OBJECTIVES: We searched and reviewed the literature including the laws or acts, statistics, guidelines, papers and conference proceedings related to home visit nursing care in South Korea. METHOD: We searched and reviewed the literature including the laws or acts, statistics, guidelines, papers and conference proceedings related to home visit nursing care in Korea. RESULTS: There are three types of home care nursing in Korea. Public health center provides home visit nursing to vulnerable population by registered nurses for free, based on community health act in public health center. As of 2017, 1,261,208 people were enrolled in the visiting health program of public health center. Health behavior and disease management has been improved and showed having cost-benefit effect among the enrolled people in visiting health program. Visiting nursing care in long-term care services is provided by registered nurses or nurse aid, based on long-term care act. The cost is paid as the unit price according to service time. 1,095,764 older people used long-term care services in 2017, only 0.2% of total cost used for home visiting nursing. Even though the number of user of home visiting nursing, it was reported that users spent less medical cost and hospitalized shorter. Hospital-based home care nursing is provided to patients and their families under the prescription of a doctor by family nurse specialists who are employed by medical institute based on medical law. Four hundred sixty family nurse specialists worked for hospital-based home care nursing and hospital-based home care services accounted for 0.038% of total medical expenses in 2017. CONCLUSION: Even though home visit nursing care services are different in aspect of legal basis, personnel, running institutes, and cost basis, home visit nursing care showed cost-benefit effect and good health outcomes. In order to advance home visit nursing care, the integrated home visiting care, improvement of working condition, and revision of legal basis should be considered.
Academies and Institutes ; Disease Management ; Health Behavior ; Home Care Services ; Home Care Services, Hospital-Based ; House Calls ; Humans ; Jurisprudence ; Korea ; Long-Term Care ; Methods ; Nurses ; Nursing Care ; Nursing ; Prescriptions ; Public Health ; Running ; Specialization ; Vulnerable Populations

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

OBJECTIVE: To evaluate the effect of hospital-based cardiac rehabilitation (CR) on quality of life (QOL) and physical ability in patients with myocardial infarction (MI). METHODS: Patients with MI who were referred to the Cardiac Health and Rehabilitation Center 2 weeks after percutaneous coronary intervention were divided into CR and non-CR groups. The CR group performed supervised exercises 3 times a week for 2 months. QOL assessment, using the 36-item Short-Form Health Survey (SF-36) and physical ability evaluation were performed at the beginning and end of CR. RESULTS: The CR group demonstrated statistically significant improvements in physical functioning (PF), physical role functioning (RP), bodily pain (BP), general health perceptions (GH), vitality (VT), social role functioning (SF), emotional role functioning (RE), mental health (MH), physical component summary (PCS), and mental component summary (MCS). The non-CR group showed improvement in RP. Secondary outcomes, including resting heart rate (RHR), maximal oxygen consumption (VO(2max)), metabolic equivalent of task (MET), maximal exercise time (ET(max)), stage 3 Borg rating of perceived exertion (3RPE), maximal Borg rating of perceived exertion (RPEmax), and stage 3 rate pressure product (3RPP), improved in the CR group. The non-CR group showed improvements in VO(2max), MET, ET(max), and 3RPE. There were significant differences in improvements in PF, RP, BP, VT, SF, MH, MCS, RHR, VO(2max), MET, ET(max), 3RPE, and 3RPP between the two groups. CONCLUSION: Male patients with MI demonstrated improvements in QOL and physical ability following hospital-based CR; the impact on the mental component was greater than that on the physical component.
Exercise ; Health Surveys ; Heart Rate ; Home Care Services, Hospital-Based ; Humans ; Male ; Mental Health ; Metabolic Equivalent ; Myocardial Infarction* ; Oxygen Consumption ; Percutaneous Coronary Intervention ; Physical Fitness ; Quality of Life* ; Rehabilitation Centers ; Rehabilitation*

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

INTRODUCTIONIn end-stage heart failure (HF) that is not eligible for mechanical assist device or heart transplant, palliative care serves to maximise symptom control and quality of life. We sought to evaluate the impact of home-based advance care programme (ACP) on healthcare utilisation in end-stage HF patients.

MATERIALS AND METHODSProspectively collected registry data on all end-stage HF recruited into ACP between July 2008 and July 2010 were analysed. Chart reviews were conducted on HF database and hospital electronic records. Phone interview and home visit details by ACP team were extracted to complete data entry. HF and all-cause hospitalisations 1 year before, and any time after ACP inception were defined as events. For the latter analysis, follow-up duration adjustment to event episodes was performed to account for death less than a year.

RESULTSForty-four patients (mean age 79 years, 39% men) were followed up for 15±8 months. Fifty-seven percent had diabetes, 80% ischaemic heart disease, and 60% chronic kidney disease. All reported functional class III/IV at enrolment. Mean serum sodium was 136±6 mmol/L, and creatinine 186±126 mmol/L. Thirty (68%) died within the programme. Mean time to death was 5.5 months. Mean all-cause and HF hospitalisations were 3.6 and 2.0 per patient before enrolment, but improved to 1.0 and 0.6 respectively after ACP. Thirty-six (71%) patients had fewer HF hospitalisations. When only those who survived more than a year were considered (n = 14), 10 (71%) and 9 (64%) experienced reduced HF (mean: 1.4 episodes per patient) and all-cause hospitalisations (mean: 2.2 episodes per patient) respectively.

CONCLUSIONHome-based advance care programme is potentially effective in reducing healthcare utilisation of end-stage HF patients, primarily by reducing HF rehospitalisations, and in probably saving costs as well.

