대한간호학회지 (Journal of Korean Academy of Nursing)

한국간호과학회 (Korean Society of Nursing Science)
권호 표지
DOI QR코드

DOI QR Code

중환자 전문간호행위에 대한 건강보험 상대가치 및 환산지수 개발

Development of a Resource-based Relative Value Scale and Its Conversion Factor for Advanced Nursing Practices in the National Health Insurance

  • 투고 : 2010.08.31
  • 심사 : 2011.06.07
  • 발행 : 2011.06.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: The purpose of this study was to develop a resource-based relative value scale (RBRVS) and its conversion factor for advanced nursing practices carried out by critical care nurse practitioners (CCNP) in intensive care units. Methods: The methodology was developed by calculating CCNP's RBRVS for 32 advanced nursing services based on CCNP's workload and time spent in the context of national health insurance. A cost analysis was performed to estimate the conversion factor of CCNP's RBRVS. The share of CCNP's contribution to fee-for-service in intensive care units was also analyzed. Results: Calculation of the RBRVS of 32 advanced nursing practices showed a range of points from 100.0 to 1,181.4 and an average of 296.1 points. The relevant conversion factor for advanced nursing practices in CCNP were estimated at 37.3-48.4 won. The contribution rate of CCNP's advanced nursing practices in the relative value scale of the national health insurance was estimated at 0.1-31.3%. Conclusion: Measuring the economic value of advanced nursing services will be a basis for esta-blishing a reimbursement system for CCNP's practices and thus encourage a social demand for advanced nurse practitioners.

키워드

참고문헌

  1. American Academy of Nurse Practitioners. (2010). Nurse practitioner facts. Retrieved October 30, 2010, from http://aanp.org/NR/rdonlyres/ 54B71B02-D4DB-4A53-9FA6-23DDA0EDD6FC/0/NPFacts2010.pdf
  2. Cooper, R. A., Getzen, T. E., McKee, H. J., & Laud, P. (2002). Economic and demographic trends signal an impending physician shortage. Health Affairs, 21, 140-154. doi:10.1377/hlthaff.21.1.140
  3. Goolsby, M. J. (2005). 2004 American Academy Nurse Practitioners national nurse practitioners sample survey, Part II: Nurse practitioner prescribing. Journal of the American Academy of Nurse Practitioners, 17, 506-511. doi:10.1111/j.1745-7599.2005.00088.x.
  4. Health Insurance Review & Assessment Service. (2006, December). Study on revised relative value scale. Seoul: Author.
  5. Hsiao, W., Brauns, P., Becker, E., Causino, N., DeNicola, M., & Dunn, D., et al. (1988). A National study of resource-based relative value scales for physician services: Final Report (HFCA Contract No. I7-C-98795/I-O3). Boston, MA: Department of Health Policy and Management, Harvard School of Public Health & Department of Psychology, Harvard University.
  6. Kim, J. H., Kim, M. A., Kim, M. W., Kim, K. S., Yoo, C. S., & Lee, E. H. (2009). Analysis on performance and new classification of advanced practices by critical care nurse practitioners. Journal of Korean Academy of Nursing Administration, 15, 527-538.
  7. Korean Accreditation Board of Nursing. (2005). Core competencies of advanced practice nurse and job performance of each branches of advanced practice nurses. Seoul: Author.
  8. Korean Accreditation Board of Nursing. (2010). Business performance on advanced nurse practitioners. Retrieved August 1, 2010, from http://www.kabon.or.kr/kabon04/index02.php
  9. Korean Hospital Nurses Association. (2001). A study on state and need on advanced practice nurse in hospital policy report. Seoul: Author.
  10. Litaker, D., Mion, L., Planavsky, L., Kippes, C., Mehta, N., & Frolkis, J. (2003). Physician-nurse practitioner teams in chronic disease management: The impact on costs, clinical effectiveness, and patients' perception of care. Journal of Interprofessional Care, 17, 223-237. doi:10.1080/1356-182031000122852
  11. Mundinger, M. O., Kane, R. L., Lenz, E. R., Totten, A. M., Tsai, W. Y., Cleary, P. D., et al. (2000). Primary care outcomes in patients treated by nurse practitioners or physicians: A randomized trial. Journal of the American Medical Association, 283, 59-68. doi:10.1001/jama.283.1.59
  12. National Health Insurance Corporation. (2009, March). 2009 Health insurance fee schedule. Seoul: Author.
  13. Nuccio, S. A., Costa-Lieberthal, K. M., Gunta, K. E., Mackus, M, L., Riesch, S. K., Schmanski, K. M., et al. (1993). A Survey of 636 staff nurses: Perceptions and factors influencing the CNS role. Clinical Nurse Specialist, 7, 122-128. https://doi.org/10.1097/00002800-199305000-00006
  14. O'Brien, J. M. (2003). How nurse practitioners obtained provider status: Lessons for pharmacists. American Journal of Health-System Pharmacy, 60, 2301-2307.
  15. Oh, P. J., Shin, S. R., Kim, I. O., Lee, K. S., Kang, K. A., Go, M. S., et al. (2003). A study on the projected workforce of advanced practice nurses in Korea. The Korean Nurse, 42(5), 63-73.
  16. Paez, K. A., & Allen, J. K. (2006). Cost-effectiveness of nurse practitioner management of hypercholesterolemia following coronary revascularization. Journal of the American Academy of Nurse Practitioners, 18, 436-444. https://doi.org/10.1111/j.1745-7599.2006.00159.x
  17. Park, K. J. (2008 February). Present and challenge in system of advanced practice nurses. Workshop presented at the meeting of Korean Nurses Association and Korean Accreditation Board of Nursing on how to obtain methods of application of Advanced Practice Nurses. Seoul, Korea.
  18. Rhoads, J., Ferguson, L. A., & Langford, C. A. (2006). Measuring nurse practitioner productivity. Dermatology Nursing, 18, 32-34, 37-38.
  19. Rose, S. B., All, A. C., & Gresham, D. (2003). Role preservation of the clinical nurse specialist and the nurse practitioner. The Internet Journal of Advanced Nursing Practice, 5(2).
  20. Schull, D. E., Tosch, P. K., & Wood, M. (1992). Clinical nurse specialist, as collaborative care managers. Nurse Management, 23(3), 30-33. https://doi.org/10.1097/00006247-199203000-00011

피인용 문헌

  1. 응급전문간호행위에 대한 건강보험 상대가치 수가개발 및 경제성 평가 vol.25, pp.3, 2011, https://doi.org/10.7475/kjan.2013.25.3.275
  2. 간호 관련 비용의 실증적 사례분석 연구 vol.23, pp.2, 2011, https://doi.org/10.11111/jkana.2017.23.2.139