Economic Evaluation of Visitng Nurse Services for the Low.;.income Elderly with Long-term Care Needs

도시 저소득층 만성질환노인을 위한 보건소 방문간호서비스의 경제성 분석

  • 이태화 (연세대학교 간호대학, 간호정책연구소)
  • Published : 2004.02.01

Abstract

Purpose: This study aimed to evaluate economic viability of public health center visiting nurse services for the low-income elderly with long-term care needs. Method: The sample consisted of 252 community dwelling elderly who enrolled in public health center visiting nurse services for three months or more. Data was collected on physical (ADL and IADL) and cognitive impairments of the elderly, contents and frequency of visiting nurse services, cost per visit, and costs of alternative services for long-term care. Result: The mean score of ADL and IADL levels of the elderly was 2.80.4904, which indicated these patients were mostly independent. Eighty four percent of the elderly subjects were cognitively intact. Among visiting nurse services supplied, providing assessment was 34%, followed by education and counseling 26%, medication 22%, and referral. The mean cost per visit was 17,824.1 won, which transformed into a total cost per person per year of 161,130.2 won. Comparing the cost of a visiting nurse service with those of other long-term care alternatives, the visiting nurse service was the least costly alternative, followed by an outpatient clinic, hospital based home care, and nursing home. Conclusion: Overall, the results of the study provide evidence of the economic viability of visiting nurse services for the low-income elderly among long-term care alternatives.

Keywords

References

  1. Chung, K. H. et al (1998). National survey on lifestyle and social welfare need of older persons. Unpublihed Report. KlHASA.
  2. Chun, K. J., & Cho, Y. M. (2001). A survey on functional status among low-income older adults living at home. J Korean Academic Nurs, 31(5), 79-758
  3. Greene, V. L., Ondrich J., Laditka S. (1998). Can home care services achieve cost savings in long-term care for older people? J Gerontol B Psychol Sci Soc Sci, 53B(4), S228-38
  4. Han, M. H. (1999). Strategies to activate primary health care for low-income population in urban area. J Korea Commu Health Nursing Academic Society, 13(1), 77-87
  5. Hwang, N. M. et al. (1999). Activation proposal of hospital based home care. Unpublished Report. KlHASA
  6. Internal Data of Ministry of Health and Welfare(2002)
  7. Kim, K. S., Suh, M. J., Cho, N.O., & Kim, I.J. (2001) . Development of an urban commuity based comprehensive service model for bed-ridden elderly. J Korean Academic Nurs, 31(4), 656-668
  8. Kim, S. R., Lee, K. Y. (1999). Health care needs and health problems of the subjects in a health center. Korean J Occupational Health Nursing, 8(1), 103-107
  9. Kim, J. J. (1999). A study of home care and home visiting nursing in Japan. J Korean Comm Nurs, 10(1), 106-120
  10. Ko, M. J. (1996). A proposal on management model applicable to visiting nursing program for a low-imcome group. J Korea Community Health Nursing Academic Society, 10(1), 18-138
  11. Korea Association of Senior Citizen Welfare Institutions (2002). Budgets of Social Welfare Institutions
  12. Lee, H. J., Kim, C. M., & Yoon, S. Y. (1998). A study for reorientation of home care service at community. J Korean Comm Nurs 9(1), 163-180
  13. Lee, K. J., Yoon, J. Y., Ko, J. S., Lee, T. W., & Joo, Y. S. (2000). A predictive model of health promotion in elderly. Unpublished Report
  14. Lee, T. W. (2000). The relationship between severity of physical impairment and costs of care in an elderly population. Geriatr Nurs, 21(2), 102-107
  15. Long- Term Care Policy Planning Committee (2000). A study on policy development of long term care services for older persons. Unpublished report. KIHASA
  16. Ministry of Health and social Welfare (2001). 2001 Visiting Nurse Service Manual
  17. Ministry of Health and social Welfare (2003). Elderly Health and social Welfare Service Guideline
  18. Natioanl Statistic Organization (2003). Korea Social Index http://www.nso.gr.kr
  19. OECD (1997). Aging in OECD countries: A critical policy challenge, Paries: OECD
  20. Park, J. H., et. al, (2001). Policy directions for establishment and expansion of home nursing care in Korea. Unpublished Report
  21. Park, J. Y., & Ko, S. K. (2000). Cost-benefit analysis of the community based home health care program. Korean Health Economic Review, 6(2), 203-245
  22. Robinson, F. M. (1997). Family caregiving: who provides the care, and at what cost? Nurs Econ, 15(5), 243-247
  23. Ryu & Hwang (1999). A study on health status of the elderly people who visited the community health care service center. Korean Journal of Research in Gerontology, 8(1), 161-177
  24. Shin, H. S., Lee, T. J., Yang, B. M. (1993). The economic analysis on visiting nurse program. J Institute Health Envi Sci, 3(1), 9-17
  25. Steel, K., Rosenfeld, A., Bissonnette, A., Pajik, M., & O'Brien, E. (1993). Home care as an effective option to institutional care of the Medicaid-eligible elderly population: a pilot study of cost and operations. Caring, 12(8), 78, 80-4.
  26. Stone, P. W., Curran, C. R., & Bakken, S. (2002). Economic evidence for evidence-based practice. J Nurs Scholarsh, 34, 277-282. https://doi.org/10.1111/j.1547-5069.2002.00277.x
  27. Sunwoo, D., Oh, Y. H., Byun, J, K, Lee, J. Y., Suk, J. E., Kim, D. Y., Chun, K. J. (2000). A Study on model development of integrated health and social service system to improve activities of daily living of older persons. Unpublished Report. KlHASA
  28. Wallace, D. C., Fields, B.L., Witucki, J., Boland, C., & Tuck, I. (1999). Use of home and community-based services by elderly black and white females. J Women Aging, 11(4), 5-20