Aged ; Aged, 80 and over ; Diabetes Mellitus ; Female ; Health Care Costs ; Health Services ; economics ; utilization ; Heart Failure ; complications ; economics ; therapy ; Home Care Services, Hospital-Based ; economics ; Hospitalization ; economics ; statistics & numerical data ; Humans ; Male ; Myocardial Ischemia ; complications ; Palliative Care ; economics ; methods ; Prospective Studies ; Registries ; Renal Insufficiency, Chronic ; complications ; Tertiary Care Centers

Despite documented efficacy and recommendations, pulmonary rehabilitation (PR) in chronic obstructive pulmonary disease (COPD) has been underutilized. Home-based PR was proposed as an alternative, but there were limited data. The adequate exercise intensity was also a crucial issue. The aim of this study was to investigate the effects of home-based PR with a metronome-guided walking pace on functional exercise capacity and health-related quality of life (HRQOL) in COPD. The subjects participated in a 12-week home-based PR program. Exercise intensity was initially determined by cardiopulmonary exercise test, and was readjusted (the interval of metronome beeps was reset) according to submaximal endurance test. Six-minute walk test, pulmonary function test, cardiopulmonary exercise test, and St. George's Respiratory Questionnaire (SGRQ) were done before and after the 12-week program, and at 6 months after completion of rehabilitation. Thirty-three patients participated in the program. Six-minute walking distance was significantly increased (48.8 m; P = 0.017) and the SGRQ score was also improved (-15; P < 0.001) over the six-month follow-up period after rehabilitation. There were no significant differences in pulmonary function and peak exercise parameters. We developed an effective home-based PR program with a metronome-guided walking pace for COPD patients. This rehabilitation program may improve functional exercise capacity and HRQOL.
Aged ; Exercise ; Exercise Test ; Female ; *Home Care Services, Hospital-Based ; Humans ; Lung/physiopathology ; Male ; Middle Aged ; Program Evaluation ; Pulmonary Disease, Chronic Obstructive/physiopathology/*rehabilitation ; Quality of Life ; Questionnaires ; Respiratory Function Tests ; Treatment Outcome ; *Walking

BACKGROUND/AIMS: Home oxygen therapy (HOT) costs a great deal every year and demand for the service is growing. In Korea, health insurance has covered HOT since November 1, 2006. The objective of this study was to evaluate clinical features of patients who used long-term HOT due to chronic respiratory failure and to determine the appropriateness of oxygen prescriptions. METHODS: Between November 2006 and April 2010, patients prescribed long-term HOT were enrolled in the study at a tertiary university referral hospital and their medical records and telephone survey information were evaluated. In total, 340 patients were evaluated retrospectively. RESULTS: Regarding the initial indications for HOT, their mean PaO2 was 49.8 mmHg and mean SpO2 was 82.2%. Underlying diseases included chronic obstructive pulmonary disease (COPD, 19.8%), lung cancer (12.6%), and interstitial lung disease (11.2%). The admission rate within 1 year was 53.4% and the average number of admissions was 1.64/patient. Other underlying diseases for which oxygen was prescribed, despite not meeting the insurance coverage criteria, were lung cancer (36.6%) and interstitial pneumonia (16.6%). CONCLUSIONS: Home oxygen prescriptions have increased since health insurance coverage was extended. However, cases of oxygen prescriptions frequently do not meet the coverage criteria. It is important to discuss extending the coverage criteria to other disease groups, such as interstitial lung disease and lung cancer, in terms of cost-effectiveness. Further, physicians prescribing oxygen therapy should be educated regarding the criteria.
Adult ; Aged ; Aged, 80 and over ; Cause of Death ; Chronic Disease ; Eligibility Determination ; Emergency Service, Hospital ; Female ; *Home Care Services, Hospital-Based ; Hospitalization ; *Hospitals, University ; Humans ; Insurance Coverage ; Insurance, Health ; Kaplan-Meier Estimate ; Male ; Middle Aged ; *Oxygen Inhalation Therapy ; Patient Compliance ; Program Evaluation ; Republic of Korea ; Respiratory Insufficiency/diagnosis/etiology/mortality/*therapy ; Retrospective Studies ; Time Factors ; Treatment Outcome ; Young Adult

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 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

PURPOSE: This study was done to develop and test a palliative care program based on home care nursing. METHODS: A quasi-experimental design was employed. Changes in the variables were evaluated to test effects of the developed program. Participants were patients with terminal cancer and their families receiving home care nursing from six hospitals (experimental group: 24 and control group: 22). Data collection was conducted from February to October, 2006. Chi-square test, Fisher's exact test, t-test, Mann-Whitney U test and repeated measures ANOVA were used to analyse the data. RESULTS: Hypothesis 1, the experimental group receiving this program will experience less pain (severe, average, weak pain) than the control group, was supported. Hypothesis 2, the experimental group will have less symptom experience than the control group, was supported. Hypothesis 3, the experimental group will have higher QOL than the control group, was supported and the last hypothesis 4, family burden in the experimental group will be less than the control group, was supported. CONCLUSION: The home care nursing based palliative program developed in this study was found to be an effective program to reduce patient pain and symptom experience, to improve patient QOL and to decrease family burden.
Aged ; Demography ; Family/psychology ; Female ; Home Care Services, Hospital-Based ; Humans ; Male ; Middle Aged ; Neoplasms/*nursing/psychology/therapy ; Pain/therapy ; Palliative Care/*methods ; Patient Satisfaction ; Program Evaluation ; Quality of Life ; Terminal Care