• Title/Summary/Keyword: Nursing Costs

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Current Situation and Reform Scheme for Personal Care Attendants(PCAs) in Workers' Accident Medical Corporation (산재의료원 간병인 관리현황 및 개선방안)

  • Oh, Jin Joo;Lee, Hyun Joo;Choi, Jeong Myung;Kim, Chun Mi
    • Korean Journal of Occupational Health Nursing
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    • v.16 no.2
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    • pp.222-231
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    • 2007
  • Purpose: This study aims to suggest political alternatives for nursing care costs for PCAs to provide qualitative medical benefit for patients with occupational disease by investigating present situation and problems of the nursing care cost system of Korea's Industrial Accident Compensation Insurance. Methods: Data was collected from 6 workers' accident medical corporation and 275 nurses affiliated with Korea labor welfare corporation using self reported questionnaire. Result: Research results were as follows; Character of nursing care cost of the Korea's Industrial accident Compensation Insurance changed as if it aims to support for living expenses for the family; As possible problems which could be caused under current system, administrative problems, decrease of service quality were made as objects of criticism. Some patients did not make every effort in rehabilitation to be beneficiaries continuously. Some patients were supplied with whole one PCA or all-night PCA even though they did not need as much caring as such. Conclusion: The research suggested that PCAs payment system improvement is necessary, and the presented nurses' opinion for the improvement method could be applied for policy making.

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Factors Related to Nursing Home Institutionalization of Elderly using Home Care Services (노인장기요양 재가서비스 이용자의 시설 입소 영향 요인)

  • Han, EunJeong;Hwang, RahIl;Lee, JungSuk
    • Journal of Korean Public Health Nursing
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    • v.30 no.3
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    • pp.512-525
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    • 2016
  • Purpose: Ageing in place may improve the quality of life of frail elderly and decrease their costs of services. The purpose of this study was to examine the factors that influence the institutionalization of elderly using home care services in a Korean long-term care insurance system. Methods: This study used the data of '2009 Satisfaction survey of Korean long-term care system'. The survey proceeded to use a sampling data based on region, level of long-term care need, and insurance type among the beneficiaries between August and September 2009. The onset dates of institutionalization of 1,095 participants were ascertained from long-term care insurance claim data. This study calculated the hazard ratio through the Cox Proportional Hazard Model. Results: A total of 176 subjects who were institutionalized in nursing homes were included. There were higher risks in the group that included those who were 85 years and over, had dementia or fracture, used home-visit nursing service, and were not supported by direct family. Conclusion: The results of this study have policy implications to supplement the home care service system and postpone nursing home institutionalization of elderly.

Estimation of nursing costs for hospitalized patients using the resource-based relative value scale (상대가치(Resource-Based Relative Value)를 이용한 간호행위별 간호원가 산정)

  • Park, Jung-Ho;Song, Mi-Sook;Sung, Young-Hee;Cho, Jung-Sook;Sim, Won-Hee
    • Journal of Korean Academy of Nursing Administration
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    • v.5 no.2
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    • pp.253-280
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    • 1999
  • A cost analysis for hospitalized patients was performed based on the RBRVS in order to determine an appropriate nursing fee schedule. The study was conducted through three phases as follows: 1) Nursing activities provided for the inpatients currently in Korea were identified and classified using a taxonomy which was developed by our research team through the Delphi process. 2) The resource-based relative points for every nursing activity according to nursing time, mental effort and judgement, technical skill, physical effort and stress were determined through a survey of 300 clinical RNs working at 5 tertiary hospitals from May 25 to July 25. 1998. 3) The nursing cost of every nursing activity for hospitalized patients was estimated based on the RBRVS. As a result, 136 nursing activities were identified and classified by nursing processes and nursing domains. However, our classification system of nursing activities should continue to be refined, and all nursing practices should be standardized. The nursing activities were given resource-based relative points ranging from 100 to 400 points, then each nursing activity was assigned a value for the RBRVS, which was determined by the exponential function of 2resource-based relative point/100. Thus, a value of 2 was calculated for 100 points, 4 for 200 points, 8 for 300 points, and 16 for 400 points. Meanwhile, the unit cost of nursing was calculated as 170 Won. The nursing cost of 136 nursing activities was estimated using the RBRVS as shown in

    . A proper nursing fee schedule for a new reimbursement system based upon the results of the above study should be prepared in the near future.

