The purpose of this study is to provide the directions for the further development of the home care services in Korea, through comparison of the home care system and visiting nursing activities for the elderly in Japan and with those of Korea. The results of this study were summarised as follows: The major difference between the two countries was that Japan emphasised the development of home services by visiting nurse service stations (VNSS), especially in the community. In contrast, Korea has emphasised providing hospital based home care services and assuring the quality of services through the preparation of home care nurses before beginning services. And many elderly in Korea have used a public health center when they have health problems. According to the result, the establishment of a VNSS system and activation of a public health center in the community must be considered as the direction to advance home care systems for the elderly.
Aged* ; Home Care Services* ; Home Care Services, Hospital-Based ; Humans ; Japan* ; Korea* ; Nurses, Community Health ; Nursing ; Public Health

PURPOSE: The purpose of this study is to identify factors influencing burnout in primary family caregivers of Home Health Care Patients. METHODS: Data were collected from 121 primary family caregivers of home health care patients in three different hospitals in ‘D’ metropolitan city and the study was conducted from August 10, 2016 to January 17, 2017. The data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's Correlation Coefficient, Stepwise Multiple Linear Regression. RESULTS: Mean scores for the nursing needs of the participants were 3.54±0.79, the family functions were 1.24±0.58, the burnouts were 2.74±0.49. The burnouts were positively correlated with the nursing needs but inversely correlated with the family function. The factor that had the greatest influence on the burnouts of primary family caregivers of Home Health Care was family function (β=−.245, p=.001), followed by patients' daily activity (β=−.213, p=.014), age (β=.208, p=.032), monthly nursing services cost (β=−.196, p=.044) and nursing needs (β=.129, p=.014). The Explanatory Power of Models was 23%. CONCLUSION: Individually customized home care nursing intervention programs are required to be provided in accordance with patient's family function and daily activity, monthly home care nursing service cost, nursing needs and general characteristics of primary caregivers of Home Health Care Patients such as their age, the number of family members living together, sex and the name of disease.
Caregivers ; Delivery of Health Care ; Home Care Services ; Home Care Services, Hospital-Based ; Home Health Nursing ; Humans ; Linear Models ; Nursing ; Nursing Services

PURPOSE: To analyze the home care services provided to the elderly aged 65 and older by a hospital-based home care agencies and to investigate the effects of long-term care insurance for the elderly. METHOD: The subjects were the home care service recipients aged 65 and older in 172 hospital-based, home care agencies registered in Health Insurance Review & Assessment Service in January, 2007. The data were collected using a questionnaire from March 16 to April 15, 2007. The questionnaire return rate was 43.8%. RESULT: The hospital-based home care agencies were able to visit 66.5% of the national administrative districts. Of the home care service recipients, over 50% were 65 years old and older. About 43% of the agencies reported that over 50% of their patients would be subject to the long-term care insurance. They expressed concern that home care services would be withdrawn once the insurance system is initiated. CONCLUSION: This study suggests that hospital-based home care agencies need to manage home care services with long-term care insurance. It also recommends developing guidelines for the use of services and referrals.
Aged* ; Home Care Agencies ; Home Care Services ; Home Care Services, Hospital-Based* ; Humans ; Insurance ; Insurance, Health ; Insurance, Long-Term Care ; Long-Term Care ; Referral and Consultation ; Surveys and Questionnaires

PURPOSE: 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. METHOD: The mail surveys were sent to 303 home health nurses nation wide and returned with a response rate of 71.8%. RESULT: (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%). CONCLUSION: These baseline results show the importance of improving home health nursing working conditions, a comprehensive prevention system and safeguards from physical discomfort.
Middle Aged ; Korea ; Humans ; Home Care Services, Hospital-Based ; *Home Care Services ; Home Care Agencies ; Female ; Data Collection ; *Community Health Nursing ; Adult

PURPOSE: This study was carried out to substantiate the application process of activity-based costing on the current cost of hospital home care (HHC) service. The study materials were documents, 120 client charts, health insurance demand bills, salary of 215 HHC nurses, operating expense, 6 HHC agencies, and 31 HHC nurses. METHOD: The research was carried out by analyzing the HHC activities and then collecting labor and operating expenses. For resource drivers, HHC activity performance time and workload were studied. For activity drivers, the number of HHC activity performances and the activity number of visits were studied. RESULT: The HHC activities were classified into 70 activities. In resource, the labor cost was 245wonper minute, operating cost was 9,570won per visit and traffic expense was an average of 12,750won. In resource drivers, education and training had the longest time of 67 minutes. Average length of performance for activities was 13.7 minutes. The workload was applied as a relative value. The average cost of HHC was 62,741won and the cost ranged from 55,560won to 74,016won. CONCLUSION: The fixed base rate for a visit in the current HHC medical fee should be increased. Exclusion from the current fee structure or flexible operation of traveling expenses should be reviewed.
Costs and Cost Analysis ; Fees and Charges ; Home Care Services, Hospital-Based/*economics ; Korea ; Task Performance and Analysis

