Research in Community and Public Health Nursing

Original Articles

[English] Comparison of Quit Rates and Predictors in Korean Inpatient and Residential Smoking Cessation Programs: A Secondary Data Analysis of Data from the National Smoking Cessation Services: Youngmee Ahn, Soyoung Jung, Hunjae Lee, Jung-Ae Cho, Min Sohn; Res Community Public Health Nurs. 2025;36(2):210-220. Published online June 27, 2025; DOI: https://doi.org/10.12799/rcphn.2025.01004

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Abstract PDF: Purpose
Inpatient and residential smoking cessation programs in Korea have demonstrated relatively high quit rates, with residential programs consistently outperforming inpatient ones. However, simple comparisons are limited by differences in participant characteristics and eligibility criteria. This study aimed to determine whether program type independently influences quit rates, using both self-reported and biochemically verified outcomes.
Methods
This descriptive study conducted a secondary analysis of data from 17,290 participants enrolled in national smoking cessation services across 18 regional tobacco control centers (2018-2020). Data included demographics, smoking history, and program participation. Quit status at 4 weeks, 12 weeks, and 6 months was assessed through self-report and biochemical verification. Multivariate logistic regression was used to evaluate the independent effect of program type on 6-month quit outcomes.
Results
The mean age of participants was 54.8 ± 12.0 years, and 14.5% were women. At 6 months, self-reported quit rates ranged from 16.5% to 34.1% for the inpatient program and from 26.0% to 62.8% for the residential program. Biochemically verified rates ranged from 8.6% to 19.0% (inpatient) and 11.9% to 46.7% (residential). After adjusting for confounders, program type was significantly associated with self-reported quitting (aOR = 0.80; 95% CI = 0.72-0.89; p < .001), but not with biochemically verified quitting (aOR = 0.91; 95% CI = 0.82-1.01; p = .082).
Conclusion
Although residential programs showed higher self-reported quit rates, program type did not predict verified cessation. This suggests differences in participant characteristics may drive outcomes. Further research should identify effective, evidence-based components for sustained quitting.

[Korean] Comparison of Risk Factors and 30 day-in Hospital mortality of Community-Acquired Pneumonia with Elderly Patients and Adult Patients: Using Secondary Data from the Korea Centers for Disease Control and Prevention: Jinseon Heo, Youngsuk Kim; Res Community Public Health Nurs. 2025;36(1):112-121. Published online March 31, 2025; DOI: https://doi.org/10.12799/rcphn.2024.00815

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Abstract PDF: Purpose
This study examines the factors influencing 30-day in-hospital mortality in elderly patients with community-acquired pneumonia (CAP) and compares them to those in adult patients.
Methods
This secondary analysis used discharge data from the Korea Disease Control and Prevention Agency, covering the period from January 1, 2020, to December 31, 2022. Statistical methods included χ² tests, t-tests, the Cox proportional hazards model for calculating adjusted hazard ratios (HR), and Kaplan-Meier analysis. Results: The study found that older age (Adjusted HR=2.40, 95% CI=2.01-2.85, p<.001) and Emergency Room admissions (Adjusted HR=2.24, 95% CI=1.94-2.59, p<.001) are significantly associated with increased mortality in elderly patients. Other contributing factors include residency area (Adjusted HR=1.73, 95% CI=1.04-2.87, p=.035), hospital setting (Adjusted HR=1.34, 95% CI=1.05-1.70, p=.017), and the number of hospital beds (Adjusted HR=1.27, 95% CI=1.11-1.46, p=.001).
Conclusion
These findings underscore the importance of improving community health screenings and developing respiratory infection prevention programs for elderly patients, especially those in high-risk areas.

