• 대한간호학회지
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• 제40권3호
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• pp.349-358
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• 2010

Purpose: The purpose of this study was to estimate nursing costs and to establish appropriate nursing fees for long-term care services for community elders. Methods: Seven nurses participated in data collection related to visiting time by nurses for 1,100 elders. Data on material costs and management costs were collected from 5 visiting nursing agencies. The nursing costs were classified into 3 groups based on the nurse's visit time under the current reimbursement system of long-term care insurance. Results: The average nursing cost per minute was 246 won. The material costs were 3,214 won, management costs, 10,707 won, transportation costs, 7,605 won, and capital costs, 5,635 won per visit. As a result, the average cost of nursing services per visit by classification of nursing time were 41,036 won (care time <30 min), 46,005 won (care time 30-59 min), and 57,321 won (care time over 60 min). Conclusion: The results of the study indicate that the fees for nurse visits currently being charged for long-term care insurance should be increased. Also these results will contribute to baseline data for establishing appropriate nursing fees for long-term care services to maintain quality nursing and management in visiting nursing agencies.

• Perspectives in Nursing Science
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• 제6권1호
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• pp.77-83
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• 2009

The number of nurses per bed at acute-stage hospitals is quite low in Korea compared with other OECD countries. In order to prevent the degradation of the quality of inpatient nursing services due to insufficient nurse staffs, the national health insurance introduced the differentiated nursing care fee system. This did not work as a motive for inducing the employment of nursing staff due to insufficient cost compensation. Because of insufficient nursing staff, family members have to stay with the patient or patients have to hire a personal care attendant. This increases the burden and cost to families. For the activation of hospitals without guardians, there should be policies for raising additional nursing staff such as standardizing jobs among nursing staff, particularly between nurses and nursing assistants, setting adequate standards of staffing in nursing according to medical service, substantiating the cost of nursing under the differentiated nursing care fee system, improving the medical fee system of hospitals without guardians including health insurance payment, supplying nursing staff stably through improving their working conditions such as providing child rearing services and salary increase, clarifying the qualification of personal care attendants working at acute.stage hospitals, developing indexes for assessing the quality of nursing care services, and monitoring for the management of uniform quality.

• 가정∙방문간호학회지
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• 제20권2호
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• pp.141-151
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• 2013

Purpose: The purpose of this study was to examine the economic effectiveness of by conducting a literature review of published articles, masters theses, and doctoral dissertations. Method: Prior to the literature review, inclusion-exclusion criteria were established. We then reviewed 1,029 CINAHL, MEDLINE, and Cochrane DB papers, and 153 RISS papers collected between Results: A total of 12 studies met the inclusion-exclusion criteria.-effectiveness: 6 cost-effectiveness studies, 1 cost-utility studies, and 5 cost-benefit studies. Each of the 12 reviewed studies concluded that home care nursing had greater economic benefits than other compared healthcare services. Conclusion: Home care nursing has significant economic benefits in multi health care service settings and for various patient groups. Therefore these results will be used a critical evidence for the development of economically effective home based health care systems for future policy making.

• 간호행정학회지
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• 제14권2호
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• pp.182-195
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• 2008

Purpose: Hospice care represents all meaningful aspects of physical, mental and economical status of the end stage patients. The purpose of this study was to estimate the cost of home-based hospice care. Method: Fifteen nurses participated in counting an hour for requirement and home visit data of 50 end stage patients were analyzed. The method of to estimate the cost of home-based hospice care was three ways. Result: In case, including traffic expense, Singles fixed fee per visit via direct inquiry was 112,970 won but in case, excluding traffic expenses, was 86,036 won and traffic expenses per visit was 26,934 won. Final cost of home-based hospice care integrated the fixed fee per the needed time for visit and fee-for services. The fixed fee per 30 minutes was 35,251 won and 60 minutes was 46,595 won and 90 minutes was 57,939 won. We included pain management and the management of emergency and bereavement care among fee-for services. Conclusion: The cost of hospice care should be establish for not only patient but the living spouse, families, and children of the dying and for anyone else affected by any patient's death.

• 대한간호학회지
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• 제30권4호
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• pp.1045-1054
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• 2000

As cost pressures have escalated, policy makers, politicians, health care providers and families have tried to devise ways to reduce health care costs. While originally developed to enhance patient control and to provide better care at the end of life, hospice care has recently received significant attention as a mean of reducing health care costs. As a program providing care for patients who are dying at their homes, hospice has expanded slowly since the opening of the first hospice in Korea in 1963. Therefore, a variety of services that responds to the needs and concerns of many dying people and their families is limited The purpose of this study was to determine the potential cost savings at the end of life among patients who used home hospice compared with the patients who received institutional care in Korea. This study used a retrospective, descriptive design. The sample for this study included 46 patients who died of lung cancer: 25 patients who received home hospice care and 21 patients who received institutional care. Data on patient characteristics, kinds and frequencies of provided treatment and nursing services, and hospice and hospital charges during the last month before death were collected. Cost of care was measured by the average cost per patient per day in the last month of life. The results of the study indicated that there were significant differences in average cost of care between home hospice sample and institutional care sample (t=9.956, p<.001; home hospice sample: M=18,102 won, institutional care sample: M=317,578 won). The cost of the home hospice sample was approximately 6% of the cost of institutional care. The majority of the home hospice nursing services were education (35.7%) and supportive counseling (25.2%), followed by medication management (13.6%), assessment (12.1%), basic nursing (7.2%), treatment (5.5%) and others. In institutional care sample, basic nursing and treatment were more emphasized than education or supportive counseling among the nursing services provided. The results of this study showed the potential for hospice to reduce costs and implications for policymakers and clinicians to incorporate hospice program into the formal health care delivery system in Korea.

