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 disoharged 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 sutdy 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 instrumnets utilized for the study were a client selection criterial for Home Health Care developed by Choo (1991) and a check0list of nursing activity developed by researcher.
@ES The results of the study were as follows :
@EN 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 multipling 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 lowere calculated fee than the insurance fee were suction, catheterization, exercise education and dressing change.
The nursing activities with a higher calculated fee than the governmenr 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 evnets the nursing care fee was calaulated at 6136 per day.
4. Based upon the results of the study, a recommentdation for a Home Health Care fee per visit based on the nursing activities provided could be formulated for a Home Health Care fee system.
@ES It could be formulated as following :
@EN 1) Home health Care fee per visit
=【 [direct nursing fee (direct nursing care time per ctivity×average nursing wage)+indirect nursing fee]×average nursing activity per visit】+managemeut 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.
2) Nursing activity fees per visit.
=【[direct nursing care fee+indirect nursing fee]×average number of nursing activities provided per visit】( 6,136+travel fee ( 5,542)+managemeut fee material fee (α)
16,436+α
The nursingt fee per visit as calculated in this research of 15,000+α could be adjusted according to the patient's condition or the use of high technology nursing care or according to the amount of time spent for travel.
The nursing care fee per visit presented in this study can be validated through a Home Health Care demonstration project.
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