Estimation of Nursing Costs Based on Nurse Visit Time for Long-Term Care Services

PURPOSE: The purpose of this study was to estimate nursing costs and to establish appropriate nursing fees for long-term care services for community elders. METHODS: Seven nurses participated in data collection related to visiting time by nurses for 1,100 elders. Data on material costs and management costs were collected from 5 visiting nursing agencies. The nursing costs were classified into 3 groups based on the nurse's visit time under the current reimbursement system of long-term care insurance. RESULTS: The average nursing cost per minute was 246 won. The material costs were 3,214 won, management costs, 10,707 won, transportation costs, 7,605 won, and capital costs, 5,635 won per visit. As a result, the average cost of nursing services per visit by classification of nursing time were 41,036 won (care time <30 min), 46,005 won (care time 30-59 min), and 57,321 won (care time over 60 min). CONCLUSION: The results of the study indicate that the fees for nurse visits currently being charged for long-term care insurance should be increased. Also these results will contribute to baseline data for establishing appropriate nursing fees for long-term care services to maintain quality nursing and management in visiting nursing agencies.

Economic Evaluation of Visitng Nurse Services for the Low-income Elderly with Long-term Care Needs / 간호학회지

PURPOSE: This study aimed to evaluate economic viability of public health center visiting nurse services for the low-income elderly with long-term care needs. METHOD: The sample consisted of 252 community dwelling elderly who enrolled in public health center visiting nurse services for three months or more. Data was collected on physical (ADL and IADL) and cognitive impairments of the elderly, contents and frequency of visiting nurse services, cost per visit, and costs of alternative services for long-term care. RESULT: The mean score of ADL and IADL levels of the elderly was 2.80.4904, which indicated these patients were mostly independent. Eighty four percent of the elderly subjects were cognitively intact. Among visiting nurse services supplied, providing assessment was 34%, followed by education and counseling 26%, medication 22%, and referral. The mean cost per visit was 17,824.1 won, which transformed into a total cost per person per year of 161,130.2 won. Comparing the cost of a visiting nurse service with those of other long-term care alternatives, the visiting nurse service was the least costly alternative, followed by an outpatient clinic, hospital based home care, and nursing home. CONCLUSION: Overall, the results of the study provide evidence of the economic viability of visiting nurse services for the low-income elderly among long-term care alternatives.

On the Feasibility of a RUG-III based Payment System for Long-Term Care Facilities in Korea / 간호학회지

PURPOSE: The purpose of this study was to classify the elderly in long-term care facilities using the Resource Utilization Group(RUG-III) and to examine the feasibility of a payment method based on the RUG-III classification system in Korea. METHOD: This study measured resident characteristics using a Resident Assessment Instrument-Minimum Data Set(RAI-MDS) and staff time. Data was collected from 530 elderly residents over sixty, residing in long-term care facilities. Resource use for individual patients was measured by a wage-weighted sum of staff time and the total time spent with the patient by nurses, aides, and physiotherapists. RESULT: The subjects were classified into 4 groups out of 7 major groups. The group of Clinically Complex was the largest (46.3%), and then Reduced Physical Function(27.2%), Behavior Problems (17.0%), and Impaired Cognition (9.4%) followed. Homogeneity of the RUG-III groups was examined by total coefficient of variation of resource use. The results showed homogeneity of resource use within RUG-III groups. Also, the difference in resource use among RUG major groups was statistically significant (p<0.001), and it also showed a hierarchy pattern as resource use increases in the same RUG group with an increase of severity levels(ADL). CONCLUSION: The results of this study showed that the RUG-III classification system differentiates resources provided to elderly in long-term care facilities in Korea.