Browse > Article
http://dx.doi.org/10.5762/KAIS.2017.18.6.119

Optimal Nursing Workforce and Financial Cost to Provide Comprehensive Nursing Service in the National Health Insurance System  

Kim, Jinhyun (College of Nursing, Seoul National University)
Kim, Sung-jae (Department of Nursing, Kyungbok University)
Lee, Eunhee (College of Nursing, Hallym University)
Publication Information
Journal of the Korea Academia-Industrial cooperation Society / v.18, no.6, 2017 , pp. 119-128 More about this Journal
Abstract
This study estimated the optimal nursing workforce and financial costs of providing comprehensive nursing services at hospitals under the national health insurance system. Data on registered nurses, nursing aids, medical institutions, and number of patients were obtained from the Health Insurance Review and Assessment Service. The optimal size of the nursing workforce was calculated using the workload model. A bottom-up approach was used to estimate the annual total financial cost of comprehensive nursing services. The number of registered nurses and nursing aids would need to be increased by 81.75% and 83.23%, respectively, in order to fully apply comprehensive nursing care on a national scale. The additional financial costs for comprehensive nursing services at all hospitals was estimated to be as much as 110.39% of the current cost. For the comprehensive nursing service, nurses with a career and newcomers need to be retained at their hospitals, and the validity of the nurse-patient ratio should be continuously checked. The financial shock to the national health insurance system could be minimized by gradually extending the system to all hospitals.
Keywords
comprehensive nursing care; nursing fee; nurse staffing level; nurse-patient ratio; health insurance;
Citations & Related Records
Times Cited By KSCI : 1  (Citation Analysis)
연도 인용수 순위
1 B. J. Kalisch, G. L. Landstrom, A. S. Hinshaw, "Missed nursing care: a concept analysis", Journal of advanced nursing, vol. 65, no. 7, pp. 1509-17, 2009. DOI: https://doi.org/10.1111/j.1365-2648.2009.05027.x   DOI
2 Bookman, A., & Harrington, M. "Family caregivers: a shadow workforce in the geriatric health care system?", Journal of Health Politics, Policy and Law, vol. 32, no. 6, pp. 1005-1041, 2007. DOI: https://doi.org/10.1215/03616878-2007-040   DOI
3 M. Bastawrous, "Caregiver burden-a critical discussion", International journal of nursing studies, vol. 50, no. 3, pp. 431-41, 2013. DOI: https://doi.org/10.1016/j.ijnurstu.2012.10.005   DOI
4 Y. K. Lee, "The political subject of comprehensive nursing services introduction", KIHM Issue Paper. Korean Institute of Hospital Management. 23, pp. 1-24, 2015.
5 Korea Centers for Disease Control and Prevention. Middle East Respiratory Syndrome Coronavirus Outbreak in the Republic of Korea, 2015, Osong Public Health and Research Perspectives, vol. 6, no. 4, pp. 269-78, 2015. DOI: https://doi.org/10.1016/j.phrp.2015.08.006   DOI
6 Y. Koh, "Guidance for reorganising the nursing workforce structure to prevent nosocomial infection", issued in 2015, pp. 1-13, 2015.
7 H. S. Ahn, H. J. Kim, "Tasks of comprehensive nursing services introduction", Journal of Hospital Management & Policy. Korean Institute of Hospital Management, vol. 4, no. 1, pp. 6-16, 2014.
8 Y. Koh, "The progress report of comprehensive nursing service", National Health Insurance Service. 2017.
9 W. H. Kwag, "Details and problems of a pilot comprehensive nursing care project", Healthcare Policy Forum. Research Institute of Healthcare Policy, Korean Medical Association, vol. 13, no. 2, pp. 50-55, 2015.
10 A. M. Tomey, Nursing management and leadership. Eighth Edition, Elsevier, Missouri, pp. 413-415, 2009.
11 H. J. Yoo, T. G. Lee, "A Study on the Condition of the Work of Nurse Assistants at Hospitals and Clinics", Journal of the Korean Academy of Health and Welfare for Elderly, vol. 8, no. 1, pp. 117-135, 2016.
12 National Assembly Law Information. Chapter 4 Clause 50 of the Korean Labor Standard Act. Retrieved March 15, 2017, from http://likms.assembly.go.kr/law/lawsLawtInqyDetl1010.do
13 H. Y. Shin, J. U. Won, Y. J. Chun, S. J. Lee, Modelling for Long-term Financial Projections of Social Security, pp. 13-31, pp. 54-60, p. 135, Korea Institute for Health and Social Affairs, 2013.
