• 제목/요약/키워드: In-Home Care Services

검색결과 650건 처리시간 0.028초

일개 시지역의 가정간호 수혜자들의 만족도 조사 (A Survey on Clients' Home Care Satisfaction in Taejon City in Korea)

  • 김선숙;소희영;이태용
    • 가정간호학회지
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    • 제5권
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    • pp.73-83
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    • 1998
  • This study enrolled one thousand five hundred twenty one clients that were receiving home care services at five health centers and a home care services center in the city of Taejon from November 17 through December 7, 1997. The purpose of this study was to analyze satisfaction levels, general characteristics and efficacies, of the client served home care. The main results were as follows; The age group of most of the subjects was 70-79 years: 76.9% of them were female and 87.3% were over 65 years. In education variables, over 90% of the clients were below primary school. In marital status variables, 63.4% of them had no spouse, 57.5% of them were widows and widowers. In living arrangement variables, alone(35.8%) was the most. In insurance status variables, medical aid(69.9%) was the most. In household income variables, below 000 won(72.6%) was the most. In hospitalization variables, 53% of the clients had no hospitalization. The satisfaction level of home care service of male and female was similar. The older the age, the higher the satisfaction level. The satisfaction level of the group having religion was higher than the group having no religion and the Christianity group had the highest satisfaction level(p<0.001). In education variables, the over high school group was the highest satisfaction level(p<0.01). In living arrangement variables, the other (sisters or neighbors etc.) group indicated the highest satisfaction level(p<0.001). In insurance status variables, the other group(except for medical aid) was the highest satisfaction level(p<0.001). In household income variables, below 390,000 won was the highest satisfaction level(p<0.001). In hospitalization variables, 'over 4 times' group indicated the highest satisfaction level (p<0.01). Home care took place more in health centers than in home care services center. In frequency of home care per month three times was the most. In opinion of home care frequency per month 82.8% of the people answered 'proper'. A lot of present illness was neuralgia, arthritis, digestive disease, hypertension & CVA. In contents of home care services variables, education & counselling was the most and medication was second. In duration of illness variables, over 10 years was the most. In place of treatment before home care service variables, hospital(57%) was the most. In illness condition after home care variables, 'moderate' was the most and 'much better'(85.5%) was second. In help of home care variables, 'much help'(71.5%) was the most and 'moderate'(28.1%) was second. In contents of counselling variables, treatment method of illness was the most. Home care services center indicated higher level of satisfaction than health center(p<0.001). In opinion of home care frequency per month variables, 'less' was the highest satisfaction level (p<0.001). In duration of illness variables, below one year was the highest and over 10 years was second(p<0.001). In place of treatment before home care service variables, health center was the highest (p<0.001). In illness condition after home care variables 'much better' was the highest and 'worse' was second (p<0.001). I n help of home care variables, 'much help' was the highest (p<0.001). In contents of counselling variables, cause of illness was the highest(p<0.001). According to the 14 items which consisted of 3 point scales the total level of satisfaction of home care service was very high, with total mean score 36. According to the above results, most clients taking home care services are satisfied. However, organization and a fund are required to support high quality home care services to those who need them. Furthermore, a follow-up survey should be accomplished to evaluate the status of clients.

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성당연계 가정간호사의 가정간호 서비스 필요도와 유헬스케어 인식정도 (The Need for Home Care Services and Awareness of U-healthcare in Nurses of the Catholic Parish Home Care Center)

  • 오정아;김희승;윤건호;송민선;박민정;정현숙
    • 가정간호학회지
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    • 제15권2호
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    • pp.67-74
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    • 2008
  • Purpose: We analyzed the need for home care services and awareness of U-healthcare in nurses of the Catholic Parish Home Care Center to link the ubiquitous health care system and the home care. Methods: We recruited 46 nurses from a home care center in the catholic parish of the C medical center from April 4th to June 8th, 2007. Results: The highest needs were 'assessment and diagnosis of the problem', 'management of hypertension & diabetes patients', 'counseling of the patient', and 'counseling of major caregiver and family problems'. Therapeutic nursing showed the highest needs in bedsore care. Nurses want hospital medical records available through the ubiquitous health care system. Conclusion: Home care services are supported from the agency, with high needs in assessing and diagnosing the problem, counseling, and managing of hypertension & diabetes patients. Education and public relations efforts on the U-healthcare system should improve system awareness.

