대한간호학회지 (Journal of Korean Academy of Nursing)

한국간호과학회 (Korean Society of Nursing Science)
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Nurse Staffing and Health Outcomes of Psychiatric Inpatients: A Secondary Analysis of National Health Insurance Claims Data

  • Park, Suin (College of Nursing, Kosin University) ;
  • Park, Sohee (Department of Biostatistics, Graduate School of Public Health, Yonsei University) ;
  • Lee, Young Joo (College of Nursing, Daegu Catholic University) ;
  • Park, Choon-Seon (Department of Quality Assessment Administration, Health Insurance Review and Assessment Service) ;
  • Jung, Young-Chul (Department of Psychiatry, College of Medicine, Yonsei University) ;
  • Kim, Sunah (College of Nursing, Yonsei University)
  • 투고 : 2019.10.01
  • 심사 : 2020.03.31
  • 발행 : 2020.06.30
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초록

Purpose: The present study investigated the association between nurse staffing and health outcomes among psychiatric inpatients in Korea by assessing National Health Insurance claims data. Methods: The dataset included 70,136 patients aged 19 years who were inpatients in psychiatric wards for at least two days in 2016 and treated for mental and behavioral disorders due to use of alcohol; schizophrenia, schizotypal and delusional disorders; and mood disorders across 453 hospitals. Nurse staffing levels were measured in three ways: registered nurse-to-inpatient ratio, registered nurse-to-adjusted inpatient ratio, and nursing staff-to-adjusted inpatient ratio. Patient outcomes included length of stay, readmission within 30 days, psychiatric emergency treatment, use of injected psycholeptics for chemical restraint, and hypnotics use. Relationships between nurse staffing levels and patient outcomes were analyzed considering both patient and system characteristics using multilevel modeling. Results: Multilevel analyses revealed that more inpatients per registered nurse, adjusted inpatients per registered nurse, and adjusted inpatients per nursing staff were associated with longer lengths of stay as well as a higher risk of readmission. More adjusted inpatients per registered nurse and adjusted inpatients per nursing staff were also associated with increased hypnotics use but a lower risk of psychiatric emergency treatment. Nurse staffing levels were not significantly associated with the use of injected psycholeptics for chemical restraint. Conclusion: Lower nurse staffing levels are associated with negative health outcomes of psychiatric inpatients. Policies for improving nurse staffing toward an optimal level should be enacted to facilitate better outcomes for psychiatric inpatients in Korea.

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참고문헌

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피인용 문헌

  1. Physical Comorbidity According to Diagnoses and Sex among Psychiatric Inpatients in South Korea vol.18, pp.8, 2020, https://doi.org/10.3390/ijerph18084187
  2. Time to readmission in psychiatric inpatients with a therapeutic leave vol.144, 2020, https://doi.org/10.1016/j.jpsychires.2021.09.050