• Perspectives in Nursing Science
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• v.6 no.1
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• pp.67-76
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• 2009

Recently, small and medium-sized hospitals which are located in rural areas have many difficulties in securing high quality nurses. That is because working environments for nurses in small and medium-sized hospitals in rural areas are poor compared with those of big hospitals in urban. As a result, the migration of nurses from small and medium-sized hospitals in rural areas to big hospitals in urban is continuously happening. In general, big hospitals provide nurses with high level of salary and fringe benefits. To prevent the migration of nurses, chief executive officers of small & medium hospitals in rural areas have been interested in improving nurses' working conditions including wages. Also, they have raised nurses' salary and improved working conditions. But, basically these individualized efforts have some limit. In connection with this, medical interest groups have produced various voices in terms of interpretation and solutions for these issues. However, from the future perspectives, it seems evident that two approaches for both manpower supply and demand plans of nurses are necessary. They should contain not only accurate estimation of the supply-demand of nursing manpower but also the improvement of working conditions and wages of nurses. Estimation of nursing manpower supply-demand depends on the standards and criteria being used. Supply and demand may be met or not in accordance with the points emphasized on the decision. In the articles, issues regarding nursing manpower, levels of salary, other working conditions and social support system for child care are discussed. According to Joe's report (2005), most health institutions did not meet the guidelines of nurse staffing in Medical Law. The wages of nurse vary on every hospital and there is a big difference in wages' range. The average starting salary for a nurse is 22 million won a year. In case of tertiary hospitals, it reaches up to 30 million won a year. Nurse as a profession should have a strong responsibility and should take care of the patients for 24 hours with three working shifts. Also, most of them are female who have the burden of child rearing. Therefore, it is suggested to increase the salary, to provide comfortable working conditions, and to have social support system for nurses with household affairs.

• Journal of Preventive Medicine and Public Health
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• v.24 no.4 s.36
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• pp.531-548
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• 1991

To assess the adequacy of medical manpower and medical fee for the newborn nursery care, the author visited 20 out of 24 hospitals with the pediatric training program in Youngnam area between July 29 and August 14, 1991. Total number of newborn, both normal and sick, admission and discharge in 1-30 June 1991 was obtained from the logbook of nursery. Head nurse and staff pediatrician of the nursery were interviewed to get the current staffing for the nursery and their subjective opinion on the adequacy of nursery manpower and the difficulties in recruiting manpower. Average medical fee charged for the maternity and normal newborn nursery care was obtained from the division of self-audit of medical insurance claim of each hospital. Average minimum requirement of nursing care time for one normal newborn per day was 179.5 (${\pm}58.6$) minutes; 202.3(${\pm}50.7$) minutes for the university hospitals and 164.2(${\pm}60.5$) minutes for the general hospitals. The ratio of minimum requirement of nursing care time and available nursing time was 1.42 on the average. Taking the additional requirement of nursing care for the sick newborns into consideration, the ratio was 2.06. The numbers of R. N. and A. N. in the nurserys of study hospitals were 31%, and 17%, respectively, of the nursing manpower for the nursery recommended by the American Academy of Pediatrics. These findings indicate that the nursing manpower in newborn nursery is in severe shortage. Ninety percent of the head nurses and 85% of the staff pediatrician stated that the newborn nursery is short of R.N. and 75% of them said that the nurse's aide is also short. Major reason for not recruiting R.N. was the financial constraint of hospital. For the recruitment of nurse's aide, short supply was the second most important reason next to the financial constraint. However, limit of quarter in T.O. was the mar reason for the national university hospitals. Average total medical fee for the maternity and newborn nursery cares of a normal vaginal delivery who stayed two nights and three days at hospital was 219,430won. Out of the total medical fee, 20,323won(9.3%) was for the newborn nursery care. In case of C-section delivery who stayed six nights and seven days, total medical fee was 732,578won and out of the total fee 76,937won (12.0%) was for the newborn care. Cost for a newborn care per day by cost accounting was 16,141won for the tertiary care hospitals and 14,576won for the all other hopitals. The ratio of cost and the fee schedule of the medical insurance for a newborn care per day was 5.0 for the tertiary care hospitals and 4.9 for the all other hospitals. Considering the current wage level of the medical personnel, capital investment for the hospital facilities and equipments, and the cost for hospital maintenance, it is hard to expect adequate quality care in the newborn nursery under the current medical insurance fee schedule.

• Health Policy and Management
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• v.3 no.1
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• pp.146-168
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• 1993

The study was conducted to project supply and demand of the nurses till year 2010 based on analysis of supply and demand of nurses up to year 1991. Results of the study will provide invaluable information for nurses manpower planning as well as overall health manpower planning for the 21th century. It is projected that nurses will be oversupplied based on the current prductivity which is undesirable situation if the quality of care is considered, and undersupplied based on the the medical law as well as optimal productivity. Thus, it is desirable to increase active supply of nurses. One of the ways of increasing active supply would be increasing the size of training and education. But, considering low employment rate of nurses which is about 59% better way of solving problems related to nurses shortage would be improvement in nurses' employment rate. According to simulation study done as part of this study, if nurses' employment rate goes up to 80%, there is no need for increasing the size of training to meet the demand at the level of medical law.