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

  • 이태화
    • 간호행정학회지
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    • 제4권2호
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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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건강보험 자료를 이용한 전국 의료기관 가정간호 실시 및 이용 현황 분석: 2008년-2017년 (Analysis of Hospital-based Home Care Service Utilization Using National Health Insurance Claim Data from 2008 to 2017)

  • 고정연;윤주영
    • 가정간호학회지
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    • 제26권1호
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    • pp.36-50
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    • 2019
  • Purpose: The purpose of this study is to analyze the status quo of hospital-based home care utilization in Korea from 2008 to 2017. Methods: Data from a total of 1,396 medical institutions, 350,390 patients, and 3,563 home care nurses were analyzed using claim data from the Health Insurance Review & Assessment Service. Results: The number of hospital-based home care agencies decreased from 177 in 2008 to 115 in 2014. This number started to increase in 2015 and reached 179 in 2017. The number of hospital-based home care patients declined from 35,056 in 2008 to a low of 26,848 in 2013. This number started to increase in 2014 and reached 67,863 in 2017. Essential hypertension was the most common disease among hospital-based home care patients from 2008 to 2015. The number of hospital-based home care visits declined from about 500,000 in 2008 to a low of 362,000 in 2013. This number started to increase in 2014 and reached 658,000 in 2017. Conclusion: It is necessary to vigilantly monitor hospital-based home care agencies, patients, and the utilization of services. This may help establish platforms for providing community and home-based nursing services for the super-aged society in Korea.

가정간호수가 적정성 검증 및 수가체계 개선 방안 (Test on the Cost and Development on the Payment System of Home Health Care Nursing)

  • 유호신;정기선;임지영
    • 대한간호학회지
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    • 제36권3호
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    • pp.503-513
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    • 2006
  • Purpose: This study focused on analysing costs per home health care nursing visit based on home health care nursing activities in medical institutes. Method: The data was collected in three stages. First, the cost elements of home health care nursing services were collected and 31 home care nurses participated. Second, the workload and caseload of home care nursing activities were measured by the Easley-Storfjell Instrument(1997). Third, the opinions on improving the home health care nursing reimbursement system were collected by a nation-wide mailing survey from a total of 125 home care agencies. Result: The cost of home health care nursing per visit was calculated as 50,626\. This was composed of a basic visiting fee of $35,090{\\}({\fallingdotseq}355$)$ and travel fee of $15,536{\\}({\fallingdotseq}15$)$. The major problems of the home care nursing payment system were the low level of the cost per visit, no distinction between first visit and revisits, and the limitations in health insurance coverage for home health care nursing services. Conclusion: This study's results will contribute as a baseline for establishing policies for improvement of the home health care nursing cost and for applying a community-based visiting nursing service cost.

병원가정간호사업 운영 현황 및 서비스 만족도에 관한 연구 (A Study for the Present Conditions and the Service Satisfaction with Hospital Home Care Service)

  • 홍춘실;오경옥;박미영;심희숙;차영남
    • 가정간호학회지
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    • 제8권2호
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    • pp.121-134
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    • 2001
  • The purpose of this study were to analyze the home care services and to evaluate the client's satisfaction with the home care services provided by home care service center in the C hospital. The data were collected by reviewing charts of 128 home care clients who were receiving home care services at C hospital from October 1997 to September 2000. The subjects for satisfaction of home care service were 20 clients from July 10 to September 30, 2000. The tool for measurement of present condition of home care service was developed by the researchers. The satisfactions of the home care services were measured by using the instrument developed by Im(997). The data were analyzed by using the SPSS/PC+. The results of this study were as followings : 1. Majority of the subjects was female(61.7%). The average of age was 63.5 years. The service has been used mostly by the elderly 60 years of age or older(71.1%). The economic level of most of subjects was in middle class(94.5%). 2. Majority of the subject had a cancer(55.4%), following stroke(25.0%). The average duration of disease for the subjects was 31 months. The average time of hospitalization for the subjects was 3.3 times. The duration of hospitalization was 10$\sim$30 days(26.6%), 30$\sim$60 days(23.4%) and above of the 210 days(9.4%). 3. Most of the subjects used his/her doctor (47.7%), as a consultant, following his/her nurse (28.1%), other patients or their family (21.9%). Most of reasons for a consultation were supportive management(Infusion or medication, 60.94%), following tube management(L-tube or T-tube, 25%), Foley catheter management (15.63%) etc. 4. 28 types of nursing diagnoses were used by the home care service. The nursing diagnosis altered nutrition: less than body requirement were used mostly by the home care service, following risk for infection, impaired skin integrity, impaired swallowing, ineffective airway clearance altered comfort: pain, impaired physical mobility. By the human-response pattern, exchanging(63.2%), moving(7.5%), feeling(10.4%), knowing(5.2%), communicating (2.6%), relating(0.5%) perceiving(0.4%) and choosing(0.3%). There were 42 nursing intervention types were performed by the home care service. By the NIC(nursing intervention classification. McCloskey. Bulech. 1996). physiologic: complex (30.3%) was the most, safety(28.3%), behavioral(20.0%), physiologic: basic(10.8%) and health system(1.7%). Observation or assessment was the most nursing intervention performed by the home care service. following IV infusion. vital sign observation. infusion management and fluid-electrolyte balance management. 5. The level of client's satisfaction with provided home care services showed considerably high(2.67/ 3).

