당뇨병성 족부질환자에 대한 가정간호서비스의 비용-효과분석 = Cost-effectiveness Analysis of Home Care Services for Patients with Diabetic Foot

다국어 초록 (Multilingual Abstract)

Purpose: This study was a retrospective survey to examine economic feasibility of home care services for patients with diabetic foot. Methods: The participants were 33 patients in the home care services (HC) group and 27 in the non-home care services (non-HC) group, all of whom were discharged early after inpatient treatment. Data were collected from medical records. Direct medical costs were calculated using medical fee payment data. Cost-effectiveness ratio was calculated using direct medical costs paid by the patient and the insurer until complete cure of the diabetic foot. Effectiveness was the time required for a complete cure. Direct medical costs included fees for hospitalization, emergency care, home care, ambulatory fees, and hospitalization or ambulatory fees at other medical institutions. Results: Mean for direct medical costs was 11,118,773 won per person in the HC group, and 16,005,883 won in the non-HC group. The difference between the groups was statistically significant (p=.042). Analysis of the results for cost-effectiveness ratio showed 91,891 won per day in the HC patients, and 109,629 won per day in the non-HC patients. Conclusion: Result shows that the cost-effectiveness ratio is lower HC patients than non-HC patients, that indicates home care services are economically feasible.

참고문헌 (Reference)

1 성영희, "정주형 항생제치료에 대한 병원중심 가정간호서비스 효과분석" 병원간호사회 10 (10): 129-144, 2005

2 정춘희, "우리나라 당뇨병성 족부질환의 현황: 건강보험자료 분석결과" 대한당뇨병학회 30 (30): 372-376, 2006

3 송종례, "당뇨병성 족부궤양 환자의 치료형태 및 가정간호 연계" 한국가정간호학회 18 (18): 32-39, 2011

4 Apelqvist, J., "What is the most effective way to reduce incidence of amputation in the diabetic foot?" 16 : s75-s83, 2000

5 Lee, T. W., "The costs of long-term care alternatives for the elderly" 4 : 351-361, 1998

6 Ku, B. J., "The clinical observation in diabetic patients with foot ulcer" 3 : 244-252, 2002

7 Drummond, M. F., "Methods for the economic evaluation of health care programmes" Oxford university press 2005

8 Lee, T. W., "Methodological issues in nursing research on cost-effectiveness analysis" 31 : 1202-1209, 2001

9 Tennvall, G. R, "Health-economic consequences of diabetic foot lesions" 39 : s132-s139, 2004

10 Yang, B. M., "Health economics" Nanam Press 2009

11 Ministry of Health and Welfare., "Guide on the medical institute base home health agency management" Yimungieob 2010

12 Kang, S. W., "Effects of home health care on social cost containment : Evidence from the patients undergone by knee arthroplasty in Korea" 11 : 85-99, 2005

13 Kim, E. Y., "Economic evaluation of longterm care service" 18 : 1-17, 2002

14 Health Insurance Review & Assessment Service, "Diseases of frequent home care visiting by year in national health insurance claim database" Home Care Nurses Association 2010

15 Kim, D. I., "Diabetic foot: Diagnosis & treatment" Euihakmunhwa 2006

16 Frykberg, R. G., "Diabetic foot disorders: A clinical practice guideline (2006 revision)" 45 : s1-s66, 2006

17 Holzer, S. E., "Costs and duration of care for lower extremity ulcers in patients with diabetes" 20 : 169-181, 1998

18 Carter, M. J., "Cost-effectiveness research in wound care : Definitions, approaches, and limitations" 56 : 48-59, 2010

19 Paul, I. M., "Cost-effectiveness of postnatal home nursing visits for prevention of hospital care for jaundice and dehydra tion" 114 : 1015-1022, 2004

20 Lim, J. Y., "Cost-effectiveness analysis of home care service for cerebrovascular disease patients" Korea University 2001

21 Hwang, N. M., "Cost-benefit analysis of the hospital-based home health care program for terminal cancer patients" Seoul National University 2000

22 Park, J. Y., "Cost-benefit analysis of the community-based home health care program" 6 : 203-245, 2000

23 Stockl, K., "Cost of lower-extremity ulcers among patients with diabetes" 27 : 2129-2134, 2004

24 Lavery, L. A., "Classification of diabetic foot wounds" 35 : 528-531, 1996

25 Basic statistics diabetes Task Force Team, "Basic statistics on diabetes Task Force Team report: Diabetes in Korea 2007" Korean Diabetes Association & Health Insurance Review & Assessment Service 2007

26 Harris, C., "An innovative enterostomal therapy nurse model of community wound care delivery" 35 : 169-183, 2008

27 Nathwani, D., "Advisory group on home based and outpatient care (AdHOC): An international consensus statement on non-inpatient parental therapy" 6 : 464-476, 2000

28 Bryant, R. A., "Acute & chronic wounds current management concepts" Mosby Elsevier 2007

29 Choi, G. C., "A survey of medical costs for health insurance patients in 2008" National Health Insurance Corporation 2009

30 Kim, J. H., "A cost-effectiveness analysis of long-term home oxygen therapy for patients with chronic obstruction pulmonary diseases (COPD) and policy implication in Korea" 11 : 1-38, 2005