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2 "Nursing payment system"
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Original Articles
Development and Analysis of Community Based Independent Home Care Nursing Service
Jung Ho Park, Mae Ja Kim, Kyung Ja Hong, Kyung Ja Han, Sung Ae Park, Soon Nyoung Yun, In Sook Lee, Hyun Cho, Kyung Sook Bang
Journal of Korean Academy of Nursing 2000;30(6):1455-1466.   Published online March 29, 2017
DOI: https://doi.org/10.4040/jkan.2000.30.6.1455
AbstractAbstract PDF

The purpose of this study was to develop the framework of community-based home care nursing delivery system, and to demonstrate and evaluate the efficiency of it. The study was carned out over a period of 3years from September 1996 to August 1999. The researchers developed Standards for operations, this was all aimed toward a home care recording system, and an assessment intervention algorithm for various diseases quality control and standardization. In the center, 185 patients enrolled, and of the enrollments cerebrovascular disorder and cancer were the most prevailment diseases. Also, a home care nursing activity classification was developed in six domains. Those domains were assessment, medication, treatment, education and consultation, emotional care, and referral or follow-up care. Ten sub-domains were divided according to the systematic needs. Among these nursing activities, treatment, assessment, and education and consultation were frequently performed. In sub-domain classification, skin integrity, respiration, circulation, and immobility related care were provided most frequently. The cost of home care nursing per visit was also suggested. The cost include direct and indirect nursing care, management, and transportation cost. Also, the researchers tried to overcome the limitations of hospital-based home care to provide more accessible, efficient, safe, and stable home care nursing. Therefore, clients were referred from other patients, families, public health care centers, industries, and even hospitals. As a result of this study, several limitations of operation were found. First, it was difficult to manage and communicate with doctor in the emergency situations. Second, there was too much time spent for transportation. This was because they are only five nurses, who cover all of the areas of Seoul and nearby cities. Third, preparation for special care of home care nurses was lacking. Fourth, criteria for the termination of care and the frequency of home visits were ambiguous. Finally, interconnection with home care machinery company was so yely needed. New paragraphs' strategies for solving these problems were suggested. This study will be the basis of community-based home care nursing, and the computerized information delivery system for home care nursing in Korea.

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Test on the Cost and Development on the Payment System of Home Health Care Nursing
Hosihn Ryu, Keysun Jung, Jiyoung Lim
Journal of Korean Academy of Nursing 2006;36(3):503-513.   Published online June 30, 2006
DOI: https://doi.org/10.4040/jkan.2006.36.3.503
AbstractAbstract PDF
Purpose

This study focused on analysing costs per home health care nursing visit based on home health care nursing activities in medical institutes.

Method

The data was collected in three stages. First, the cost elements of home health care nursing services were collected and 31 home care nurses participated. Second, the workload and caseload of home care nursing activities were measured by the Easley-Storfjell Instrument(1997). Third, the opinions on improving the home health care nursing reimbursement system were collected by a nation-wide mailing survey from a total of 125 home care agencies.

Result

The cost of home health care nursing per visit was calculated as 50,626 won. This was composed of a basic visiting fee of 35,090₩(≒35$) and travel fee of 15,536₩(≒15$). The major problems of the home care nursing payment system were the low level of the cost per visit, no distinction between first visit and revisits, and the limitations in health insurance coverage for home health care nursing services.

Conclusion

This study's results will contribute as a baseline for establishing policies for improvement of the home health care nursing cost and for applying a community-based visiting nursing service cost.

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