DOI QR코드

DOI QR Code

Economic Effect of Home Health Care Services for Community-dwelling Vulnerable Populations

재가 취약계층을 위한 지역사회 중심 가정간호서비스의 경제적 효과

  • Lee, Eunhee (Division of Nursing, Hallym University) ;
  • Kim, Jinhyun (College of Nursing, The Resrarch Institute of Nursing Science, Seoul National University)
  • 이은희 (한림대학교 간호학부) ;
  • 김진현 (서울대학교 간호대학 간호과학연구소)
  • Received : 2015.08.25
  • Accepted : 2016.05.18
  • Published : 2016.08.31

Abstract

Purpose: In this study the costs and benefits of a home health care program were examined to evaluate the economic feasibility of the program. Methods: The study participants included 349 patients in the community who had been registered at a home health care center for 5 years. The costs and benefits of the program were analyzed using performance data and health data. The benefits were classified as the effects of pressure ulcer care, skin wound care and catheters management. The program effect was evaluated on the change of progress using transition probability. Benefits were divided into direct benefit such as the savings in medical costs and transportation costs, and indirect benefits which included saving in productivity loss and lost future income. Results: Participants had an average of 1.82 health problems. The input cost was KRW 36.8~153.3 million, the benefit was KRW 95.4~279.7 million. Direct benefits accounted for 53.4%~81.2%, and was higher than indirect benefits. The net benefit was greater than 0 from 2006 to 2009, and then dropped below 0 in 2010. Conclusion: The average net benefit during 5 years was over 0 and the benefit cost ratoi was over 1.00, indicating that the home health care program si economical.

