• 한국노년학
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• v.31 no.2
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• pp.371-380
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• 2011

This study was to address changes on hospital-based home care utilization after long-term care insurance(LTCI) was launched. National electronic data information(EDI) on hospital-based home care from Health Insurance Review Agency in 2007.7~2008.6(prior to LTCI) and in 2009(posterior to LTCI) was analyzed. After the launch of long-term care insurance, 40 hospital-based home health care agencies(HHCA) were diminished and regions not having any HHCA were increased from 53% to 59%. Hospital-based home care utilization was decreased in the elderly(clients 13.4%, visits 20.9%) as well as non-elderly(clients 3.5%, visits 3.9%). It is presumed that diminished HHCAs result in decreased accessibility to hospital-based home health care for non-elderly. The clients, visits, and reimbursed cost per agency were not changed. It is presumed that small agencies were closed already. The total reimbursed cost per agency in 2009 was 121,850,000 won. Results suggest that the government has to give support to open more HHCA to increase the accessibility for non-elderly. Also, hospital-based home care services utilization has to be monitoring regularly.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.10 no.3
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• pp.354-360
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• 2003

Purpose: This study was done for the purpose of identifying the relationship between work stress and job satisfaction of nurses who were evaluating medical insurance. Method: The participants in the study were 154 nurses who were in charge of evaluating medical insurance in 32 hospitals in Korea. Data were collected for 1 month from April 20 to May 20, 2001. Result: The mean total work stress score was 93.79. In comparison with work stress scores according to the work stress factors, 'work overload'(2.95) had the highest work stress score. The mean total job satisfaction score was 69.56. The total work stress scores did not show significant differences for any of the variables. The total job satisfaction score showed significant differences for the variables of age (F=3.51, p=.01), position (F=3.16, p=.02) and reason for transfer from one department to another (F=3.40, p=.003). Conclusion: The total work stress score showed a inverse correlation(v=-.36, p=.001) with the total job satisfaction score.

• Health Policy and Management
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• v.34 no.1
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• pp.78-86
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• 2024

Background: The purpose of this study was to determine the effectiveness of the specialty hospital system by comparing the medical use of inpatients who had artificial joint replacement surgery in specialty hospitals and non-specialty hospitals. Methods: This study utilized 2021-2022 healthcare benefit claims data provided by the Health Insurance Review and Assessment Service. The dependent variable is inpatient medical use which is measured in terms of charges per case and length of stay. The independent variable was whether the hospital was designated as a specialty hospital, and the control variables were patient-level variables (age, gender, insurer type, surgery type, and Charlson comorbidity index) and medical institution-level variables (establishment type, classification, location, number of orthopedic surgeons, and number of nurses). Results: The results of the multiple regression analysis between charges per case and whether a hospital is designated as a specialty hospital showed a statistically significant negative relationship between charges per case and whether a hospital is designated as a specialty hospital. This suggests a significant low in charges per case when a hospital is designated as a specialty hospital compared to a non-specialty hospital, indicating that there is a difference in medical use outcomes between specialty hospitals and non-specialty hospitals inpatients. Conclusion: The practical implications of this study are as follows. First, the criteria for designating specialty hospitals should be alleviated. In our study, the results show that specialty hospitals have significantly lower per-case costs than non-specialty hospitals. Despite the cost-effectiveness of specialty hospitals, the high barriers to be designated for specialty hospitals have gathered the specialty hospitals in metropolitan and major cities. To address the regional imbalance of specialty hospitals, it is believed that ease the criteria for designating specialty hospitals in non-metropolitan areas, such as introducing "semi-specialty hospitals (tentative name)," will lead to a reduction in health disparities between regions and reduce medical costs. Second, it is necessary to determine the appropriateness of the size of hospitals' medical staff. The study found that the number of orthopedic surgeons and nurses varied in charges per case. Therefore, it is believed that appropriately allocating hospital medical staff can maximize the cost-effectiveness of medical services and ultimately reduce medical costs.

