Purpose: The purposes of this study were to explore the functional status of elderly residents and to analyze time use, and finally identify factors to predict nursing care needs in relation to functional status and health related variables. Methods: In this study a descriptive-correlational design was used. Functional status of participants was obtained through interviews, and nursing care time was examined using a 1 min time-motion study with a standardized instrument developed by Korea Long-Term Care Planning Committee (2005). Results: The mean total functional score was 65 (range 28-125) and mean total nursing care time was 144.15 min per day. There were significant positive relationships between total nursing care time, marital status, back pain, dementia, and vision impairment. Multiple regression analyses showed that a liner combination of number of illnesses, types of primary disease, ADL, IADL, cognitive function, nursing demand, and rehabilitation demand explained 42.8% of variance of total nursing time. ADL (${\beta}$=-.533) was the most significant predictor of nursing service need. Conclusion: Identifying factors that result in variations of service need has implications for adequate nursing service, estimation of optimum nurse to patient ratio, quality of care and patient safety.
Kim, Young-Hae;Park, Nam-Hee;Kim, Duk-Sun;Lee, Hwa-Za;Kim, Jung-Sun
Journal of Home Health Care Nursing
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v.10
no.1
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pp.73-84
/
2003
This study was done to examine the home care service provided by home care nurses and the level of client satisfaction. Data were collected from 110 clients who received the home care service at the P-hospital in Pusan from 23th April, 2001 to 30th November, 2002. The tool for measurement of satisfaction was composed of 16 items and was 4 score scale. Data was analyzed by using SPSS/WIN 10.5 program, the results of this study are summarized as follows; 1) 77.3% among 110 clients were over sixty years old. By the disease pattern. subjects were distributed into cancer(52.7%), cerebro-vascular disease(22.7%) and the others. 36.4% of clients were received home visits from 10 to 20 times by home care nurse. 2) The total number of home care services was 20,828. And most of the clients received the health education and training. 3) The mean score of satisfaction on provided home care services was $3.36\pm0.45$, out of 4. among 16 items. 'The home care nurses were kind enough' was highest ($3.59\pm0.49$), the total level of satisfaction of home care services was very high. with total mean score $53.84\pm7.16$. As mentioned above. the satisfaction level of home care services was very high. so we can except that the prospect of home care services is very challengeable. Therefore. we should try to expand the service recipients with promotional education to the home care clients under the cooperation with medical staff and make more efforts to develop the management system about clients' information. to improve the quality of the service, to assure close ties with the public health centers for the continuous home care service linking.
The purpose of this study was to identify a survey on total care services, to verify the perception, performance and importance of nursing practices between nursing students and nurses. The sample of the study were 93 nursing students and 38 nurses, A structured questionnaire used in this study composed of 235 items. The collected data were analyzed using the SPSS WIN 20.0 to calculate frequencies, percentage, mean, standard deviation and t-test. The Major findings of this study were as follows: The amount and responsibility of nursing practices in total service showed that 'very much increase'was the most. There were statistically significant differences in performance of total care service by nutritional care and elimination care. There were statistically significant differences in importance of total care service by respiratory Care.
Purpose : This study was done to examine the home care service provided by home care nurses and the level of client satisfaction in community. Method : Data were collected from 120 clients who received the home care service at the community home care service center in Pusan from 2th May. 2003 to 31th May 2003. The tool for measurement of satisfaction was composed of 16 items and was 4 score scale by Kim. Data were analyzed by using SPSS/WIN 10.5 program. Result: 1) 67.5% among 120 clients was over sixty years old and 30.6% of clients received home visits 20 times by home care nurse. 2) The total number of home care services was 15,783. And most of the clients received therapeutic nursing care. 3) The mean score of satisfaction on provided home care services was 3.31, among 16 items, "The home care nurses kept up the secret of patients and family" was the highest($3.67{\pm}0.48$). the total level of satisfaction of home care services was very high, with mean score $3.31{\pm}0.32$. Conclusion : The satisfaction level of home care services was very high. so we can expect that the prospect of home care services is very challengeable. Therefore we should try to expand the service recipients with promotional education to assure close ties with the public health centers for the continuous home care service linking and make more efforts to improve the quality of the service.
Government provides financial support to the 74 Home help service centers, 36 Day care service centers, and 18 Short stay service centers for the elderly. The number of service centers that receive financial support from the government is far less to meet the potential demand for the community care services. This paper applies cost-benefit analysis to evaluate the net social benefit of the services provided by the 3 types of the community care service centers sponsored by the government to justify the expansion of the government support. The benefit is calculated as community care services are provided privately in the market without financial support from the government. The potential market price is regarded as the benefit or value provided to the elderly. The price levels that potential users are willing to pay for these services are surveyed in the Census for the Elderly by the KIHASA, 1998. The market prices for the community services are generated by equating limited amount of service supply, as in number of users in one year in 3 types of community care service centers, and potential demand for the services. Market prices are multiplied to the number of users of 3 types of community centers to get the total benefit. Total operating cost of the community care service centers is regarded as cost. According to the cost-benefit analysis, Home-help service centers generated net social benefit of 137 billion Won, Day Care service centers generated 15 billion Won, and Short stay service centers generated 6 billion Won. Significant amount of net social benefit indicates that government should increase level of financial support to these service centers.
