Test on the Cost and Development on the Payment System of Home Health Care Nursing

Abstract

(KIHASA, 1994;Ryu, 1994). • 인건비 : 인건비산출을 위한 조사대상자는 해당 가정간호 사업소에 근무하고 있는 정규직 가정간호사만을 대상으로 하였다. 이러한 수가구조에서 개별행위료는 입원비 수가와 동일한 수유• • 지급임차료: 장비리스료는 가정간호사업소와 관련이 없으 므로 제외• 여비교통비: 가정간호 시 교통비 6천원을 별도로 받으므로 Purpose: This study focused on analysing costs per home health care nursing visit based on home health care nursing activities in medical institutes. Method: The data was collected in three stages. First, the cost elements of home health care nursing services were collected and 31 home care nurses participated. Second, the workload and caseload of home care nursing activities were measured by the Easley-Storfjell Instrument(1997). Third, the opinions on improving the home health care nursing reimbursement system were collected by a nation-wide mailing survey from a total of 125 home care agencies. Result: The cost of home health care nursing per visit was calculated as 50,626₩. This was composed of a basic visiting fee of 35,090₩(≒35$) and travel fee of 15,536 ₩(≒15$). The major problems of the home care nursing payment system were the low level of the cost per visit, no distinction between first visit and revisits, and the limitations in health insurance coverage for home health care nursing services. Conclusion: This study's results will contribute as a baseline for establishing policies for improvement of the home health care nursing cost and for applying a community-based visiting nursing service cost.

A Proposal to Improve Nursing Fee Differentiation Policy for General Hospitals Using Profitability-Analysis in the National Health Insurance

“…(Cho & Park, 1993;Park, Hwangbo, & Lee, 1992;Ryu, Jung, & Lim, 2006) (Marcell, Ernst, & Gerald, 1992 …”