Keywords

References

  1. Ryu H. Home health care in Korea: Home health care nursing, visiting health care nursing, visiting health care. Journal of Korean Academic Society of Home Care Nursing. 2007;14(2):98-105.
  2. Sanford DE, Olsen MA, Bommarito KM, Shah M, Fields RC, Hawkins WG, et al. Association of discharge home with home health care and 30-day readmission after pancreatectomy. Journal of the American College of Surgeons. 2014;219(5):875-886.e871. http://dx.doi.org/10.1016/j.jamcollsurg.2014.07.008
  3. Health Quality Ontario. In-home care for optimizing chronic disease management in the community: An evidence-based analysis. Ontario Health Technology Assessment Series. 2013;13(5):1-65.
  4. Lee T. Community-based home healthcare project for Korean older adults. Osong Public Health and Research Perspectives. 2013;4 (5):233-239. http://dx.doi.org/10.1016/j.phrp.2013.09.002
  5. Lee E, Park S. A study on the operating status of communitybased home health care centers. Journal of Korean Academy of Nursing Administration. 2011;17(2):180-188. http://dx.doi.org/10.11111/jkana.2011.17.2.180
  6. Kwon MY, Lim JY, Lee YW, Kim HS. A study of nurses' perception of the visiting nursing services of long-term care insurance. Journal of Korean Public Health Nursing. 2010;24(1):5-18.
  7. Suk LJ, Hwang RI, Han EJ. Trends in home-visit nursing care by agencies' characteristics under the national long-term care insurance system. Journal of Korean Academy of Community Health Nursing. 2012;23(4):415-426. https://doi.org/10.12799/jkachn.2012.23.4.415
  8. Lee JS, Han EJ, Kang IO. The characteristics and service utilization of home nursing care beneficiaries under the Korean long term care insurance. Journal of Korean Academy of Community Health Nursing. 2011;22(1):33-44. http://dx.doi.org/10.12799/jkachn.2011.22.1.33
  9. Kim H, Kwon S, Yoon NH, Hyun KR. Utilization of long-term care services under the public long-term care insurance program in Korea: Implications of a subsidy policy. Health Policy. 2013;111(2):166-174. http://dx.doi.org/10.1016/j.healthpol.2013.04.009
  10. Park JY, Ko SK. Cost-benefit analysis of the community-based home health care program. The Korean Journal of Health Economics and Policy. 2000;6(2):203-245.
  11. Kim SY, Park SA. A study for evaluating the performance of a community-based home care services model. Journal of Korean Academy of Community Health Nursing. 2008;19(4):673-683.
  12. Welton NJ, Ades AE. Estimation of markov chain transition probabilities and rates from fully and partially observed data: Uncertainty propagation, evidence synthesis, and model calibration. Medical Decision Making. 2005;25(6):633-645. http://dx.doi.org/10.1177/0272989x05282637
  13. Perez ED. Pressure ulcers: Updated guidelines for treatment and prevention. Geriatrics. 1993;48(1):39-44.
  14. Sato M, Sanada H, Konya C, Sugama J, Nakagami G. Prognosis of stage I pressure ulcers and related factors. International Wound Journal. 2006;3(4):355-362. http://dx.doi.org/10.1111/j.1742-481X.2006.00267.x
  15. Landi F, Onder G, Russo A, Bernabei R. Pressure ulcer and mortality in frail elderly people living in community. Archives of Gerontology and Geriatrics. 2007;44(Suppl 1):217-223. http://dx.doi.org/10.1016/j.archger.2007.01.030
  16. Towfigh S, Clarke T, Yacoub W, Pooli AH, Mason RJ, Katkhouda N, et al. Significant reduction of wound infections with daily probing of contaminated wounds: A prospective randomized clinical trial. Archives of Surgery. 2011;146(4):448-452. http://dx.doi.org/10.1001/archsurg.2011.61
  17. Guanche-Garcell H, Requejo-Pino O, Rosenthal VD, Morales-Perez C, Delgado-Gonzalez O, Fernandez-Gonzalez D. Device-associated infection rates in adult intensive care units of Cuban university hospitals: International nosocomial infection control consortium (INICC) findings. International Journal of Infectious Diseases. 2011;15(5):e357-e362.http://dx.doi.org/10.1016/j.ijid.2011.02.001
  18. Health Insurance Review & Assessment Service. 2006-2010 medical utilization[Internet]. Seoul: Author; 2011[cited 2014 August 3]. Available from: http://opendata.hira.or.kr/op/opc/olapHthInsRvStatInfo.do.
  19. Ministry of Health & Welfare and Family Affairs, Korea Center for Disease Control & Prevention. Korea health statistics 2005: Korea national health and nutrition examination survey (KNHANES III). Seoul: Korea Center for Disease Control & Prevention; 2006.
  20. Ryu H. Current status of costs and utilizations of hospital based home health nursing care in Korea. Journal of Korean Academy of Nursing. 2006;36(7):1193-1203. https://doi.org/10.4040/jkan.2006.36.7.1193
  21. June KJ, Park JY. Cost-effectiveness analysis of home health care program for cerebrovascular accident patients. Journal of Korean Community Nursing. 2001;12(1):22-31.
  22. Kim MJ. Cost analysis of community-based home health care (HHC) versus hospital-based home health care (HHC)[master's thesis]. Seoul: Yonsei University; 2000. p. 1-74.
  23. Kim J, Lee T, Lee J, Shin S, Lee E. A cost benefit analysis of individual home visiting health care. Journal of Korean Academy of Community Health Nursing. 2010;21(3):362-373. http://dx.doi.org/10.12799/jkachn.2010.21.3.362
  24. Im MJ, Park HS. A study on the pressure ulcers in neurological patients in intensive care units. Journal of Korean Academy of Fundamentals of Nursing. 2006;13(2):190-199.
  25. Gunningberg L, Stotts NA, Idvall E. Hospital-acquired pressure ulcers in two Swedish county councils: Cross-sectional data as the foundation for future quality improvement. International Wound Journal. 2011;8(5):465-473. http://dx.doi.org/10.1111/j.1742-481X.2011.00818.x
  26. Sturkey EN, Linker S, Keith DD, Comeau E. Improving wound care outcomes in the home setting. Journal of Nursing Care Quality. 2005;20(4):349-355. http://dx.doi.org/10.1097/00001786-200510000-00011
  27. Rodrigues I, Megie MF. Prevalence of chronic wounds in Quebec home care: An exploratory study. Ostomy Wound Manage. 2006 ;52(5):46-48, 50, 52-57.
  28. Kubler A, Duszynska W, Rosenthal VD, Fleischer M, Kaiser T, Szewczyk E, et al. Device-associated infection rates and extra length of stay in an intensive care unit of a university hospital in Wroclaw, Poland: International nosocomial infection control consortium's (INICC) findings. Journal of Critical Care. 2012;27(1):105, e105-e110. http://dx.doi.org/10.1016/j.jcrc.2011.05.018
  29. Vonberg RP, Behnke M, Geffers C, Sohr D, Ruden H, Dettenkofer M, et al. Device-associated infection rates for non-intensive care unit patients. Infection Control and Hospital Epidemiology. 2006;27(4):357-361. http://dx.doi.org/10.1086/503339

Cited by

  1. Senior Citizen Centers Utilization: Role of Socio-Demographic Factors, Life Satisfaction and Health Condition in Korea vol.45, pp.3, 2016, https://doi.org/10.5393/jamch.2020.45.3.141