This study aimed to develop a web-based cost management program for visiting nursing centers (CMP-VNC), using time-driven activity-based costing (TD-ABC), and to analyze effects of the program.

The CMP-VNC was developed using the combined prototyping approach and system developing life cycle method following four stages: need analysis with comprehensive literature reviews and focus group interviews, design and development of program algorithm, evaluation of the developed program validity using experts and users group, and application and effects analysis. The non-equivalent control group pretest-posttest design was used to analyze the effects of the program. The program demonstration was conducted for four weeks with 60 visiting nurses in 35 visiting centers.

The web-based program was developed. It has five interfaces with basic and special functions using TD-ABC, namely, input, visiting nursing activity, visiting nursing activity cost, cost efficiency, and cost calculation report. The experimental group showed significantly higher cost perception and cost confidence than control group.

We found that the CMP-VNC can be an effective tool to increase visiting nurses’ competency of costing and enhance efficiencies of visiting nursing centers.

The purpose of this research was to address the working conditions of home health nurses through a nationwide home health agency survey conducted at hospitals.

The mail surveys were sent to 303 home health nurses nation wide and returned with a response rate of 71.8%.

(a) Seventy-five percent of home health agencies were established within the past5 years and half of home health nurses are over 40 years old. (b) Working conditions were considered as follows: Seventy-one percent of respondents were full-time employees, sixty-sixpercent of home health nurses had unscheduled visits on a regular day of duty and forty-eight percent were on vacation. Fifty-one percent of home health nurses have experienced traffic accidents and paid penalties (65.9%). Self-reported monthly income level per year was an average of 28,364,000 won. (c) Rates were significantly higher for shoulder pain (61.5%), lower back pain (54.1%), knee pain (39.4%), and gastrointestinal problems (33.0%).

These baseline results show the importance of improving home health nursing working conditions, a comprehensive prevention system and safeguards from physical discomfort.

This study was to identify the relationship between stress, social support and depression in the elderly.

The subjects were 283 elderly adults over 60 in Seoul. Data was collected by questionnaire surveys using convenience sampling. The instruments used in this study are the ELSI developed by Aldwin(1990), the Interpersonal Support Evaluation List developed by Cohen & Hoberman (1983), and the Geriatric Depression Scale by Yesavage & Brink(1982). Data was analyzed by the SAS program, using descriptive statistics, Pearson Correlation Coefficient, t-test, ANOVA and progressed Multiple Regression.

The relationship between stress and depression had a positive correlation (r= 0.33), but the relationship between stress and social support had no significant correlations. The relationship between social support and depression had a negative correlation (r= -0.38). The most powerful predictor of depression was the economic status and then a combination of stress, and social support account for 39% of the variance in depression in the elderly.

These results suggested that stress and social support deficits can be potential risk factors in old age depression. Therefore, these findings give useful information for constructing an intervention program focused on depression in the elderly.

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.

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.

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.

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.

This study focused on analysing the workload of visiting nurses based on a health center.

A Prospective descriptive analysis of self-records for workload data from 115 visiting nurses during 4 weeks was done. In addition, a cross-sectional analysis of linked data to grasp the priority of visiting nursing services from 155 visiting nurses at the 25 health centers in Seoul.

Time allocation that was performed on all nursing workload of visiting nurses was identified as follows: First, the inside workload of the health center took up 60% of all visiting nurse activities. Second, providing direct nursing care(caseload) took up 25%. Third, outside nursing activities excluding the caseload provided in the health center took up 15% of all working time. Fourth, the core works to have a high priority among visiting nursing activities were family health assessment, planning and evaluation of a visiting nursing program, personal health assessment, and so forth.

The workload of a visiting nurse suggests that the caseload of visiting nurses in a health center needs to be increased. Also, our results will contribute to baseline data used to establish a proper visiting nurses infrastructure based on the demand of visiting nursing services.

This study was designed to compare direct cost and indirect cost between home care and hospital care according to subject's characteristics.

The subjects of this study were patients with cerebrovascular disease. They were 50 patients in six university hospitals and 49 in four home care centers. Data were collected by using two type of questionnaires and reviewing medical records, home care service records and medical-fee claims from April 4th to September 13th, 2001.

The results were as follows; First, there was a statistically significant difference of direct cost between home care and hospital care, however, there was not a statistically significant difference of indirect cost. Second, according to subject's characteristics, six variables had statistically significant differences; sex, age, marital status, economy, job and diagnosis.

