• 간호행정학회지
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• 제15권2호
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• pp.264-274
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• 2009

Purpose: This study is to develop job standards in order to propose proper job level of the advanced nurse practitioners and apply the results to the work and enhance the expertism. Method: This study is a methodical study. The validity was examined by using the content validity index(CVI). Result: The pre-items of job standards for advanced health insurance review nurses were established and the final job standards comprising of 12 standards, 46 criteria, 92 indicators, 418 activities were determined after the examination by the advisory group. The validity of the job standards were examined for two times by the seven professionals. The relevance of the modified job standards was examined by the working level employees above the assistant manager position working in the general hospitals and the result was 93.14% relevance. The job standards comprising of 12 standards, 46 criteria, 89 indicator and 409 activities were developed. Conclusions: By the development of the job standards, it is expected to prove that advanced health insurance review nurses are the most suitable professionals for dealing with medical affairs such as management and propriety evaluation of medical expenses while defining the roles of advanced health insurance review nurses.

• 종양간호연구
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• 제11권2호
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• pp.155-162
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• 2011

Purpose: The purpose of this study was to examine the actual care costs paid to Korean Oncology Advanced Practice Nurses (KOAPN). Methods: We collected data using a group discussion and questionnaire identified 115 tasks from job descriptions developed by the Korean Accreditation Board of Nursing. Forty-two KOAPN working at three university hospitals in Seoul were asked to evaluate each task as to type and whether the cost is paid or not. They were also asked to indicate the tasks in urgent need of development of a care cost with high priority. Results: Only five tasks (4.3%) related to treatment and complication related interventions or education were paid, and they were paid only once during the entire treatment period and were not covered by national health insurance. It was approved as a medical fee by health insurance review & assessment service. Furthermore, the names of the authority (doctor) and the actual provider (nurse) of the prescriptions were different for three of those tasks. Most of the suggested tasks needing development of care costs were actions specifically performed by nurses (physical-psychosocial-spiritual assessment, independent nursing interventions). Conclusion: KOAPN are currently paid for few tasks. To maximize the utilization of KOAPN, the establishment of a clear rational payment system directly related to their actual activities is needed.

• 지역사회간호학회지
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• 제32권1호
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• pp.24-39
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• 2021

Purpose: This study was to review the previous studies on the 'Willingness to Pay (WTP)' for healthcare services and suggest future implications for nursing research. Methods: Using the scoping review method, we used RISS, KISS, KMbase, Koreamed, PubMed, EMbase, CINAHL as searching engines. According to the selection and exclusion criteria, 40 appropriate studies were selected and analyzed. Results: 24 studies were categorized into medical service field among medical, public health, and nursing service fields. A total of 16 studies were related to healthcare system (policies), 13 studies were to the healthcare intervention, and 11 studies were categorized into the health management. Most of the methods for eliciting WTP (70%) were about a contingent valuation method (CVM), and the use of double bounded dichotomous choice (DBDC) tended to increase. In the nursing field, five WTP studies were identified: two studies published in the early years of 2000, which were conducted on hospital-based home health visit services. Recent studies were mostly about counseling and education by advanced practice nurses (APNs). Conclusion: WTP studies on healthcare services were largely published from the medical fields and health policy areas with the CVM method. In the field of nursing, studies have been conducted on the subject of limited service areas. More active exploration of research topics is required, particularly under the current policy setting, where discussion of the public health insurance fee for nursing practice is essential.

• 한국산학기술학회논문지
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• 제18권8호
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• pp.162-170
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• 2017

본 연구는 중소병원 간호인력 현황과 관련 정책을 분석하고 인력 확보에 영향을 주는 요인을 파악하여 중소병원 간호인력 확보를 위한 정책을 입안하고 결정하는 데에 근거를 제시하고자 실시되었다. 보건복지부와 건강보험심사평가원 등에서 제시한 통계자료를 2차 분석한 후 그 결과를 다양한 내 외적 보건의료환경에 대한 이해를 기반으로 조명하였다. 연구결과 우리나라의 활동 간호사 수는 면허간호사 수의 50% 미만으로 그 수는 해마다 감소하고 있었으며, 이는 간호대학 정원증가의 비용 대비 성과의 효율성을 재고할 필요가 있음을 의미한다. 또한 간호관리료 차등제 실시로 인해 신규간호사는 물론 간호사 인력부족이 심각한 중소병원의 경력간호사들이 상급종합병원으로 이동하게 되는 결과를 야기하였으며, 결국 중소병원 간호인력 부족 현상을 더욱 악화시키는 원인이 되었다. 따라서 입원환자 간호관리료 차등제가 중소병원 간호인력 확보 정책으로 실효성이 있는지에 대한 재검토가 필요하며, 면허간호사에 대한 추적 관리 시스템을 통해 간호인력 수급의 불균형을 해소할 수 있어야 한다.

• 의료법학
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• 제9권1호
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• pp.385-411
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• 2008

The goal of medicine is to contribute to promoting national health by preventing diseases and providing treatment. The scope of modern medicine isn't merely confined to disease testing, treatment and prevention in accordance to that, and making experiments by using the human body is widespread. The advance in modern medicine has made a great contribution to valuing human dignity and actualizing a manly life, but there is a problem that has still nagged modern medicine: treatment and healing for terminal patients including cancer patients. In advanced countries, pain care and hospice medicine are already universal. Offering a helping hand for terminal patients to lead a less painful and more manly life from diverse angles instead of merely focusing on treatment is called the very hospice medicine. That is a comprehensive package of medical services to take care of death-facing terminal patients and their families with affection. That is providing physical, mental and social support for the patients to pass away in peace after living a dignified and decent life, and that is comforting their bereaved families. The National Hospice Organization of the United States provides terminal patients and their families with sustained hospital care and home care in a move to lend assistance to them. In our country, however, tertiary medical institutions simply provide medical care for terminal patients to extend their lives, and there are few institutional efforts to help them. Hospice medicine is offered mostly in our country by non- professionals including doctors, nurses, social workers, pastors or physical therapists. Terminal patients' needs cannot be satisfied in the same manner as those of other patients, and it's needed to take a different approach to their treatment as well. Nevertheless, the focus of medical care is still placed on treatment only, which should be taken seriously. Ministry for Health, Welfare & Family Affairs and Health Insurance Review & Assessment Service held a public hearing on May 21, 2008, on the cost of hospice care, quality control and demonstration project to gather extensive opinions from the academic community, experts and consumer groups to draw up plans about manpower supply, facilities and demonstration project, but the institutions are not going to work on hospice education, securement of facilities and relevant legislation. In 2002, Ministry for Health, Welfare & Family Affairs made an official announcement to introduce a hospice nurse system to nurture nurse specialists in this area. That ministry legislated for the qualifications of advanced nurse practitioner and a hospice nurse system(Article 24 and 2 in Enforcement Regulations for the Medical Law), but few specific plans are under way to carry out the regulations. It's well known that the medical law defines a nurse as a professional health care worker, and there is a move to draw a line between the responsibilities of doctors and those of nurses in association with medical errors. Specifically, the roles of professional hospice are increasingly expected to be accentuated in conjunction with treatment for terminal patients, and it seems that delving into possible problems with the job performance of nurses and coming up with workable countermeasures are what scholars of conscience should do in an effort to contribute to the development of medicine and the realization of a dignified and manly life.