• Health Policy and Management
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• v.1 no.1
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• pp.136-152
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• 1991

The study was conducted to project supply and demand of the physicians from year 1991 to year 2010 based on the analysis of supply and demand of the physicians up to year 1989. Results of the study will provide information for the physicians manpower planning of the 7th 5-year Economic Social Development Planning(1992-1996) and contribute to the overall health manpower planning for the 21the century. It is projected that physician will be oversupplied from the very near future based on the current productivity or underestimated based on the optimal productivity. Thus, it is desirable not to change size of training and education during the 7the 5-year planning period and re-examine the status of the physician manpower at the end of the 7th 5-year period taking into consideration medical services utilization pattern, patients' satisfaction, and physicians' productivity.

• Korea Journal of Hospital Management
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• v.7 no.1
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• pp.121-130
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• 2002

As a hospital deals with people in their particular states, namely patients, computerization and automation in organization systems are very limited. Even though state-of-the-art medical systems such as the OCS, the HIS, the EMR, and the FACS are facilitating the computerization and informatization processes, they are for convenience and effectiveness. Ultimately, however, we should depend on specialists including doctors, nurses, pharmacists, and medical engineers. Therefore, a hospital is a representative labor-intensive body. Like other similar organizations, hospitals require a lot of manpower. But they are quite different in that hospital people hold variety and complexity in their qualifications and licenses. In personnel management, a hospital is twice controlled owing to the special characteristics that human life is at stake. First, the quota of medical manpower should be obeyed lest the quality of medical services should be lowered, and their roles and interrelations are even regulated. Second, in spite of the peculiarity of hospitals, the duties of obligatory employment and social insurances should not be neglected like other companies. In order that each hospital can preserve the proper level of medical services, securing the appropriate level of medical personnel has to be regulated. However, as the personnel cost is one of the important indices of hospital management, too much regulation in manpower supply can lead to poor hospital management and, in the end, the drop of the quality of medical services. In sum, as far as hospital personnel is concerned, some autonomy ought to be given to each hospital so that it can control the quality of hospital services. In addition to this minimum regulation of personnel, certain incentive and reward systems like the graded nursing system need to be prepared.

• Health Policy and Management
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• v.16 no.4
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• pp.112-127
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• 2006

The purpose of this study is to develop performance indicators for quality of public health center based home healthcare through the study the major factors of registrated weaken poorly residents in the community based home healthcare. Various literature review was conducted to study the performance indicators for quality of public health center based home healthcare of advanced countries and Korea. Mail survey was conducted from national wide PHC(public health centers), sub health centers and primary health care posts. of the surveys mailed, 2,293 centers(67%) were returned within the allotted and we included in the analysis these who completed the questionnaire. Data was analysed by SPSS for windows 12.0. The major results of the research were as follows; Firstly, major factors of registrated weaken poorly residents in the community based home healthcare in the multivariate analysis were jurisdictional families per manpower(OR:0.78, 95%CI:0.64-0.94, P=0.011), weaken poorly families per manpower(OR:0.42, 95%CI:0.35-0.50, P<0.001), business vehicles per manpower(OR:1.13, 95%CI:1.04-1.24, P=0.007) type of public health center(OR:4.42, 95%CI:3.32-5.90, P<0.001), region of public health center(OR:0.53, 95%CI:0.32-0.89, P=0.017). Secondly, performance indicators for quality of public health center based home healthcare were developed as basic investigation, registration, intervention and discharge level. Preparing for Activation of public health center based home healthcare in Korea, the result application as follows is possible. Firstly, we can conclude that the major factors of registrated weaken poorly residents in the community based home healthcare are jurisdictional families per manpower, weaken poorly families per manpower, type of public health center, region of public health center, business vehicles per manpower. Secondly, the new developed performance indicators which are divided into basic investigation, registration, intervention, discharge for public health center based home healthcare could be applied it for improving quality of home healthcare services.

• Journal of Korean Academy of Nursing Administration
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• v.1 no.1
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• pp.132-146
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• 1995