It was found that cost-saving effect of home care was affected by subject's characteristic factors. More study needs to be done to develop a more detailed selection criteria for home care subjects.

There is evidence that parent-child cohesion is a potentially influential factor in children's self-esteem and acculturation. However, no research to date has examined cohesion with parents as a potential pathway between Korean proficiency and self-esteem or acculturation among children from multicultural families. This study was done to address these limitations by examining whether and to what extent cohesion with parents mediated the effect of Korean proficiency on self-esteem and acculturation among children from multicultural families.

Data were collected from a sample of 138 mothers and their children living in Seoul, Daegu, Kyungi province, and Kyungpook province. Multiple regression analysis was used to examine the relationships between the variables of interest. Mediation effects of cohesion with parents were tested by following the procedure recommended by Baron and Kenny (1986).

Cohesion with parents partially mediated the relationship between Korean proficiency and self-esteem. For children's acculturation, the effect of Korean proficiency was partially mediated through father-child cohesion. Mother-child cohesion completely mediated the relationship between Korean proficiency and acculturation.

These findings suggest that to help children from multicultural families experiencing difficulties with self-esteem or acculturation, it might be useful to develop programs that are aimed at strengthen cohesion with parents.

The aim of this study was to compare statistical methods to control response bias in nursing activity surveys.

Data were collected at a medical unit of a general hospital. The number of nursing activities and consumed activity time were measured using self-report questionnaires. Descriptive statistics were used to identify general characteristics of the units. Average, Z-standardization, gamma regression, finite mixture model, and stochastic frontier model were adopted to estimate true activity time controlling for response bias.

The nursing activity time data were highly skewed and had non-normal distributions. Among the 4 different methods, only gamma regression and stochastic frontier model controlled response bias effectively and the estimated total nursing activity time did not exceeded total work time. However, in gamma regression, estimated total nursing activity time was too small to use in real clinical settings. Thus stochastic frontier model was the most appropriate method to control response bias when compared with the other methods.

According to these results, we recommend the use of a stochastic frontier model to estimate true nursing activity time when using self-report surveys.

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.

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.

The estimated net benefit of the three different methods were $1,273.01, $-3,749.42, and $-5,122.55 respectively.

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.

Time-driven activity-based costing was applied to analyze the nursing activity cost and efficiency of a medical unit.

Data were collected at a medical unit of a general hospital. Nursing activities were measured using a nursing activities inventory and classified as 6 domains using Easley-Storfjell Instrument. Descriptive statistics were used to identify general characteristics of the unit, nursing activities and activity time, and stochastic frontier model was adopted to estimate true activity time.

The average efficiency of the medical unit using theoretical resource capacity was 77%, however the efficiency using practical resource capacity was 96%. According to these results, the portion of non-added value time was estimated 23% and 4% each. The sums of total nursing activity costs were estimated 109,860,977 won in traditional activity-based costing and 84,427,126 won in time-driven activity-based costing. The difference in the two cost calculating methods was 25,433,851 won.

These results indicate that the time-driven activity-based costing provides useful and more realistic information about the efficiency of unit operation compared to traditional activity-based costing. So time-driven activity-based costing is recommended as a performance evaluation framework for nursing departments based on cost management.

In this study a cognitive enhancement group training program of 10 sessions was provided for community-dwelling elders and the effects on cognitive function, depression and quality of life were tested.

A quasi-experimental study using a nonequivalent control group, pre-post design was used. The participants were 87 elders whose cognitive function was within the normal range. Of these elders, 45 were assigned to the experimental group and 42 to the control group. The intervention was conducted once a week for 10 weeks. Chi-square test, t-test, paired t-test, Wilcoxon rank sum test and Wilcoxon signed rank test were used to analyze the data.

After the program, the cognitive function (t=-2.85, p=.006), depression (z=2.82, p=.005) and quality of life (t=2.79, p=.007) of the experimental group was significantly better than those of the control group. Especially, immediate recall (z=2.45, p=.014) and concentration (z=2.58, p=.010) in the subcategory of cognitive function were significantly better than that of the control group.

The findings indicate that the cognitive enhancement group training program was effective in enhancing the cognitive function, depression and quality of life for elders and could therefore be considered as a positive program for emotional and cognitive support for community-dwelling elders.

This study was conducted to analyze the factors that influence the life satisfaction of the elderly according to their cognitive impairment level.

