保健看護事業의 費用-便益分析

• 영문명: Cost-Benefit Analysis of Nursing Intervention Program for the Aged
• 발행기관: 한국노년학회
• 저자명: 姜榮洙 李善子 梁奉玟 許程
• 간행물 정보: 『한국노년학』제8권, 120~144쪽, 전체 25쪽
• 주제분류: 사회과학 > 사회복지학
• 파일형태: PDF
• 발행일자: 1988.03.30

영문 초록

As average length of a man's life increases, the proportion of the elderly people in the whole population is growing continuously. This trend let the public's concern concentrate on the problem of the aged, especially in the field of health of old age. Nowadays, chronic illnesses such as diabetes and hypertension take a major part of the diseases of old age and burdened the government with growing health care expenditure as a result. For the purpose of studying and measuring the economic efficiency of health services programs against these diseases, a nursing intervention program for the aged was performed in downtown areas of city Seoul under WHO financial assistance. The project was carried out to measure and evaluate the impact of nursing intervention program for the aged on elderly's health status. For comparison, the target population, who were 60 and over, was divied into two groups, 127 members in experimental group and 124 members in control group. General characteristics of the target population were as follows: (1) There were 103 males and 148 females. (2) Mean age of the target population was 73 and the mean educational level was less than primary school education. (3) Of those 127 constituents of the experimenta group, 45 turned out to have hypertension and 26 to have diabetes. Out of 124 in the control group, 36 turned out to have hypertension, 29 to have diabetes. The rest were in good health. For those in the experimental group, health education on diabetes and hypertension were performed and required nursing services were provided by two registered nurses once a week. Such an intervention lasted for 9 months, from Nov.1, 1986 to July 31, 1987. We tried to observe if the level of KAP (Knowledge, Attitude, Practice) about these diseases were changed with the intervention. Upon completion of the program, survey team members tested urine sugar and blood pressure of the constituents of both experimental and control groups. This enable us to compare the degrees of variations in urine sugar and blood pressure measurement between the two groups. Cost-benefit analyisis was used in this study to test whether the project was economically adequate or not. Four steps of the cost-benefit analysis were taken : First, divide the constituents of each group into three subgroups ; diabetics, hypertensives and people in normal condition. The division was based on the results of pre-screening test. Second, calculate total cost of the nursing intervention program. Third, measure total benefits of the program in terms of blood pressure and urine sugar and quantify them in monetary terms. In case of people in normal condition, the differences in occurrence rate of diabetes mellitus and hypertension between the two groups were quantified in monetary terms. Fourth, compare total benefit with total cost and calculate benefit-cost ratio as criteria for judging economic efficiency of the program. Findings of the cost-benefit analysis using very conservative assumptions and their policy implications were summarized as follows : (1) The monetary amount of net benefit (: Total benefit-Total cost) was equal to 7,909,696 won, and the benefit-cost ratio reached as much as 4.7: 1. This empirical result backs the economic acceptibility of this program. Therefore, we safely conclude that the implementation of the program produces net welfare gains in society, its benefit exceeds its cost sufficiently. (2) Total amount of benefits obtained in the case of diabetes were 1.8 times greater than those of hypertensions. This suggests that the program for caring diabetics and preventing diabetes was very useful on economic ground. (3) Adherence rate of the experimental group was about 40 percents. We were not successful in finding the correlation between benefit and adherence rate due to limited patient cases. However, since there is high return from the intervention program, if we could raise the adherence rate by any means, the b

목차

Ⅰ. 序輪

Ⅱ. 分析方法-費用ㆍ便益分析

Ⅲ. 結果의 分析

Ⅳ. 要約 및 結論

Ⅴ. 參考文獻

ABSTRACT