• 간호행정학회지
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• 제17권1호
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• pp.5-13
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• 2011

Purpose: The purpose of this study was to examine the effect of patient perception of the switching cost and negative word of mouth on revisit intention of patients in out-patient departments (OPDs) of general hospitals. Method: The participants were 306 patients in general hospital, selected through convenience sampling. Data were collected using a structured questionnaire and analyzed using descriptive statistics, Spearman correlation coefficient, and logistic regression with SPSS Win. Results: Relational switching cost was positively correlated with revisit intention (r=.58, p=<.001), but not financial switching cost or procedural switching cost. Negative word of mouth was negatively correlated with revisit intention (r=-.22, p=<.001). The significant predictors influencing revisit intention in patients was relational switching cost. Conclusion: The findings of this study suggest that hospital and nursing managers should seek to bolster perceptions of switching costs and negative word of mouth, which subsequently increases revisit intentions in small hospitals located in the country as well as urban large hospitals.

• 한국콘텐츠학회논문지
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• 제18권4호
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• pp.480-494
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• 2018

본 연구는 이현희(2017)의 연구에서 개발한 병동 간호활동원가계산 프로그램의 실무 적용 확대를 위하여 자료의 저장 및 그래프 변환 출력 기능을 보완하여 수정 개발한 후속 연구이다. 전체 프로그램 개발과정은 프로그램 요구사항 분석과 프로그램 설계 및 개발, 프로그램 타당성 검토의 3단계로 이루어졌다. 본 프로그램은 단순히 원가계산에서 그치는 것이 아니라 원가효율성 및 원가분석 추세 비교까지 결과를 산출하여 간호관리자가 병동 간호단위 관리에 필요한 원가정보를 얻을 수 있고 이를 기반으로 원가관리전략을 수립할 수 있도록 하여 그 활용도를 확장한 점에서 의의가 있다. 또한 향후 이를 기반으로 병동 단위 뿐 아니라 수술실, 중환자실과 같은 특수부서 그리고 외래와 같이 간호활동의 구성과 범위가 다른 부서별 간호활동원가계산을 수행하는 원가분석 프로그램 개발할 수 있는 토대를 마련한 점에서도 의의가 있다. 이에 본 연구를 기반으로 이를 다양한 실제 임상 간호관리 실무에 적용함으로써 임상 간호사의 원가관리 역량을 강화하고 나아가 간호단위 간호활동의 수익과 이익 분석을 통해 계량화된 간호의 기여도를 측정, 제시함으로써 간호성과 측정 연구를 확대해 나갈 것을 제안한다. 아울러 본 TD-ABC 간호활동원가계산 프로그램의 적용과 활용을 학부 수준의 간호관리학 교과과정과 접목하고, 임상간호사의 보수교육 프로그램으로도 활용하여 간호원가관리 역량 강화를 위한 교육매체로도 활용할 것을 제안한다.

• 간호행정학회지
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• 제17권4호
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• pp.432-442
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• 2011

Purpose: The purpose of this study was to identify the factors influencing the intention of the reuse in patients admitted in university hospital emergency medical center. Method: The participants were 253 patients admitted to a niversity hospital emergency medical center. Data were collected with self-administrated questionnaires and analyzed by hierarchical multiple regression. Results: Patient satisfaction with nursing care service and switching cost were positively correlated with reuse by patients while the perceived risk was negatively correlated. As levels of satisfaction with nursing care services and switching cost increase, intention of reuse increases. Satisfaction with nursing care service, switching cost and perceived risk in emergency medical center influence intention to reuse and explain 68.8% of total variation of intention to reuse. Conclusion: Findings provide strong empirical evidence for importance of atient satisfaction with nursing care service, the switching costs and the perceived risk in explaining the intention of reuse an emergency medical center.

• 대한간호학회지
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• 제41권6호
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• pp.750-757
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• 2011

Purpose: Cost-benefit analysis is one of the most commonly used economic evaluation methods, which helps to inform the economic value of a program to decision makers. However, the selection of a correct benefit estimation method remains critical for accurate cost-benefit analysis. This paper compared benefit estimations among three different benefit estimation models. Methods: Data from community-based chronic hypertension management programs in a city in South Korea were used. Three different benefit estimation methods were compared. The first was a standard deterministic estimation model; second, a repeated-measures deterministic estimation model; and third, a transitional probability estimation model. Results: The estimated net benefit of the three different methods were $1,273.01, $-3,749.42, and $-5,122.55 respectively. Conclusion: The transitional probability estimation model showed the most correct and realistic benefit estimation, as it traced possible paths of changing status between time points and it accounted for both positive and negative benefits.

• 대한간호학회지
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• 제34권3호
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• pp.449-457
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• 2004

Purpose: The aim of this study was to analyze economical efficiency of home care service by comparing a cost-utility ratio(CUR) between home care and hospitalization. Method: The analytic framework of this study was constructed in 5 stages: Identifying the analytic perspectives, measurement of costs, measurement of utility, analysis of CUR, and sensitivity test. Data was collected by reviewing medical records, home care service records, medical fee claims, and other related research. Result: The mean of the annual total cost was 23,317,636 Won in home care and 73,739,352 Won in hospital care. QALY was 0.389 in home care and 0.474 in hospital care, so CUR was 299,712,545 QALY in home care and 777,841,266 QALY in hospital care. Conclusion: The findings affirmed that home care had an economical efficiency in the aspect of utility compared to hospitalization. Therefore, the findings of this study can be used to develop a governmental health policy or to expand the home care system. In addition, the cost-utility analysis framework and process of this study will be an example model for cost-utility analysis in nursing research. Therefore, it will be used as a guideline for future research related to cost-utility analysis in nursing.