본문 바로가기
HOME> 논문 > 논문 검색상세

논문 상세정보

조기퇴원 수술환자의 병원중심 가정간호 효과 및 비용분석에 관한 연구
A Study on Effectiveness of the Hospital-based Home Nursing Care of the Early Discharged Surgical Patients and its Cost Analysis

박경숙    (중앙대학교 의과대학 부속병원   ); 정연강    (중앙대학교 의과대학 간호학과  );
  • 초록

    Medical insurance and health care delivery system enabled Korean people to get the necessary medical service, but it caused increased needs for medical service, and resulted in the occurence of some problems such as a lack of manpower and medical facilities. In order to solve these problems, many countries, which already had medical insurance system had developed home care system and it has been regarded effective both in reducing costs and in increasing the rates of turnover of bed. Recently, Korea has included home nursing care in its health care delivery system, and some models of the hospital based home nursing care had been tried and its effects had been evaluated. So, author tried to run a home nursing care for the Cesarean section mothers and evaluate Its effects both in the mother's health and costs. This study was designed as a Quasi-experimental study. Subjects were thirty mothers who got Cesarean section operation in hospital in Seoul. Experimental group consisted of 15 volunteers, and control group were selected by means of matching technique. Data were gathered from February 1st to March 26th by two assistants who were trained by author. Experimental group were discharged on the 4th day after their operation, and got nursing care and assessment about their home three times on the 5th, 6th, and 7th day. Control group stayed in the hospital until 7th day as usual and were checked on the same day as above mentioned To evaluate the state of physiological recovery, vital signs, H.O.F, presence of edema in the legs, bathing, appetite, sleep, presence of pain or discomfort in the breasts, amount of lochia, color of lochia, defecation urination. To compare incidence of complication in experimental group with that in control group, specific assessment was done such variables as smell of lochia, presence of inflammation of operation wound, dizziness, and presence of immobilization in the extremities. The activities of daily living were checked Satisfaction of nursing were checked To calculate costs, author asked subjects to specify expenditure including hospital charge, traffic enpenses, and food expenses. The results were as fellows. 1. On effectiveness of home nursing careThere were n significant differences between experimental and control group in incidence of abnormal symptoms and any complication. The number of taking a bath [POD #5 P=0.001, #6 P=0.0003, #7 P=0.001] and the degree of appetite [POD #5 P=0.03, #6 P=0.02, #7 P=0.013] were significantly higher in experimental group than in control group. Contrary to author's expectation, the degree of the activities of daily living in experimental group was not higher than that of control group. All of the experimental group said they were satisfied with the home nursing care. 2. Cost analysis 1) Hospital charge of experimental group was lower than that of control group. [P=0.009] By taking home nursing care, average period of hospitalization was shortened to 3.1 days, and family members could save 22.8 hours. Total amount of money saved by early discharge was 3,443,093 Won. It is estimated that total amount of money saved by early discharge in a year will be 40,398,956 Won. 2) Home nursing care charge of 15 mothers was 1,781,633 Won. It is estimated that total amount of money Saved by it in a year Will be 20,904,493 Won. It was lower altogether than hospital charge of the three days which is 5th, 6th, 7th day of operation. The average cost of single home visit was calculated 10,940 Won. It took 87 minutes per round and it costed 1,017.3 Won. The average hour of home care was 39.0 minutes. 3) It is expected that early discharge can bring forth the increase of hospital income. On the condition that the rate of running bed is 100%, the expected increase of hospital income will be 202,374, 026 Won in a year. Suggestions for further study and nursing practice are as follows : 1. For the welfare of patients and the increased rates of running bed, home nursing care system s


  • 주제어

    가정간호 .   의료비용.  

 저자의 다른 논문

  • 박경숙 (73)

    1. 1995 "고등학교 학생들의 성에 관한 인식과 성교육에 대한 요구 조사 연구" 韓國學校保健學會誌 = The Journal of the Korean society of school health 8 (2): 233~243    
    2. 1995 "입원환자의 투약체계와 방법의 개선을 위한 현장연구" 간호행정학회지 = Journal of Korean academy of nursing administration 1 (1): 147~211    
    3. 1996 "골관절염 환자의 슬관절 전치환술 경험" 류마티스건강학회지 = The journal of rheumatology health 3 (2): 135~150    
    4. 1996 "뇌졸중(腦卒中) 환자(患者)의 신체적(身體的).심리적(心理的).사회적(社會的) 적응도(適應度)에 관(關)한 연구(硏究)" 기본간호학회지 = Journal of Korean Academy of Fundamentals of Nursing 3 (2): 213~233    
    5. 1997 "수술전.후 재원일수에 관한 조사연구" 기본간호학회지 = Journal of Korean Academy of Fundamentals of Nursing 4 (2): 245~265    
    6. 1998 "장루 보유자 교육용 자료에 대한 조사 연구" 대한간호학회지= Journal of Korean academy of nursing 28 (3): 705~717    
    7. 1999 "간호기록의 개선과 전산화를 위한 기초연구" 대한간호학회지= Journal of Korean academy of nursing 29 (1): 21~33    
    8. 1999 "퇴원전.후 암환자와 가족원이 지각하는 간호요구 비교" 재활간호학회지 = The Korean journal of rehabilitation nursing 2 (2): 215~224    
    9. 1999 "중환자실 간호사의 호흡기병원감염 예방에 관한 연구" 기본간호학회지 = Journal of Korean Academy of Fundamentals of Nursing 6 (3): 397~413    
    10. 2000 "자궁적출술 환자를 위한 critical pathway 개발과 적용효과" 여성건강간호학회지 = Korean journal of women health nursing 6 (2): 234~257    
  • 정연강 (46)

 활용도 분석

  • 상세보기

    amChart 영역
  • 원문보기

    amChart 영역

원문보기

무료다운로드
유료다운로드

유료 다운로드의 경우 해당 사이트의 정책에 따라 신규 회원가입, 로그인, 유료 구매 등이 필요할 수 있습니다. 해당 사이트에서 발생하는 귀하의 모든 정보활동은 NDSL의 서비스 정책과 무관합니다.

원문복사신청을 하시면, 일부 해외 인쇄학술지의 경우 외국학술지지원센터(FRIC)에서
무료 원문복사 서비스를 제공합니다.

NDSL에서는 해당 원문을 복사서비스하고 있습니다. 위의 원문복사신청 또는 장바구니 담기를 통하여 원문복사서비스 이용이 가능합니다.

이 논문과 함께 출판된 논문 + 더보기