• Journal of Internet of Things and Convergence
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• v.8 no.6
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• pp.99-113
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• 2022

This study is descriptive research to investigate the effects of COVID-19 stress, interpersonal (caregiver-patient) stress, and emotional labor on burnout in emergency room (ER) nurses during the COVID-19 pandemic. The data collection of this study was conducted from December 9 to 23, 2021 with ER nurses working at five tertiary general hospitals and general hospitals of Medical Center H. The data was collected with a questionnaire using tools measuring the subjects' general & job-related characteristics, COVID-19 stress, interpersonal(caregiver-patient) stress, emotional labor and burnout. The collected data was analyzed using the SPSS/WIN 25.0 statistical program for frequency analysis, descriptive statistical analysis, independent sample t-test, one-way ANOVA, Scheffé test, correlation analysis, and multiple regression analysis. The average score of COVID-19 stress in ER nurses was 3.64, interpersonal(caregiver-patient) stress 4.35, emotional labor 3.38, and burnout 3.44. As a result of analyzing differences according to general & job-related characteristics, burnout showed a significant difference according to gender, marital status, total clinical experience, and working organization. And burnout showed a significant positive correlation with COVID-19 stress, interpersonal stress and emotional labor. As a result of multiple linear regression analysis, regional emergency medical centers and local emergency medical centers among the work organization types, interpersonal stress, COVID-19 stress, and gender and the explanatory power was 28.6%. Through these results, we intend to provide basic data for the development of an intervention program to prevent burnout of emergency room nurses and improve nursing performance at the time of a new infectious disease pandemic.

• Journal of Hospice and Palliative Care
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• v.20 no.1
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• pp.37-45
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• 2017

Purpose: The purpose of this study was to identify the relationships between death anxiety and terminal care performance of nurses at long term care hospitals. Methods: Data were collected from 148 nurses working at 12 long term care hospitals in Busan from March 16, 2016 through May 16, 2016. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, $Scheff{\acute{e}}$ test and Pearson's correlation coefficient with SPSS 18.0 for Windows. Results: Terminal care performance was positively correlated with anxiety about other people's death (r=0.310, $P{\leq}0.001$) and that of their own death (r=0.250, P=0.002). Conclusion: It appears necessary to develop a systematical educational program for terminal care nurses of to reduce their death anxiety and improve their terminal care performance.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.8
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• pp.162-170
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• 2017

This study analyzed the current situation of medium and small-sized hospital nursing staff and related policies, and identified the factors that affect staffing level to provide evidence for planning and adopting policy. By analyzing the statistical data published by public institutions such as the Ministry of Health and Welfare and Health Insurance Review and Assessment Service, the result was viewed based on the understanding of various internal and external health care environments. The number of active nurses was less than 50% of the number of licensed nurses and has decreased every year. This means that the cost-effectiveness of increases in nursing college enrollment should be reconsidered. Inpatient nursing fees by staffing grades has caused nurses to move from medium and small-sized hospitals, where there is a severe lack of staff, to more advanced general hospitals. As a result, the lack of nursing staff in medium and small-sized hospitals has worsened. In conclusion, reexamination is needed to improve effectiveness of inpatient nursing fees by staffing grades as a policy to secure the workforce of medium and small-sized hospitals. Furthermore, the tracking management system of licensed nurses must be able to solve the imbalance between demand and supply of nursing staff.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.6
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• pp.119-128
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• 2017

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.

• Journal of Korean Academy of Nursing
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• v.50 no.6
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• pp.837-847
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• 2020

Purpose: The purpose of this study was to investigate the effects of hospital characteristics on employment rate, working period, and retirement of ward nurses in Korea through a retrospective cohort study based on HIRAS data. Methods: Data were obtained from a report on medical care institutions of Health Insurance Review & Assessment Service (HIRAS). Data from 259,941 nurses who were working for a day or more from January 1, 2012, to December 31, 2016, at 2,942 medical care institutions were analyzed. Life table method analysis, Kaplan-Meier analysis, and Cox proportional hazard regression analysis were conducted. Results: The employment rates of 5 yeas and 10 years for the total sample were 38% and 28%, respectively. The estimated mean value of the working period was 3,642.7 days (SE: 17.4 days). Cox proportional hazard regression analyses revealed that nurses who were working at the general hospital/hospital, clinic, and nursing hospital were more likely to leave the hospital compared to those who were working at the 3rd general hospital. Nurses who were working at the medical institutions which were located in cities and countries, established by the private foundation, rated lower levels of nursing, and owned an insufficient number of beds, nurses and doctors were more likely to leave their workplace compared to those of the counterparts. Conclusion: This study indicates that hospital characteristics may play a significant role in retirement and working period of ward nurses in Korea. The improvement of hospital conditions to reduce ward nurses' retirement are needed.