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Effectiveness of Community-based Case Management for Patients with Hypertension
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Soon Nyoung Yun, In Sook Lee, Jin Hyun Kim, Young Ko
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J Korean Acad Community Health Nurs. 2014;25(3):159-169. Published online September 30, 2014
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DOI: https://doi.org/10.12799/jkachn.2014.25.3.159
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 Abstract
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- PURPOSE
The purpose of this study was to evaluate the effectiveness of case management for patients with hypertension on their health status and medical service utilization.
METHODS
This study was a secondary analysis of data collected for a larger study of chronic disease management in 2008 using the National Health Insurance Corporation database. A total of 12,944 patients who received case management for hypertension were included in this analysis. The subjects of case management were classified into subgroups, namely, over-use, under-use, and non-use groups according to the amount of medical service utilization. To compare the medical service utilization, a control group was selected randomly. The data were analyzed through descriptive statistics, McNemar test, and ANOVA.
RESULTS
All the subgroups displayed significant differences in blood pressure, self-management, social support, and their characteristics of medical service utilization. The total medical expense of the under-use and non-use groups increased after case management. However, there was no decrease in the medical expense of the over-use group.
CONCLUSION
This finding suggests that there is a need to re-examine why patients overuse medical services and to supplement specific strategies for encouraging appropriate medical service utilization, and enhancing case management efforts for the over-use group.
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A Cost Benefit Analysis of Individual Home Visiting Health Care
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Jin Hyun Kim, Tae Jin Lee, Jin Hee Lee, Sang Jin Shin, Eun Hee Lee
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J Korean Acad Community Health Nurs. 2010;21(3):362-373. Published online September 30, 2010
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DOI: https://doi.org/10.12799/jkachn.2010.21.3.362
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Citations
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Abstract
PDF
- PURPOSE
The purpose of this study is to evaluate the costs and benefits of individual home visiting health care using secondary data and literature review.
METHODS
The total number of subjects was 1,008,837. A specific program was classified into disease management, care of infant, child and women, or elderly care. The costs and effects of a program were identified from a societal perspective, and the effects were converted into monetary terms or benefits. The total cost was calculated in the way that medical expenses, travel costs and productivity losses were offset by the decrease in benefits and thus only the program budget was included in the total cost.
RESULTS
The total program cost was 47.6 billion won per year and the total annual benefit was estimated at 435.6 billion won. The benefits of arthritis management were the biggest among disease management programs. The net benefit was 388.0 billion won per year and the benefit/cost ratio was 9.16.
CONCLUSION
Home visiting health care was validated to be economically effective. It made a positive contribution to improving the health status of vulnerable populations and reducing medical expenses. These results suggest that home visiting care should be extended more broadly to vulnerable populations.
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Citations
Citations to this article as recorded by  - Effects of a nurse-led structured home visiting program on quality of life and adherence to treatment in hemodialysis patients
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The Korean Journal of Food And Nutrition.2015; 28(4): 717. CrossRef - Ethical concerns of visiting nurses caring for older people in the community
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