14 I. Y. Choi, "Actual condition and Problems of Female Non-regular Workers in the Healthcare Industry : with focus on S Hospital", Korean Sociological Association, pp. 59-80, 2007.
15 S. Y. Jeong, J. H. Kim, "A Critical Review of Nurse Demand Forecasting Methods in Empirical Studies 1991-2014", Perspectives in Nursing Science, vol. 13, no. 2, pp. 81-87, 2016. DOI: https://doi.org/10.16952/pns.2016.13.2.81   DOI
16 Organization for Economic Co-operation Development :Health at a glance 2013. OECD Publishing Paris, 2013.
17 S. J. You, "Policy implications of nurse staffing legistlation", Journal of Digital Contents Society, vol. 13, no. 6, pp. 380-389, 2013.
18 Hospital Nurses Association, "The hospital nurse's actual working conditions research", Annual report of hospital nurses association in 2013, 2013.
19 M. Kingma, "Nurses on the move: a global overview", Health services research, 42(3 pt 2), pp. 1281-98, 2007. DOI: http://doi.org/10.1111/j.1475-6773.2007.00711.x   DOI
20 M. Jo, M. Artz, J. Haebler, P. McMenamin, C. Peterson, "Optimal Nurse Staffing to Improve Quality of Care and Patient Outcomes", American Nurses Association, 2015.
21 Health Insurance Review & Assessment Service "Medical expenses statistical index", Retrieved March 1, 2017, from http://khiss.go.kr/board/bbs_read.jsp?tname=MINBOARD358&bbsid=B301&bbs_seq=466&htxt_code=12536978062659050219061516896964&reverseNum=214&forwardNum=1
22 S, Kim, J, Kim, "Financial projection of the nursing fee differentiation policy improvement proposal in the national health insurance: using a break-even analysis model for the optimal nursing fee", Journal of Korean Academy of Nursing Administration, vol. 19, no. 5, pp. 565-77, 2013. DOI: https://doi.org/10.11111/jkana.2013.19.5.565   DOI
23 L. H Aiken, W. Sermeus, K. Van den Heede, D. M. Sloane, R. Busse, M. McKee, L. Bruyneel, A. M. Rafferty, P. Griffiths, M. T. Moreno-Casbas, C. Tishelman, A. Scott, T. Brzostek, J. Kinnunen, R. Schwendimann, M. Heinen, D. Zikos, I. S. Sjetne, H. L. Smith, A. Kutney-Lee, "Patient safety, satisfaction, and quality of hospital care: cross-sectional surveys of nurses and patients in 12 countries in Europe and the United States", BMJ. 344, e1717. 2012. DOI: https://doi.org/10.1136/bmj.e1717   DOI
24 S. K. Park, "A Study on Reorganization of Nursing Workforce", pp. 105-112, Korea Health Industry Development Institute, 2013.
25 K. O. Park, Y. M. Kim, J. K. Kim, "Experience of Nurses Participating in Comprehensive Nursing Care" The Journal of Korean Nursing Administration Academic Society, vol. 23, no. 1, pp. 76-89, 2017. DOI: https://doi.org/10.11111/jkana.2017.23.1.76
26 N. M. Hwang, "Expansion plans of comprehensive nursing care for a quality assurance of hospitalization service", Issue & Focus. 286, pp. 1-8, 2015.
27 J. Hui, Y. Wenqin, G. Yan, "Family-paid caregivers in hospital health care in China". Journal of nursing management, vol. 21, no. 8, pp. 1026-33, 2013. DOI: https://doi.org/10.1111/jonm.12017   DOI
28 J. Buchan, L. Aiken, "Solving nursing shortages: a common priority", Journal of clinical nursing, vol. 17, no. 24, pp. 3262-8, 2008. DOI: https://doi.org/10.1111/j.1365-2702.2008.02636.x.   DOI
29 J. Buchan, "Evidence of nursing shortages or a shortage of evidence?", Journal of Advanced Nursing, vol. 56, no. 5, pp. 457-458, 2006. DOI: https://doi.org/10.1111/j.1365-2648.2006.04072_2.x   DOI
30 S. Jang, N. Avendano, M. Kawach,, "Informal caregiving patterns in Korea and European countries: A cross-national comparison", Asian Nursing Research, vol. 6, no. 1, pp. 19-26, 2012. DOI: https://doi.org/10.1016/j.anr.2012.02.002   DOI
31 S. H. Cho, H. R. Kim, "Family and paid caregivers of hospitalized patients in Korea", Journal of Clinical Nursing, vol. 15, no. 8, pp. 946-953, 2006. DOI: https://doi.org/10.1111/j.1365-2702.2006.01342.x   DOI