PURPOSE: This study was designed to develop quality outcome indicators for nursing homes and community-based home care that would contribute to an appropriate evaluation and improvement of quality of long term care in Korea. METHODS: The preliminary quality indicators of long term care were developed from a literature review and clinical expert panel. A content validity testing was done using a panel of experts who were selected from academic and clinical field of long-term care. The final quality indicators were confirmed after application in four nursing homes and four home care agencies to test clinical validity. RESULTS: The preliminary quality indicators consisted of 3 domains and 19 indicators. The final quality indicators were composed of 4 domains and 17 indicators. CONCLUSION: This study demonstrated the feasibility of outcome quality indicators in long term care. These quality indicators can be effectively used to evaluate the quality of nursing home and home care and to improve the quality of care in the Korean long-term care system.
Home Care Agencies ; Home Care Services ; Long-Term Care ; Nursing Homes ; Quality Indicators, Health Care

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 They expressed concern that home care services would be withdrawn once the insurance system is initiated.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 aimed to evaluate the quality of life (QOL) in home health care patients according to change in health status outcomes between the start of care and discharge or 60 days, whichever came first. METHODS: This is a prospective descriptive study. The convenience sample consisted of 100 home health care patients, who started receiving home health care services from a home health care agency in the United States. The World Health Organization Quality of Life Scale-Brief (WHOQOL-BREF) was used for measuring QOL; activities of daily living (ADLs) and instrumental ADLs were collected from the Outcome and Assessment Information Set data via Centers for Medicare and Medicaid Services-required home health agencies. Descriptive statistics, paired t tests, and multiple linear regressions were used for data analysis. RESULTS: ADLs and instrumental ADLs of participants significantly improved between start of care and discharge or 60 days. Overall QOL, general health, and three of four QOL domains (physical, psychological, and environmental, but not social domain) were significantly improved at discharge or 60 days. CONCLUSION: Home health care nurses should maintain and improve the functional ability of patients, as this could improve the QOL of these patients.
Activities of Daily Living ; Delivery of Health Care ; Home Care Agencies ; Home Care Services ; Humans ; Linear Models ; Medicaid ; Medicare ; Porphyrins ; Prospective Studies ; Quality of Life ; United States ; World Health Organization

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