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  • Health Status of International Students in Korea (외국인 유학생의 건강 실태 조사)

    • Lee, Nae-Young;Han, Ji-Young
      • Journal of East-West Nursing Research
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      • v.17 no.1
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      • pp.48-56
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      • 2011
    • Purpose: This study explored the health-related information of international students in Korea. Methods: Data were collected from 112 international students of 4 universities in P city regarding perceived health belief, health status, health habits, health management and medical costs. Results: International students in Korea perceived that their health belief was good and most of them belonged to healthy group. Also they reported good health habits and less severe physical complaints which can be easily treated. However, the portion of underweight or obese was large and physical complaints were frequent. Conclusion: To promote health of international students, nurses in university or community should develop appropriate programs to improve health habits and to access to health care services.

    Cost-Effectiveness Analysis of Home Care Service for Cerebrovascular Disease Patients (가정간호서비스의 비용효과분석;뇌혈관질환자를 중심으로)

    • Lim, Ji-Young;Park, Young-Joo
      • Journal of Korean Academy of Nursing Administration
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      • v.8 no.2
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      • pp.323-334
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      • 2002
    • Purpose: This study was designed to analyse economical efficiency of home care service by comparing a cost-effectiveness ratio(CER) between hospitalization and home care service. Method: The analytic framework of this study was constructed in 5 stages; perspective of the analysis, measurement of costs, measurement of effects, analysis of CER, and sensitivity analysis. The SAS program was utilized for the general characteristics of the subjects, descriptive statistics, homogeneous test, normality test and difference test. Result: The results were as follows; 1) CER was 35,248,256 of ADL, 7,996,026 of nursing satisfaction, 6,144,946,000 of QALY of patients in the hospital and 11,168,863 of ADL, 2,322,239 of nursing satisfaction, 3,674,556,000 of QALY of patients in the home care center. ICER was 438,067,932 of ADL, -190,044,176 of nursing satisfaction, 8,615,336,000 of QALY. 2) In the sensitivity analysis of sex, age and discount rate, the CER of patients in the home care center was lower than the CER of patients in the hospital. Conclusion: With these findings, it affirmed that home care service had an economical efficiency compared with hospitalization in cerebrovascular disease patients. Therefore, these results will be used to develop governmental policy or expansion of the home care service.

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    Effect of an Integral Care System: a Combination of Oriental and Western Care for Older Adults with Degenerative Arthritis (퇴행성 관절질환을 앓고 있는 노인환자를 위한 한방과 양방을 적용한 통합의료 서비스의 효과)

    • Lee, Ji-A;Ji, Eun-Sun
      • Journal of Korean Academy of Nursing
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      • v.41 no.1
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      • pp.18-25
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      • 2011
    • Purpose: This study was done to examine the effect of an integrated care service which included a combination of oriental and western care on health outcomes in elderly patients with degenerative arthritis. Methods: A prospective comparative design was used. Data were collected from May 1, 2008 to June 30, 2009 from 85 elderly patients with degenerative arthritis in the lower extremities who were followed in a hospital out-patient department for 8 weeks. The integrated care service group (n=36) received a combination of physical therapy, acupuncture, western medicines or herbal medicines, and the western care group (n=49) received physical therapy or western medicines. Functional independence, walking speed, rotation balance, pain intensity, service satisfaction and total medical costs for the two groups were compared at 8 weeks. Results: Functional independence (t=2.14, p=.036) and walking speed (t=2.51, p=.014) improved significantly in the integrated care group while pain intensity improved significantly in the western care group (t=3.35, p=.002). The integrated care group reported higher scores for service satisfaction (t=2.09, p=.041) and higher medical costs than the western care group (t=2.15, p=.035). Conclusion: The results suggest that integrated care services are effective modalities to improve mobility and quality of life for elders with degenerative arthritis.