[Korean] A Study on Outcomes of the Utilization of Visiting Nursing Service at the Integrated Visiting Nursing Center in Bucheon-si: Hyun-Kyung Park, Ae Jung Yoo, Ju Young Yoon, Jae Woo Choi; Res Community Public Health Nurs. 2023;34(2):127-134. Published online June 30, 2023; DOI: https://doi.org/10.12799/rcphn.2023.00045

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Abstract PDF: Purpose
The government has implemented a pilot project for community care for older adults and the integrated visiting nursing center in Bucheon-si operated by public fund of government to provide visiting nursing service for older adults. This study aimed to analyze the outcomes of the utilization of visiting nursing service at the integrated visiting nursing center in Bucheon-si.
Methods
This study linked the personal data from the pilot project for community care with the National Health Insurance data. The final subjects comprised 30 participants and 110 of the matched control group. The length of home stay, hospitalization, and the admission for long-term care facilities or convalescent hospitals were measured. Statistical analysis was performed through difference-in-differences analysis using generalized estimating equation and Cox proportional hazards model.
Results
The results indicated an increase of 28.2 days for length of home stay and a reduction of 69% in hospitalization from medical institutions and 81% in admission of long-term care facilities or convalescent hospitals among participants compared to the control group.
Conclusion
The visiting nursing service of the integrated visiting nursing center was effective in extending length of home stay and lowering the hospitalization of medical institutions and admission of long-term care facilities or convalescent hospitals.

[English] Factors Related to Long-term Hospital Length of Stay and Opinions on Discharge-related Community-based Medical and Welfare Service on Elderly Patients with Chronic Diseases in Korean Veterans Hospitals: Young Mi Yoon, Jin Hee Park, Moon Sook Hwang; J Korean Acad Community Health Nurs. 2022;33(4):357-371. Published online December 31, 2022; DOI: https://doi.org/10.12799/jkachn.2022.33.4.357

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Abstract PDF: Purpose
This study aims to investigate factors related to long-term length of stay (LOS) of patients with chronic diseases in Korean veterans hospitals. Methods: The subjects were 196 elderly patients with chronic disease staying in the hospital for more than 10 days, Data were collected by the survey of patients with structured questionnaires and medical records review by nurses from July 15 to August 10, 2019. Collected data were analyzed using t-test, ANOVA, Pearson's correlation coefficient and stepwise multiple regression. Results: The present and desired LOS were 37.78±32.66 days and 60.87±45.95 days, respectively. Factors affecting hospital LOS were found to be main disease (genitourinary) (p<.001), assistance in activities of daily living (p<.001), area of hospital (p<.001), payment of medical fees (p=.026), hospital satisfaction (p=.036) and the explanatory power of these variables was 26.4%. The most common health problems that need to be solved after discharge were symptom alleviation and health promotion. These problems can be solved using community-based facility services or visiting medical-welfare services (especially home care nursing). Conclusion: In order to reduce hospital LOS, the following measures are required: personalized self-management education, provision of transportation services for dialysis therapy of inactive patients, linking patients with visiting medical-welfare services including home care nursing and mobile healthcare services, operation of the case management system including the notice of the discharge date at admission, interim check of patient status, and connecting the patient with community resources or transferring the patient to long-term care facilities at discharge.

[English] Economic Evaluation of Hospital-based Home Care Services for the Breast Cancer Surgery Patients: Jeong Yeon Ko, Ju Young Yoon; J Korean Acad Community Health Nurs. 2021;32(3):356-367. Published online September 30, 2021; DOI: https://doi.org/10.12799/jkachn.2021.32.3.356