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뇌졸중 이환 노인의 일상생활수행능력 변화에 미치는 영향: 장기요양 재가 서비스와 시설 서비스를 중심으로 (Factors Associated with the Changes in Activities of Daily Living in Older Adults with Stroke: A Comparison of Home Care and Institutional Care)

  • 정운숙;임은실
    • 지역사회간호학회지
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    • 제27권4호
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    • pp.388-398
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    • 2016
  • Purpose: To compare the changes in activities of daily living (ADLs) in older adults with stroke in different modalities of long term care (LTC) services, which include home care and institutional care. Methods: This is a comparative study using secondary data from the Korean national LTC insurance. Home care (HC) services users (n=3,494) and institutional care (IC) users (n=1,428) were extracted and compared in terms of ADLs and changes in ADLs to investigate the effects of HC and IC services in LTC. Results: All of the ADLs and LTC services benefit levels for 2 years had improved in both HC and IC services. The ADLs of older adults with stroke who received HC improved, while those who received IC experienced deterioration. The LTC services benefit levels of the HC and IC groups were significantly different after 2 years. Conclusion: The study has found that HC services may lead ADLs better for older adults with stroke. We recommend LTC policy makers to further develop HC and IC service programs to deliver quality LTC services.

당뇨병성 족부질환자에 대한 가정간호서비스의 비용-효과분석 (Cost-effectiveness Analysis of Home Care Services for Patients with Diabetic Foot)

  • 송종례;김용순;김진현
    • 간호행정학회지
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    • 제19권4호
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    • pp.437-448
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    • 2013
  • Purpose: This study was a retrospective survey to examine economic feasibility of home care services for patients with diabetic foot. Methods: The participants were 33 patients in the home care services (HC) group and 27 in the non-home care services (non-HC) group, all of whom were discharged early after inpatient treatment. Data were collected from medical records. Direct medical costs were calculated using medical fee payment data. Cost-effectiveness ratio was calculated using direct medical costs paid by the patient and the insurer until complete cure of the diabetic foot. Effectiveness was the time required for a complete cure. Direct medical costs included fees for hospitalization, emergency care, home care, ambulatory fees, and hospitalization or ambulatory fees at other medical institutions. Results: Mean for direct medical costs was 11,118,773 won per person in the HC group, and 16,005,883 won in the non-HC group. The difference between the groups was statistically significant (p=.042). Analysis of the results for cost-effectiveness ratio showed 91,891 won per day in the HC patients, and 109,629 won per day in the non-HC patients. Conclusion: Result shows that the cost-effectiveness ratio is lower HC patients than non-HC patients, that indicates home care services are economically feasible.

노인장기요양보험 구강위생서비스의 활성화를 위한 재가장기요양기관 관리책임자 심층면담 (In-depth interview with the center managers for home visit dental hygiene services in the long-term care insurance)

  • 김한나;김기연;노희진;김남희
    • 한국치위생학회지
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    • 제18권4호
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    • pp.455-462
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    • 2018
  • Objectives: This study was carried out to identify plans to activate home visit oral care services by dental hygienists in Long-term care insurance. Methods: In-depth interviews were carried out with 21 Long-term Home Care Center Managers as target. A total of 21 (27%) Home Care Centers were selected through convenience sampling among 78 Home Care Centers that are located in Won-ju city. The Managers were presented with questions and answered in 20-30 minutes in accordance with the interview instructions. The interview results were analyzed through content analysis, and their experiences and perceptions were classified into two themes and categorized again into four components. Results: The Home Care Center Managers suggested that dental hygienists should activate home-visit oral hygiene services. It is necessary to improve the management process and awareness of the elderly. Conclusions: To activate oral hygiene services, it is necessary to improve the service guideline and enhance the efficiency of the service process. This should be acceptable both to the elderly who need the services and the dental hygienists who provide them.

일개 지역사회 중심 가정간호사업소의 운영실태 및 운영방안 (A Study on the Operating Status of Community-based Home Health Care Centers)

  • 이은희;박성애
    • 간호행정학회지
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    • 제17권2호
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    • pp.180-188
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    • 2011
  • Purpose: This study was done to evaluate the operating status of community-based home health center for revitalization of the centers. Method: In this study performance data including organization plan and service utilization plan were evaluated according process theory. Target of evaluation was the community-based home health care center. Results: The vulnerable part of the organization was the information system and financial resources. The home health center introduced PDA (Personal Digital Assistants) in 2005, however home health care nurses did not make full use of it. This service received full support from Seoul city and local government and there were no other sources of income. The vulnerable part of service utilization was service expansion and standardization due to vulnerability of organizational aspects. Conclusions: The home health care center provides high quality services to underprivileged people. In the future, these services should be provided with equity for continuous health care for this population.