Proceedings of the Korea Inteligent Information System Society Conference
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2001.01a
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pp.373-377
/
2001
This study is to examine the factors that influence the performances of service quality in university hospitals by investigating systematically the condition of service quality. A synthesis of the health care quality is conducted to identify physical quality, operating process quality, and human resources quality that relate to both the overall satisfaction and intention of revisit. Based on the proposed hypotheses, the relationships between the service quality factors and performance are examined using data collected from 167 patients in three hospitals, Korea. Reliability and validity tests are performed for examining its relationship with service quality in health care systems. Total eight independent variables with respect to three service quality levels and two dependent variables for performance are identified for relationships between service quality and performance in health care systems. The results provide health care managers with a managerial insight to the planning function of performance with service quality in health care systems as well as other operations (business, government, or other service organizations) systems. Implication of the study for theory, future studies, and practices are discussed.
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.
This paper has the objectives to define the concept of 'Good Care' which is the service goal we are aiming essentially for the improvement of long-term care service quality, to find out the components for 'Good Care', and to explore the conditions that create a good care. In addition, we tried to find the answer about what is the best way to measure the service quality. For this, I referred the advanced researches which explored the fundamental properties of care and tried to find the answer from the accumulated wisdom of service field through the 5-year long term care service experience. As a result of research, the good care can be defined as helping someone to be able to maintain his own life as maximum as possible with the goal to assure total quality life. The most important condition for good care is making 'a good care relationship'. Without damaging the relationship between care provider and care receiver, the individualized service focusing on the demand of care receiver based on mutual reliability, mutual respect and smooth communication should be provided. For the evaluation system, it is reasonable to set the standard according to the size of each institution for the core quality of facility service and establish the certification system of absolute standard to carry out the quantitative evaluation rather than the relative evaluation in the whole. For the part over the absolute certification standard, it is reasonable for each institution to characterize its own characteristics autonomously and carry out the qualitative evaluation for this. For the evaluation of home visit care service, it is recommended to contain the evaluation contents such as user satisfaction, satisfaction of care worker, how well the case management system of home care service center is operated etc.
Purpose: This study was conducted to explore the meaning and contents of high-quality aged care facilities and provide basic data for evaluation of service quality in such facilities. Methods: The focus group interviews and participants consisted of two user groups, for a total of 16 family caregivers of the elderly living in facilities and four service provider groups, for a total of 26 chief managers and caregivers working in aged care facilities. All interviews were recorded and transcribed as they occurred. Content analysis was used and debriefing notes were referred to in order to analyze the data. Results: Four themes of a high-quality aged care facility emerged from the analysis; 1) a place to rest for comfortable later years; 2) systematic value-based management; 3) providing professional care; 4) comprehensive service provision in response to diverse needs. Conclusion: The findings of the study showed the importance of client centered care and ethical mindset of providers, which had not been included in the existing quality evaluation programs. Based on these results, medical treatments, end-of-life care and more comprehensive and extended services including family care need to be provided in facilities to ensure good quality aged care.
Variation in the utilization of medical services is a very important issue in cost containment and quality assurance of health care. Practice variation directly affects health care expenditure especially in fee-for-service system, which is the payment system of health insurance in Korea. In addition to cost issue it is generally accepted that variations in medical practice and the cost of inpatient care suggest the possibility of inappropriate quality of care. This study is to closely examine the patterne and degrees of variation in cost structure of inpatient care among types of hospital and individual hospitals in some tracer diseases, and also to inquire into the service items which contribute much to the variation of total medical care cost. Foru common diseases, i.e. Cesarean Section, appendectomy, cataract extraction and pediatric pneumonia, were selected as tracer diseases. In most tracer diseases there were statistically significant differences in total medical care cost among hospitals in same type of hospital as well as among types of hospital(p<0.01). When total medical care cost were subdivided into the types of service, cost of medication and diagnostic examination varied the most prominenly. When the cost of medication were subdivided again, cost of parenteral antibiotics showed the most prominent variation. Of total medical care cost, medication was most contributory to the variation of total medical care cost(58.1~82.3%), and cost of antibiotics was most contributory to the variation of medication cost(63.9~92.2%). The results of study implicated that reducing the variation of medication may plays a significant role in containing the cost of inpatient care. In order to sort out the factors affecting practice variations including drug prescription pattes further researches are required.
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