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2 Citations

Abstract PDF

Purpose
This study conducted an economic evaluation of hospital-based home care services for the patients who had undergone breast cancer surgery.
Methods
A total of 12,483 patients over 18 years of age who had received breast cancer surgery in 26 tertiary hospitals in 2018 were analyzed with the claim data from the Health Insurance Review & Assessment Service using cost-minimization analysis and societal perspectives.
Results
There were 156 patients who utilized hospital-based home care services within 30 days after breast cancer surgery, and they received 2.17 (SD=1.17) hospital-based home care service on average. The average total cost was 5,250,028 KRW (SD=1,905,428) for the group receiving continuous hospital-based home care and 6,113,402 KRW (SD=2,033,739) for the group not receiving continuous hospital-based home care (p＜.001). The results of the economic evaluation of continuous hospital-based home care services in patients who had undergone breast cancer surgery indicated a total benefit of 953,691,000 KRW, a total cost of 819,004,000 KRW, and a benefit-cost ratio of 1.16 in 2018.
Conclusion
Continuous hospital-based home care was considered economically feasible as the total costs for the group receiving continuous hospital-based home care were lower than those of the group not receiving continuous hospital-based home care. Therefore, policy modification and financial incentives are recommended to increase the utilization of hospital-based home care services for patients who had undergone breast cancer surgery.

Citations

Citations to this article as recorded by

Economic evaluation of the hospitalist care model in an acute medical unit: a benefit–cost analysis
Hyun Jeong Kim, Jinhyun Kim, Jung Hun Ohn, Nak-Hyun Kim
BMJ Open.2024; 14(7): e081594. CrossRef
Dimensions and components of hospital-at-home care: a systematic review
Parniyan Nikmanesh, Jalal Arabloo, Hasan Abolghasem Gorji
BMC Health Services Research.2024;[Epub] CrossRef

[English] Characteristics and Mortality Risk Factors in Geriatric Hospital Patients visiting One Region-wide Emergency Department: Kyoung Wan Kim, Soong Nang Jang; J Korean Acad Community Health Nurs. 2016;27(4):327-336. Published online December 31, 2016; DOI: https://doi.org/10.12799/jkachn.2016.27.4.327

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6 Citations

Abstract PDF

PURPOSE
This study was to examine the clinical characteristics and mortality risk factors of geriatric hospital patients who visited one region-wide emergency department (ED). It's basically meant to develop criteria for the patient management of geriatric hospitals and to provide related information.
METHODS
A retrospective research study was implemented using electronic medical records. The subjects in this study included 484 geriatric hospital patients who were selected from among 15,994 patients that visited one region-wide ED between January 1, 2014, and December 31, 2015.
RESULTS
There were significant differences in death, a change for the better and no change for the better, which were results of treatment, according to the length of stay in hospital, hospitalization in a general ward, not having an operation or surgery, the presence or absence of malignant neoplasm, the insertion of foley catheter, intubation, ventilator and the insertion of central venous catheter.
CONCLUSION
The results of this study suggest that a patient management system is necessary in geriatric hospitals and that competent healthcare workers who can properly respond to emergencies are required as well.

Citations

Citations to this article as recorded by

Mortality Outcomes and Contributing Risk Factors in Patients with Hospital-Associated Disability
Soo-Jeong Jo, So-Hee Lee, Hyo-Jin Min, Hee-Ji Kim, Hyun-Ho Kong
Journal of Clinical Medicine.2024; 13(16): 4798. CrossRef
Factors Associated with Acute Hospitalizations and Mortality of Older Adults in Long-Term Care Facilities and Long-Term Care Hospitals: A Population-Based, Pubic-Insurance Big-Data Analysis
Seyune Lee, Nan-He Yoon, Jung-Yeon Choi, Kwang-Il Kim, Hongsoo Kim
Journal of Korean Gerontological Nursing.2022; 24(2): 162. CrossRef
Development and Application of a Surveillance Method for Healthcare-Associated Infections in Long-Term Care Hospitals in Korea
Sun Young Jeong, JeongHwa Choi, Jae Yeun Kim, Hyuk Ga
Annals of Geriatric Medicine and Research.2020; 24(4): 274. CrossRef
Nurses' Experiences of End-of-life Care for Elderly Patients in Long-term Care Hospitals
Chun Yee Lee, Ga Eon Lee
Journal of Korean Academy of Community Health Nursing.2020; 31(2): 199. CrossRef
Factors of Revisit of Older Adult that Emergency Departments
Juhee Hwang, Sungran Kim, Myounghee Won, Dokyung Hu, Juhyun Ahn, Dong-Soo Shin
Journal of Digital Contents Society.2019; 20(12): 2555. CrossRef
Clinical outcomes and prognostic factors in patients directly transferred to the intensive care unit from long-term care beds in institutions and hospitals: a retrospective clinical study
Su Hwan Lee, Soo Jung Kim, Yoon Hee Choi, Jin Hwa Lee, Jung Hyun Chang, Yon Ju Ryu
BMC Geriatrics.2018;[Epub] CrossRef