PURPOSE: The purpose of this study were to examine the need of community care services and the influencing factors of the need in the family care givers of hospital-based home care patients. METHODS: Data were collected from 256 family caregivers, who were recruited from 10 hospitals in a metropolitan city. A structured questionnaire on the characteristics of caregivers, resources, and patients was administered. Also, questions on the need of community care services were added. Logistic regression analysis was used to identify the influencing factors of the need for community care services. RESULTS: The participant needed more transportation service, lease of health care devices, visiting bath, caring, visiting hair dressing than that of housekeeping, short-term care, and day care service. Various variables from the three factors were found to be influenced on the need of community care services. CONCLUSION: The accessibility of the higher need of community care services should be increased for hospital-based home care users. Also, the factors of Family care giver, Resource, and Patient might be considered to provide community care services of hospital-based home care users.
Bandages ; Baths ; Caregivers* ; Day Care, Medical ; Delivery of Health Care ; Hair ; Home Care Services ; Home Care Services, Hospital-Based* ; Housekeeping ; Humans ; Logistic Models ; Transportation ; Surveys and Questionnaires

Due to the increase in elderly population, there has been an increase in number of patients with dysphagia in the community. Dysphagia results in aspiration pneumonia and complications such as malnutrition, dehydration in the elderly. These complications increase the hospital admission rates and are often the cause of death. For this reason, the goal of healthcare for elderly with dysphagia living in the community is to select elderly with dysphagia by early screening, maintain adequate nutritious status and prevent future complications. The families of dysphagia elders should be educated and supported in order to successfully care for these patients at home. Severe cases of elderly with dysphagia are to receive health professional service in conjunction with the services from hospital based home care medical center. It also requires governance support so that health professionals such as speech language pathologists will care for dysphagia patients in home.
Aged* ; Cause of Death ; Deglutition Disorders* ; Dehydration ; Delivery of Health Care ; Health Occupations ; Home Care Services* ; Home Care Services, Hospital-Based ; Humans ; Malnutrition ; Mass Screening ; Pneumonia, Aspiration

PURPOSE: As a part of analysis of home-based cancer patients management of public health centers, regional cancer center, and hospice institution in Jeju, this study was undertaken to establish their role. METHODS: We investigated current status of hospice palliative care, especially home-based cancer patients management and summary demand of public health centers. RESULTS: Services provided through the home-based cancer patients management project included physical, emotional, spiritual and education/informative services, even though there was little difference between them. The result showed that in the view of patients there was little relationship between public health centers, regional cancer center and hospice palliative institution. CONCLUSION: The relationship between home-based cancer patients management and institutions should be reinforced. Patients in acute state and difficulty care of patients should be referred to regional cancer center whereas maintenance state of patients should be referred to public health center.
Cancer Care Facilities ; Home Care Services, Hospital-Based ; Hospices ; Humans ; Palliative Care ; Public Health ; United States Public Health Service

PURPOSE: The purpose of this study was to describe the current status of utilization and costs of home health nursing care by the levels of medical institutes in Korea. METHOD: A secondary analysis of existing data was used from the national electronic data information(EDI) of 148 home health agencies for 6 months from May to Oct 2005 in total. RESULT: The 148 agencies had multiple services in cerebral infaction, essential hypertension, sequela of cerebrovascular disease, type 2 diabetes mellitus, etc.. The highest 10 rankings of 76 categories of home health nursing services were composed of 96.4% of the total services, such as simple treatment, inflammatory treatment, urethra & bladder irrigation, inserting indwelling catheter etc., in that order. The highest 20 rankings of 226 categories of home examination services were composed of 77.0% of the total home examination services. In addition, the average cost of home health care per visit was 46,088 Won (approximately equal to 48 Dollars, 1 Dollar=960 Won). The costs ranged from 74,523 Won (approximately equal to 78 Dollars, loss of chronic kidney function, N18) to 32,270 Won (approximately equal to 34 Dollars, other cerebrovascular diseases, I67). CONCLUSION: Results suggest that client characteristics of hospital based HHNC are not different from community based HHNC or visiting nursing services for elderly. The national results will contribute to baseline data used to establish a policy for the home health nursing care system and education.
Adult ; Aged ; Aged, 80 and over ; Community Health Nursing ; Costs and Cost Analysis ; Fees and Charges ; Female ; Health Services for the Aged/*economics/utilization ; Home Care Agencies/*economics/utilization ; Home Care Services, Hospital-Based/*economics/utilization ; Home Nursing ; Humans ; Korea ; Male ; Middle Aged

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.
Cerebrovascular Disorders ; Classification ; Education ; Emergencies ; Home Care Services* ; Home Care Services, Hospital-Based ; House Calls ; Humans ; Korea ; Nursing Care ; Nursing Services* ; Nursing* ; Public Health ; Quality Control ; Referral and Consultation ; Respiration ; Seoul ; Skin ; Transportation