• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.15 no.6
• /
• pp.3534-3547
• /
• 2014

Although there are many positive sides of the current fee-for-service payment schedule, there is a strong necessity to control the rapidly increasing national healthcare expenditure. The global budget is often mentioned as one prominent alternative for solutions. In this article, both microscopic and macroscopic approaches are considered to set the hospital medical expenditure budget. In a macroscopic aspect, the SGR model, which considers the financial limit of the healthcare system, is used to set the next year target budget. In addition, the DEA model is used to measure the inefficiency and cost recognition. In this article, the national medical target expenditure is distributed to an individual hospital based on the level of efficiency. By combining the SGR and DEA, it will be possible to set a real world applicable target medical expenditure budget model.

• Journal of Korean Clinical Nursing Research
• /
• v.16 no.3
• /
• pp.99-109
• /
• 2010

Purpose: This study was aimed to examine changes of hospital nurse staffing by hospital characteristics during 2008-2010. Methods: The study sample included 44 tertiary hospitals, 226 general hospitals, and 532 non-general hospitals that were operating during 2008-2010. Grade of nursing management fee was categorized from Grade 1(highest) to 6 (lowest) in tertiary hospitals, l or Grade 7 in general hospitals and non-general hospitals based on the nurse-to-bed ratio. For data analysis, ${\chi}^2$ and GEE were conducted. Results: For three years, the number of tertiary hospitals below Grade 2 were increased from 8 to 12, the number of those above Grade 4 were decreased from 15 to 6. The number of general hospitals above Grade 6 decreased from 123 to 86. Tertiary hospitals and general hospitals had more possibilities to improve nurse staffing grade than general hospital (OR 79.69, 95% CI 50.77~125.09, OR 11.25, 95% CI 8.15~15.53, respectively). Greater likelihood of improvement in grade of nursing management fee was found in university hospital or hospitals with 300 or more beds than other types of hospitals. Conclusion: Differentiating nurse staffing system by hospital type and increasing financial incentives according to the grades are needed to improve hospital nurse staffing.