업무분석)

  • Kim, Myung-Hee
    • Journal of Korean Public Health Nursing
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    • v.23 no.2
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    • pp.232-250
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    • 2009
  • Purpose: This study was designed to define the roles, tasks, and activities of home visiting nurses aimed at enhancing the quality of nursing care under the long-term care insurance regulation for the elderly introduced on July 1, 2008 in Korea. Methods: A review of domestic and foreign literature was used to formulate the proposed roles, tasks, and activities of visiting nurses, which were subsequently modified and complemented by the agreement of home visiting nurse experts and acceptance of 127 nurses. Data was collected from 04 June - 17 September 2008 and analyzed concerning frequency and percentile using SPSS ver. 15.0. Results: The established functions of home visiting nurses were direct nursing service provider, case manager, patient educator, decision maker, care coordinator, and research worker. These functions involved 27 different tasks and 167 activities. Conclusion: The roles, tasks, and activities of visiting nurses, established based upon the guidelines of the Long-term Care Insurance Act for the elderly, were verified for their applicability by nurses involved in home care delivery. These parameters will provide a useful tool in developing an assessment to enhance the quality of home-based care for the elderly in Korea.

Cost-Effectiveness Analysis of Home Health Care Program for Cerebrovascular Accident Patients (뇌졸중환자 가정간호 및 방문간호서비스의 비용효과 비교)

  • June, Kyung-Ja;Park, Jeong-Young
    • Research in Community and Public Health Nursing
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    • v.12 no.1
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    • pp.22-31
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    • 2001
  • Purpose of this study is to compare the cost effectiveness of home care services for the cerebrovascular accident patients by the type of institution. The method is the secondary analysis using the patients' charts. 107 subjects and 1.417 visits were sampled from each type of home care institution such as one hospital based home care center. one KNA home care center, one urban health center, one rural health center and one health care post. Result: There were differences in the functional status of patients and the service contents and frequencies provided by the type of home care institution, The cost per visit for one unit of ADL by the hospital based home care was higher than by the community-based home care. Conclusion: It was suggested that the referral system among the home care institutions would be developed to improve the cost-effectiveness.

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Trends in Home-visit Nursing Care by Agencies' Characteristics under the National Long-term Care Insurance System (노인장기요양보험의 방문간호 제공기관 특성별 서비스 제공 추이)

  • Lee, Jung Suk;Hwang, Rah Il;Han, Eun Jeong
    • Research in Community and Public Health Nursing
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    • v.23 no.4
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    • pp.415-426
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    • 2012
  • Purpose: This study aimed to investigate trends in home-visit nursing care by agencies' characteristics under the national long-term care insurance system. Methods: Cochran-Mantel-Haenzel tests were conducted, using data drawn from the nationwide long-term care insurance claim database of the Korean National Health Insurance Corporation from 2009 to 2011. Results: The number of home-visit nursing care agencies has decreased continuously since 2009. There were also similar trends in the total amount of service provided by home-visit nursing care agencies, the number of recipients, the number of employees, and payments. This study showed that there were statistically significant differences in the trends in home-visit nursing care by agencies' characteristics. Despite the overall downward trend, there were some increases in the percentage of home-visit nursing care provided by agencies which were established by individuals, located in large cities, and which combined home-visit care with home-visit bathing. Conclusion: Home-visit nursing care agencies are responsible for providing community-based healthcare services. For past three years, however, they have not been utilized to their full potential. Understanding the trends in home-visit nursing care by agencies' characteristics is important to develop utilization strategies for home-visit nursing care.

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.

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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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.

Comparison of Community Rehabilitation Services for the Elderly in South Korea and Japan: Focusing on the Long-Term Care Insurance System (한국과 일본의 노인 대상 지역사회 재활서비스 비교 연구: 노인장기요양보험 제도를 중심으로)

  • Lee, Minyoung
    • Physical Therapy Korea
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    • v.29 no.2
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    • pp.94-105
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    • 2022
  • Background: As South Korea enters an aged society, the government has emphasized the need for a soft landing of the older adults into the community after the acute and recovery periods under a national policy of "community care." However, the institutionalization of community rehabilitation services to implement this is insufficient. Japan had already entered an aged society when the Long-Term Care Insurance System was introduced in 2000. Thus, the case of Japan's institutionalization of the system is expected to have implications for us in supplementing a suitable system for the aged society. Objects: This study compared the institutionalization process of the Long-Term Care Insurance System in South Korea and Japan and the services currently being implemented in each country. Methods: To examine the institutionalization process and services of the system, related legal rules and regulations, government reports, and articles were reviewed. To examine the operation status of the system, statistical data provided by each country's government were analyzed. Results: Japan recognized the importance of community rehabilitation even before the enactment of Long-Term Care Insurance. Thus, community rehabilitation services, such as home-visit rehabilitation and health facilities, were already stipulated in the law. Under such institutional legacy, Long-Term Care Insurance was able to establish a service system, which balanced welfare and health-related services, including various types of services with enhanced rehabilitation functions. In South Korea, rehabilitation policies were not much considered in the process of institutionalizing the system; thus, it was composed mainly of services focusing on care and recuperation. Conclusion: In order to realize community care, rehabilitation services need to be developed in Long-Term Care Insurance System in various forms such as home-visit services, daily services, short stay, and facility services.