    The Current State of Hospital-based Home Care Services in Korea: Analysis of Data on Insurance Claims for Home Care from 2007 to 2012 (의료기관 가정간호의 현황(2007-2012): 가정간호 급여청구자료 분석)

    • Song, Chong Rye;Lee, Mi Kyoung;Hwang, Moon Sook;Yoon, Young Mi
      • Journal of Home Health Care Nursing
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      • v.21 no.2
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      • pp.127-138
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      • 2014
    • Purpose: The objectives of this study were to analyze the state of hospital-based home care (HC) services annually and to provide basic information for research and policy regarding home care. Methods: This study is a secondary analysis of the yearly state of HC services from the Health Insurance Review & Assessment Services from 2007 to 2012. Results: The decreased by 34.6%, from 214 agencies in 2007 to 140 in 2012. The annual average number of active home care nurses was 440, which included 6.7% of the licensed home care nurses until 2012. The annual average number of HC patients were 32,000, and this number decreased by 21% in 2012, compared to that of 2008. Of the HC patients, about 70% were over 60 years of age. The chronic diseases among HC patients have been decreasing steadily since 2007. Seventy to eighty percent of the home visits were made in general hospitals or higher level hospitals. The total medical cost for HC services was 21 billion won in 2007, which consisted of 0.06% of the national medical costs, and it was 22 billion won and 0.03% in 2012. Conclusion: Based on the results of this study, further research on HC services is necessary to frame policies for the expansion of HC agencies.

    Cost-Benefit Analysis for Periodical Inspection of Press (일부 사업장의 프레스 정기검사에 대한 비용-편익 분석)

    • Kim, Ji-Yun;Jung, Hye-Sun;Kim, Eun-Young;Choi, Eun-Sook;Choi, Sook-Ja;Gal, Won-Mo;Kim, Woo-Young;Yang, Bong-Min
      • Korean Journal of Occupational Health Nursing
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      • v.12 no.2
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      • pp.99-109
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      • 2003
    • Although occupational accidents caused by presses are found to be the highest in manufacturing industrial groups, there are no study regarding to annulment for periodical inspection of press. The purpose of this study was to evaluate the economic benefit of periodical inspection of press for preventing accidents. The cost-benefit analysis in this study was conducted to evaluate the relative magnitude of benefit to cost. Study samples were 26 and years analysed were 1995, 1996, 1998 and 1999. Personal interviews with safety managers were held from October 7 to November 2, 2002. Costs of the periodical inspection program were compared with the benefit of accident that caused by presses. Costs and benefits were calculated at an discount rate of 5%. The benefit-cost ratio was 5.7. The sensitivity analysis for the discount rate, the number of press, and size of industry showed that every benefit-cost ratios were upper than one(1.0). The results of this study suggested that periodical inspection for press is important program for preventing accident and the regulation for periodical inspection program should be reenforced by government.

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    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.

    Triggers and Outcomes of Falls in Hematology Patients: Analysis of Electronic Health Records (혈액내과 입원 환자의 낙상 위험 요인과 환자 결과: 전자의무기록 분석)

    • Jung, Min Kyung;Lee, Sun-Mi
      • Journal of Korean Academy of Fundamentals of Nursing
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      • v.26 no.1
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      • pp.1-11
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      • 2019
    • Purpose: The goal was to use electronic health records to identify factors and outcomes associated with falls among patients admitted to hematology units. Methods: This retrospective case-control study included data from a tertiary university hospital. Analysis was done of records from 117 patients with a history of falls and 201 patients with no history of falls who were admitted to the hematology unit from January 1, 2013 to December 31, 2014. Risk factors were analyzed using hierarchical logistic regression; patient outcomes were analyzed using multiple logistic regression, Cox proportional hazards regression, and multiple linear regression. Results: Clinical factors such as self-care nursing (OR=4.47, CI=1.64~12.11), leukopenia (OR=6.03; CI=2.51~14.50), and hypoalbuminemia (OR=2.79, CI=1.31~5.96); treatment factors such as use of narcotics (OR=2.06, CI=1.01~4.19), antipsychotics (OR=3.05, CI=1.20~7.75), and steroids (OR=4.51, CI=1.92~10.58); and patient factors such as low education (OR=3.16, CI=1.44~6.94) were significant risk factors. Falls were also associated with increased length of hospital stay to 21.58 days (p<.001), and healthcare costs of 17,052,784 Won (p<.001). Conclusion: These findings can be a resource for fall prevention education and to help develop fall risk assessment tools for adults admitted to hematology units.


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