광주.전남지역 요양병원 간호사의 포괄수가제에 대한 인식 및 적용 후 간호업무 변화

Nurses' Cognition of Diagnosis Related Group (DRG) in Long-term Care Hospitals and Changes in Nursing Care after Application of DRG

  • 하은 (화순마루요양병원) ;
  • 김계하 (조선대학교 간호학과)
  • 투고 : 2012.04.06
  • 심사 : 2012.05.06
  • 발행 : 2012.06.30

초록

Purpose: The purpose of this study was to examine nurses' cognition of the diagnosis related group (DRG) in long-term care hospitals and changes in nursing care after application of the DRG system. Method: This study was a descriptive survey involving 161 nurses working in 12 long-term care hospitals located in Gwangju city and Chonnam area. Data were analyzed using the SPSS 18.0 version program. Data analyses utilized descriptive test, chi-square test, Fisher's exact probability test, t-test, and one-way ANOVA. Result: There was no change in cognition of DRG in 55.3% of the nurses, and 26.1% takes to 'change positively'. More than half of the respondents (57.8%) agreed to the application of DRG. After application of DRG, the nurses responded 'there were changes in nursing care' in 23 of the 25 care items. Two items had an increase in nursing care. Conclusions: No distinct changes in nursing care were evident after DRG application. Therefore, there is need to provide education programs related to DRG for nurse in long-term care hospitals.

키워드

참고문헌

  1. Cleverley, W. O., & Cleverley, J. O. (2011). Is there a cost associated with higher quality? Healthcare Financial Management, 65(1), 96-102.
  2. Department of Health Policy and Management (2000, June). A survey on opinions on the DRG reimbursement system (11-1460000-000171-14). Seoul: Ministry of Health & Welfare.
  3. Hamada, H., Sekimoto, M., & Imanaka, Y. (2012). Effects of the per diem prospective payment system with DRG-like grouping system (DPC/PDPS) on resource usage and healthcare quality in Japan. Health Policy, in Press.
  4. Health Insurance Review & Assessment Service (2011a). Data related to job of DRG (BK6-2011). Seoul: Health Insurance Review & Assessment Service.
  5. Health Insurance Review & Assessment Service (2011b, September 29). 3rd year follow-up evaluation of long-term care hospitals. Retrieved March 23, 2012, from http://www.hira.or.kr/ dummy.do?pgmid=HIRAA020002000000&cmsurl=/cms/ notice/01/1208082_13357.html
  6. Heer, I. M., Kahlert, S., Rummel, S., Kümper, C., Jonat, W., & Strauss, A. (2009). Hospital treatment-Is it affordable? A structured cost analysis of vaginal deliveries and planned caesarean sections. European Journal of Medical Research, 14(11), 502-506.
  7. Kang, S. Y. (2010). A study on the professional self-concept of nurses working in the geriatric hospitals. Unpublished master's thesis, Soonchunhyang University, Asan.
  8. Kim, E. S. (2009). A study on the attitude of long-term care hospital nurses to elderly people and job satisfaction. Unpublished master's thesis, Daegu Haany University, Daegu.
  9. Kim, J. H. (2011, December 15). Long-term care hospital optimal payment is different from system according to ADL. Retrieved March 23, 2012, from http://doc3.koreahealthlog.com/news/ newsview.php?newscd=2011121400025
  10. Kim, M. S. (2006). Customers' dissatisfaction on hospital service-Focused on a tertiary medical center-. Unpublished master's thesis, Yonsei University, Seoul.
  11. Kim, Y. B. (2011). A study on evaluation and improvement of long-term care hospitals for changing long-term care hospital fee system. The Korean Journal of Health Service Management, 5(2), 105-117.
  12. Korea Association of Geriatric Hospital (2010). The job guidebook of long-term care hospitals. Seoul: Innosolution.
  13. Lee, S. J. (2000). DRG-based prospective payment system on the view of clinician. Journal of the Korean Medical Association, 43(6), 506-510.
  14. Lotter, O., Jaminet, P., Amr, A., Chiarello, P., Schaller, H. E., & Rahmanian-Schwarz, A. (2011). Reimbursement of burns by DRG in four European countries: an analysis. Journal of the International Society for Burn Injuries, 37(7), 1109-1116.
  15. Ministry of Health & Welfare (2007, October 22). Medical insurance fee of long-term care hospitals. Retrieved June 23, 2012, from http://www.kha.or.kr:8080/pgbuilder/cgi/board/main.asp?code=dept21&mode=v&num=1182&page=93&s=&sw=&c=
  16. Ponqpirul, K., Walker, D. G., Winch, P. J., & Robinson, C. (2011). A qualitative study of DRG coding practice in hospitals under the Thai universal coverage scheme. BMC Health Services Research, 11, 71.
  17. Prison, M., Schenker, L., Martins, D., Dunq, D., Chale, J. J., & Leclercq, P. (2012). What can we learn from international comparisons of costs by DRG? The European Journal of Health Economics, in Press.
  18. Rosenstein, A. H., O'Daniel, M., White, S., & Taylor, K. (2009). Medicare's value-based payment initiatives: Impact on and implications for improving physician documentation and coding. American Journal of Medical Quality, 24(3), 250-258.
  19. Ryu, J. H. (2012, March 23). Korean Medical Association, the opposite opinions in notice of legislation about obligation of 7 DRG. Retrieved March 23, 2012, from http://doc3.koreahealthlog.com/news/newsview.php?newscd=2012032300010
  20. Seo, H. G. (2000). An investigation and a study on the degree of understanding of the nurses in some general hospitals on the payment system of medical examination and treatment fee. Unpublished master's thesis, Kyunghee University, Seoul.
  21. Shon, C., Chunq, S., Yi, S., & Kwon, S. (2011) Impact of DRG payment on the length of stay and the number of outpatient visits after discharge for caesarean section during 2004-2007. Journal of Preventive Medicine & Public Health, 44(1), 48-55.
  22. Sim, M. R., & Kim, K. H. (2011). Job satisfaction, self-esteem, and nursing task performance among registered nurses and nurse assistants in long-term care hospitals. Journal of Korean Academy of Nursing Administration, 16(4), 446-454.
  23. Song, J. K., & Kim, C. Y. (2010). Participation determinants in the DRG payment system of obstetrics and gynecology clinics in South Korea. Journal of Preventive Medicine & Public Health, 43(2), 117-124.
  24. Trocchi, P., Kluttiq, A., Dralle, H., Sekulla, C., Biermann, M., & Stanq, A. (2012). Thyroid cancer surgery in Germany: An analysis of the nationwide DRG statistics 2005-2006. Lanqenbeck's Archives of Surgery, 397(3), 421-428.
  25. Tschannen, D., & Kalisch, B. J. (2009). The impact of nurse/physician collaboration on patient length of stay. Journal of Nursing Management, 17(7), 796-803.
  26. Woo, J. H. (2008). Recognition on outcomes and change in nursing service after application of diagnosis related group system in long term care hospitals. Unpublished master's thesis, Inha University, Incheon.