This study was conducted by dividing 3,012 elderly residents of a regional community into three groups based on the scores of the Korean version of the Mini-Mental State Examination: a normal group without any cognitive impairment, a suspicious group with a mild level of cognitive impairment, and a high risk group with a high level of cognitive impairment. Researchers made phone calls, house calls, and personal visits to health centers and shelters for the elderly to gather the information required for this study.

The results of this study revealed that social relationships, depression, and activities of daily living had a significant impact on life satisfaction for the normal group, while social relationships and depression had a high impact on life satisfaction for the suspicious group, and social relationships had high impact on the life satisfaction of the high risk group.

Based on the results of this study, we suggest that programs that promote development of the social relationship networks of the elderly should be established to promote their life satisfaction.

The purpose of this study was to develop visions of nursing service, nursing strategies and key performance indicators (KPIs) for an intensive care unit (ICU) based on a Balanced Scorecard (BSC).

This study was undertaken by using methodological research. The development process consisted of four phases; the first phase was to develop the vision of nursing in ICUs. The second phase was to develop strategies according to 4 perspectives of a BSC. The third phase was to develop KPIs according to the 4 perspectives of BSC and the final phase was to combine the nursing visions, strategies and KPIs of ICUs.

Two main visions of nursing service for ICUs were established. These were ‘realization of harmonized professional nursing with human respect’ and ‘recovery of health through specialized nursing’ respectively. In order to reach the aim of developing nursing visions, thirteen practical strategies and nineteen KPIs were developed by four perspectives of the BSC.

The results will be used as objective fundamental data to attain business outcomes for the achievement of nursing visions and strategies of ICUs.

This analysis was conducted to evaluate the cost-effectiveness of gemcitabine-cisplatin chemotherapy for non small-cell lung cancer patients in an outpatient setting compared with the traditional inpatient setting.

A cost-effective analysis was conducted from a societal perspective. The effects of treatment, which was measured as an adverse event rate, were abstracted from a published literature search and empirical data from one university hospital. The costs included both direct and indirect costs. Direct costs included hospitalizations, outpatient visits, and lab tests. Pharmaceutical costs were excluded in analysis because they were same for both options. Indirect costs included productivity loss of patients as well as care-givers. In order to determine the robustness of the results, sensitivity analysis on treatment protocol was conducted.

Literature search showed no difference in adverse effect rates between inpatient treatment protocol and outpatient treatment protocol. Therefore, this analysis is a cost-minimization analysis. Cost-savings in the outpatient setting was 555,936 won for one treatment cycle. Our sensitivity analysis indicated that the outpatient chemotherapy still showed cost-savings, regardless of changes in treatment protocol.

The outpatient gemcitabine-cisplatin chemotherapy for non small-cell lung cancer resulted in cost savings compared to inpatient chemotherapy. More importantly, outpatient chemotherapy could improve the utilization of health service resources in terms of available beds.

The aim of this study was to analysize net income of a surgical nursing ward in a general hospital.

Data collection and analysis was conducted using a performance-based costing and activity-based costing method.

Direct nursing activities in the surgical ward were 68, indirect nursing activities were 10. The total cost volume of the surgical ward was calculated at ₩119,913,334.5. The cost volume of the allocated medical department was ₩91,588,200.3, and the ward consumed cost was ₩28,325,134.2. The revenue of the surgical nursing ward was ₩33,269,925.0. The expense of a surgical nursing ward was ₩28,325,134.2. Therefore, the net income of a surgical nursing ward was ₩4,944,790.8.

We suggest that to develop a more refined nursing cost calculation model, a standard nursing cost calculation system needs to be developed.

The aim of this study was to develop a performance measurement scale for nurses in the hospital setting and to test the reliability and validity of the scale.

This study was conducted in three phases including an application of conceptual framework, development of scale items, and test of validity and reliability of the scale. In order to test validity and reliability, data was collected from 1,966 nurses who work in twenty eight hospitals nation-wide. The data was analyzed by the SAS 8.0 program using descriptive statistics, factor analysis, and reliability coefficients.

The Performance measurement scale consisted of 4 factors which included competency, attitude, willingness to improve, and application of nursing process, and a total of 17 items. The Four factors explained 63.45% of the total variance, and Cronbach's alpha of the scale was .92.

The performance measurement scale developed by this study is a reliable and valid instrument that is utilized effectively to evaluate the performance of hospital nurses. Furthermore, it could be used as a steping stone to assess educational needs of nurses, develop professionalism among nurses, and improve quality of nursing care in the hospital setting.