[English] The Effects of the Designated Doctor System on Health Care Utilization of Medical Aid Beneficiaries with Chronic Diseases: Min Jung Kim, Young Ha Cho, Nam Hee Park; J Korean Acad Community Health Nurs. 2015;26(3):278-291. Published online September 30, 2015; DOI: https://doi.org/10.12799/jkachn.2015.26.3.278

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Abstract PDF

PURPOSE
This study was conducted to examine differences in health care utilization and related costs between before and after the introduction of the designated doctor system, and to find out factors making the differences.
METHODS
Data were collected from 200 medical aid beneficiaries having one or more chronic diseases, registered in the designated doctor system during the year of 2012, and the relationship between the use of health services and claimed medical expenses was analyzed through paired t-test and multiple regression analysis using the SPSS 18.0 program.
RESULTS
There was a decrease in the number of total benefit days and the number of outpatient and medication days, but some cases showed an increase after the designation of medical institution. In general, hospital stay increased after the introduction of the system. However, the number of medical institutions utilized was reduced in most cases after designation. Conversely, medical expenses increased in most cases after the designation of medical institution.
CONCLUSION
These results suggest that a detailed scheme to designate medical institutions should be made in consideration of the seriousness of illness and classification of medical institutions not only for the beneficiaries' enhanced health but for the effective management of medical aid fund.

Citations

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A Two-step Clustering Approach for Measuring Socioeconomic Factors Associated with Cardiovascular Health among Older Adults in South Korea
Chi-Young Lee
Korean Journal of Adult Nursing.2020; 32(6): 551. CrossRef

[English] The Effects of the Designated Doctor System on the Health of Medical Aid Beneficiaries: Jeong Myung Choi, Jin Joo Oh; J Korean Acad Community Health Nurs. 2012;23(4):438-445. Published online December 31, 2012; DOI: https://doi.org/10.12799/jkachn.2012.23.4.438

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Abstract PDF

PURPOSE
Medical Aid Beneficiaries were surveyed to identify differences in health behaviors, adherence to drug regimen, and quality of life between those people in the Designated Doctor System and those who are not.
METHODS
A total of 1,327 study subjects were separated into three groups: those in the Designated Doctor System for 2 years, those in for 1 year, and those not in the system.
RESULTS
After the introduction of the Designated Doctor System, 55.8% and 67.9%, respectively, of the subjects in the Designated Doctor System complained of inconvenience in relation to hospital use and the patient referral process. Also, the rate of emergency room use or hospitalization guided by the Designated Doctor System was only 8.7% and 6.5%, respectively. There were no significant differences in health behaviors and adherence to drug regimens between those in the Designated Doctor System and those who are not.
CONCLUSION
This study was carried out early in the introduction of the system. Therefore, it is necessary to monitor the positive and negative effects of the Designated Doctor System for a full reflection of its impact.

