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A Cost Benefit Analysis of Individual Home Visiting Health Care

Article information

Res Community Public Health Nurs. 2010;21(3):362-373
Publication date (electronic) : 2014 April 04
doi : https://doi.org/10.12799/jkachn.2010.21.3.362
Jinhyun Kim1, Taejin Lee2, Jinhee Lee3, Sangjin Shin4, Eunhee Lee5
1Associate Professor, College of Nursing, The Research Institute of Nursing Science, Seoul National University, Korea.
2Associate Professor, Graduate School of Public Health, Seoul National University, Korea.
3Researcher, Health Insurance Review Agency, Korea.
4Researcher, National Evidence-based Healthcare Collaborating Agency, Korea.
5Doctoral Student, College of Nursing, Seoul National University, Korea.
Address reprint requests to: Shin, Sangjin, National Evidence-based Healthcare Collaborating Agency, 8F Changkyung Bldg, 28-7 Wonnam-dong, Jongno-gu, Seoul 110-450, Korea. Tel: 80-2-2174-2700, Fax: 80-2-727-4918, jshin@neca.re.kr
Received 2010 August 02; Revised 2010 September 20; Accepted 2010 September 27.

Abstract

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.

Keywords: Home visit; Cost-benefit analysis

Notes

This research was funded by Korea Institute for Health and Social Affairs in 2008.

References

1. Barnett WS. Economic evaluation of home visiting program. Future Child 1993;3(3):93–112.
2. Chun KJ. Structure and contents of visiting health service in the urban area. J Soonchunhyang Med Coll 1996;2(1):171–193.
3. Elkan R, Kendrick D. What is the effectiveness of home visiting or home-based support for older people? Copenhagen: World Health Organization Regional Office for Europe; 2004.
4. Han KH, Kim KN, Park DY. Drug complication and nutritional status of the elderly in Chung-buk area-I. Disease and drug consumption. Korean J Community Nutr 1998;3(1):76–93.
5. Jung IS. Home visiting as the heath management mechanism and practice based on community. Paper presented at the symposium of the Customized Home Visiting Heath Care in 2009, Seoul
6. Jung YM, Lee SE, Chung KS. Prevalence and associated factors of falls according to health status in elderly living in the community. J Korean Gerontol Soc 2006;26(2):291–303.
7. Kang YS, Lee SJ, Yang BM, Hur J. Cost-benefit analysis of nursing intervention program for the aged. J Korea Gerontol Soc 1988;8(1):121–144.
8. Kim HS. A drug use and related factors of the elderly persons in a Gwang Ju area. J Korean Public Health Assoc 2001;27(1):69–79.
9. Kim JH, Lee HY, Hwang RI, Jung HJ. Survey on the benefit coverage rate of National Health Insurance in 2006 Seoul: Health Insurance Research Institute; 2007.
10. Ko IS, Kim CJ, Lee TW, Lee KJ, Kim ES, Ma HY, et al. Evaluation of government assisted visiting nursing services of health center in 2000. J Korean Acad Nurs 2002;32(3):344–354.
11. Ko IS, Kim GS, Lim MH, Lee KJ, Lee TW, Park HS, et al. Effects of health education on the knowledge and self-care of hypertension for visiting nursing clients. J Korean Acad Public Health Nurs 2007;21(2):134–145.
12. Korea Institute for Health and Social Affairs. National health and nutrition examination survey in 2005 2006. Retrieved October 5, 2008. from http://knhanes.cdc.go.kr.
13. Lee JY, Kim HL, Kim YJ. Difference of self-care behavior implementation in clients with hypertension by visiting nursing service. Chungnam J Nurs Acad 2006;9(1):53–62.
14. Markle-Reid M, Browne G, Weir R, Gafni A, Roberts J, Henderson SR. The effectiveness and efficiency of home-based nursing health promotion for older people: A review of the literature. Med Care Res Rev 2006;63(5):531–569.
15. Mary J, Rodriguez-Artalejo F. Which is more important for the efficiency of hypertension treatment: Hypertension stage, type of drug or therapeutic compliance? J Hypertens 2001;19:149–155.
16. Ministry of Health and Welfare. Result report of customized home visiting health care project in 2007 Seoul: Ministry For Health and Welfare Press; 2007.
17. Ministry of Health and Welfare. Introduction of customized home visiting heath care project in 2009 Seoul: Ministry For Health and Welfare Press; 2008.
18. Ministry of Health and Welfare. 2007 Customized home visiting health care project yearbook Seoul: Ministry of Health, Welfare and Family Affairs Press; 2009.
19. Ministry of Labor. Survey report on wage structure: Wages of simple labor Seoul: Ministry of Labor; 2008.
20. National Health Insurance Corporation. 2007 National Health Insurance statistical yearbook Seoul: Health Insurance Review & Assessment Service, National Health Insurance Corporation; 2008.
21. Park JY, Ko SK. Cost-benefit analysis of the community-based home health care program. Bogeongyeongjeyeongu 2000;6(2):203–245.
22. Ryu HS. The effects on home visiting nursing service for community based disabled persons. J Korean Acad Nurs 2001;31(6):1098–1108.
23. Ryu HS, Hwang RH. A study on the status and policy issues of visiting nursing programs at public health centers in urban areas. J Korean Acad Community Health Nurs 2004;15(1):67–75.
24. Shin HS, Lee TJ, Yang BM. The economic analysis on visiting nurse program. J Ins Health Environ Sci 1993;3(1):9–17.
25. Statistics Korea. Economic activity participation rate 2009-b. Retrieved November 11, 2008. from http://www.kostat.go.kr.
26. Yang BM. Health economics Seoul: Nanam Publishing House; 2002.
27. Yang BM, Kim JH, Lee SY. The economic analysis of industrial health promotion program: A cost-benefit analysis of preventing occupational disease program in Korea Seoul: Ministry of Labor; 1992.
28. Yoon SN, Lee IS, Yoo IJ, Kim JN, Bae JH. A study for quality assurance of visiting nurses service of a public health center. J Korean Acad Community Health Nurs 1995;6(2):275–285.

Article information Continued

© 2013 Korean Academy of Community Health Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Funded by : Korea Institute for Health and Social Affairs

Figure 1

Figure 1

Framework.

Table 1

General Characteristics of Subject in Individual Home Visiting Health Care (N=1,008,837)

Table 1

†Multiple registration.

Table 2

Cost of the Individual Home Visiting Health Care in 2007

Table 2

Table 3

Benefit of the Individual Home Visiting Health Care in 2007

Table 3

SME=savings in medical expense; PC=prevention of complication; STC=savings in travel cost; SPL=savings in productivity loss; DM=diabetes mellitus; CD=cerebrovascular disease; UI=urinary incontinence.

†50% reduction of admission days or outpatient days was assumed; ‡It was assumed that the utilization rate of individual home visiting care is 25%.

Table 4

Cost-benefit Analysis and Sensitivity Analysis

Table 4

†This indicates the results of the individual home visiting health care program is provided for the patients with hypertension and diabetes mellitus.