Kim C J
Taehan Kanho. 1993 Jan-Feb;32(1):61-76.
This study was done in order to provide basic data to a Fee System for hospital based Home Health Care services in Korea in the future. It was done by investigating activities provided to possible Home Health Care clients who could be discharged early from general hospitals and then estimating the nursing care fee according to each nursing activity based upon the time used for activity. The subjects of the study were selected by convenience sampling and consisted of 35 clients who might be clients for Home Nursing Care and were presently admitted to a medical-surgical ward of Y University Medical Center located in Seoul, Korea. The data collection period was from September 1, 1991 to September 30, 1991. The research instruments utilized for the study were a client selection criteria for Home Health Care developed by Choo (1991) and a check-list of nursing activity developed by researcher. The results of the study were as follows: 1. There were 44 different nursing activities provided in the seven days but the time was calculated for only 25 of the nursing activities. 2. Fees for the 25 different nursing activities were calculated by multiplying the median of the average wage of a staff nurse having five years experience in an A grade general hospital to the time of the nursing activity. The results were compared with the insurance fee which the government recognized as an appropriate fee for that activity. The nursing activities with a lower calculated fee than the insurance fee were suction, catheterization, exercise education and dressing change. The nursing activities with a higher calculated fee than the government recognized fee were IM injection and vital sign check. 3. There was a range of 1-15 nursing activities provided daily to the client. For the average number of nursing activities per day of 6.26 events the nursing care fee was calculated at W 6136 per day. 4. Based upon the results of the study, a recommendation for a Home Health Care fee per visit based on the nursing activities provided could be formulated for a Home Health Care fee system. It could be formulated as following: 1) Home health Care fee per visit = [(direct nursing fee (direct nursing care time per activity x average nursing wage) + indirect nursing fee) x average nursing activity per visit] + management fee+materials fee+a travel fee. In this way a nursing fee could be calculated based upon the result of the study of the nursing fees per visit.(ABSTRACT TRUNCATED AT 400 WORDS)
本研究旨在为韩国未来基于医院的居家医疗服务收费系统提供基础数据。该研究通过调查为可能从综合医院提前出院的居家医疗服务潜在客户所提供的活动，并根据每项护理活动所花费的时间来估算护理费用。研究对象通过便利抽样选取，包括35名可能成为居家护理服务对象且当时入住韩国首尔Y大学医学中心内科 - 外科病房的患者。数据收集期为1991年9月1日至1991年9月30日。本研究使用的研究工具包括Choo（1991年）制定的居家医疗服务客户选择标准以及研究者制定的护理活动清单。研究结果如下：1. 七天内提供了44种不同的护理活动，但仅计算了其中25种护理活动的时间。2. 25种不同护理活动的费用通过将在甲级综合医院有五年工作经验的护士平均工资中位数乘以护理活动时间来计算。将结果与政府认可的该活动合适保险费用进行比较。计算费用低于保险费用的护理活动有吸痰、导尿、运动教育和换药。计算费用高于政府认可费用的护理活动有肌肉注射和生命体征检查。3. 每天为患者提供1至15种护理活动。平均每天护理活动次数为6.26次时，护理费用计算为每天6136韩元。4. 根据研究结果，可以为居家医疗服务收费系统制定基于所提供护理活动的每次居家医疗服务收费建议。可按以下方式制定：1）每次居家医疗服务费用 = [（直接护理费用（每项活动直接护理时间×平均护理工资）+间接护理费用）×每次访视平均护理活动次数] + 管理费 + 材料费 + 差旅费。这样，可根据每次访视护理费用的研究结果计算护理费用。（摘要截断于400字）