Citations

Citations to this article as recorded by

The Effect of Case Management Services for High-risk Medicaid Beneficiaries
Young Jin Ahn, Yun-Kyoung Choi
Journal of the Korea Academia-Industrial cooperation Society.2015; 16(8): 5430. CrossRef
The Effects of the Designated Doctor System on Health Care Utilization of Medical Aid Beneficiaries with Chronic Diseases
Min Jung Kim, Young-Ha Cho, Nam Hee Park
Journal of Korean Academy of Community Health Nursing.2015; 26(3): 278. CrossRef
A Study on Influential Factors on Satisfaction with the Use of Medical Services by the Qualified Recipients of Medical Aid(focusing on the period after the introduction of the selected medical center system)
Jin-Woo Lee, Se-I Yang, Kwang-Hwan Kim
Journal of Digital Convergence.2014; 12(3): 289. CrossRef

[English] Quality Dimension of Long Term Care Hospital: Chun Mi Kim, Ji Yun Lee, Ryeo Jin Ko; J Korean Acad Community Health Nurs. 2009;20(2):243-250. Published online June 30, 2009

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Abstract PDF: PURPOSE
This is a qualitative study to identify dimensions of long-term care hospital care quality that provide high-level medical services for long-term care patients in Korea.
METHODS
Service consumers and providers were interviewed, and collected data were analyzed into thesis, type and dimension. The focus group method was applied to two provider groups and individual interview was applied to two persons who had experienced a long-term care hospital.
RESULTS
The results of analyzing the comsumers and providers was integrated into 8 dimensions: physical environment, staff, clinical care and nursing, multiplicity of activity program, atmosphere, interaction with family, nutrition, and quality improvement system.
CONCLUSION
The dimensions of long-term care hospital care quality from this study can be used as a basis of quality indicators. Quantitative studies to test these dimensions are required for establishing quality management systems.

[English] An Analysis of the Elderly Care and Management in Hospital-Based Home Care Agencies: Chong Rye Song, Im Ok Kang, Yun Ok Kim, Hea Sook Jo, Moon Sook Hwang; J Korean Acad Community Health Nurs. 2008;19(4):660-672. Published online December 31, 2008

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Abstract PDF: PURPOSE
To analyze the home care services provided to the elderly aged 65 and older by a hospital-based home care agencies and to investigate the effects of long-term care insurance for the elderly.
METHOD
The subjects were the home care service recipients aged 65 and older in 172 hospital-based, home care agencies registered in Health Insurance Review & Assessment Service in January, 2007. The data were collected using a questionnaire from March 16 to April 15, 2007. The questionnaire return rate was 43.8%.
RESULT
The hospital-based home care agencies were able to visit 66.5% of the national administrative districts. Of the home care service recipients, over 50% were 65 years old and older. About 43% of the agencies reported that over 50% of their patients would be subject to the long-term care insurance. They expressed concern that home care services would be withdrawn once the insurance system is initiated.
CONCLUSION
This study suggests that hospital-based home care agencies need to manage home care services with long-term care insurance. It also recommends developing guidelines for the use of services and referrals.

[English] Factors Affecting of Long Term Care Hospital Patient's Intention of Transfer to a Nursing Home: Ji Yun Lee, Eun Gyung Park; J Korean Acad Community Health Nurs. 2008;19(2):196-204. Published online June 30, 2008

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Abstract PDF: PURPOSE
To examine factors affecting long-term care hospital patients' intention of transfer to a nursing home.
METHOD
A questionnaire survey was conducted in Aug. 2007 that included 655 patients from 49 long-term care hospitals. The survey aimed to assess the patients' health status, family status, cost and intention of transfer to a nursing home. Institutional characteristics were analyzed from the nationwide database of Health Insurance Review & Assessment Service. The affecting factors were examined by employing chi-square test and logistic regression using SAS 8.2.
RESULT
Of the subjects, 32.4% had intention of transfer to a nursing home. The intention of transfer to a nursing home was affected by moderate or severe pain, living together with the primary carer, high cost uncovered by insurance, and recognition of nursing home.
CONCLUSION
For appropriate service utilization, a higher level of care is needed to satisfy patients at nursing homes and a balanced fee schedule is needed between long term care hospitals and nursing homes. It is desirable to encourage transfer to a nursing home at which nurses support patients and their families by giving information, coordination, and to make efforts to establish a reference system.

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