Even though Korean medical law stipulates that number of patients attended by a nurse is 2.5 for hospitalization and 30 for ambulatory care, the number of patients cared by a nurse per day is much greater than the standard prescribed by the medical law. Current productivity of nurses is not desirable unless the quality of care is considered. And nursing manpower staffing based on neither current nurses' productivity nor standard of medical law cannot respond properly to dynamic situation of the medical services. Under this background, the necessity of more efficient management of nursing manpower occupying 1/3 of total hospital workers has been recognized by many nursing administrators. Many nursing researchers have studied to foretell the nursing manpower objectively on the basis of measured nursing workload according to patient classification as well. Most of These researches, however, have been conducted in the tertiary hospitals, so it is imperative to conduct other researches to predict necessary nursing manpower in the secondary and the primary hospitals. The study was performed to measure nursing workload and predict pertinent nursing manpower to a secondary hospital with 400beds. Nursing workload was surveyed using measuring tool for direct and indirect care hours in a surgical unit and a medical unit. Survey was conducted from Sep.10 to Sep.16 and from Oct.5 to Oct.11, 1994 respectively by two skilled nurses, Subjects were patients, patients' family members and nursing personnels. Results are follows : 1. Patient classification distributed as 22% of class I (mildly ill patient), 57% of class II (moderately ill patient), and 21% of class III (acutely ill patient) in the medical nursing unit, while 23% of class I, 29% of class II, 12% of class III, and 36% of classIV (critically ill patient) in the surgical nursing unit. There was no difference of inpatient number between weekday and weekend. Bed circulation rate was 89% in both units and average patients number per day was 37.4 (total 42beds) in the medical nursing unit, 32.9 (total 37beds) in the medical nursing unit. 2. Direct care hours per day measured as 2.8hrs for class I, 3.3hrs for class II, and 3.5hrs for class III in the medical nursing unit, while 3.1hrs for class I, 3hrs for class II, 2.7hrs for class III, and 2.2hrs for classIV in the surgical nursing unit. Meanwhile, hours for nursing assistant activities per patient by patients' family members were 11mins and 200mins respectively. Direct care hour rate by shift was day 36%, evening 25%, and night 39% in the medical nursing unit, while 40%, 29%, and and 31% respectively in the surgical nursing unit. 3. Measurement and observation activity held 44.2% of direct care activities of nurses and medication 36.7%, communication 11.7%, exercise 1.8%, treatment 1.3%, hygiene 1.3%, elimination and irrigation 1.1%, suction 1%, nutrition 0.5%, thermotherapy 0.3%, oxygen therapy 0.1% in order. 4. Indirect care hours per day were 294.2mins in the medical nursing unit, and 273.9mins in the surgical nursing unit. By shift, evening was the highest in both units. Indirect care hours for each patient were 44.5mins in the medical nursing unit and 46mins in the surgical nursing unit. 5. checking activities including doctor's order, medication, and delivering patients to the next shift occupied 39.7% of indirect care activities, and preparation 26%, recording 23.8%, communication and conference 6.7%, managing equipments 2.1%, messenger activity 1.7% in order. 6. On the ground of these results, nursing manpower needed in a secondary hospital was estimated ; 27 nursing personnels for the medical nursing unit of 37beds, and 20 nursing personnels for the surgical nursing unit of 33beds.

• Journal of the Korea Convergence Society
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• v.11 no.9
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• pp.287-296
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• 2020

The purpose of this study is to analyze, medical institutions wanted to investigate what caused the shortage of opticians' manpower and suggest solutions. This study was conducted on 31 opticians (11 male and 20 female) working at medical institutions through a self-reporting method survey. Through the survey, basic information of the subjects and the information and satisfaction level of the medical institution on duty were investigated and analyzed. There were many people who had a license for optometrist but did not do optometrist work, and the married people were less satisfied with their work and the proportion of people who did not do optometrist work was higher. The cause of these problems was salary. Opticians who needed higher salaries for marriage and other reasons were able to increase their salaries by adding other tasks in their own areas. This unsatisfactory salary at medical institutions has led to a shortage of optometrists at ophthalmic clinics.

• The Journal of the Convergence on Culture Technology
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• v.9 no.6
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• pp.795-799
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• 2023

The Canadian military participated in World War I and felt the limitations of the recruitment system through the continuous shortage of troops caused by the prolonged war, therefore expanded the role and scope of female manpower. The use of female manpower, which began with medical support for the first time, increased its necessity and importance as medical support personnel were dispatched overseas and women's manpower was expanded to combat support missions for the Army, Navy, and Air Force. Since then, the proportion of female manpower has been limited to 1.5% of the total number of employees at the end of the Second World War and the reduction of troops and the dismantling of the women's unit. In this situation, the Austrian Defence Force gradually accepts the recommendation of the Royal Canadian Women's Status Committee to improve the service conditions of women, marking a turning point in expanding the role of women in the Canadian military. The the Austrian Defence Force conducted long-term combat experiments to increase the proportion and role of female manpower, increasing reliability through observation and analysis to prove whether female manpower is suitable for combat troops. Korea also wants to draw implications for the future direction by comparing the history and current appearance of the Canadian military's use of female manpower with the Korean military at a time when the problem of a shortage of troops is emerging due to the recent decline in fertility and low birth rates.

• Journal of Korean Academy of Nursing
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• v.26 no.2
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• pp.399-412
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• 1996

Even though Korean medical law stipulates that number of patients attended by a nurse is 2.5 for hospitalization and 30 for ambulatory care, the number of patients cared by a nurse per day is much greater than the standard prescribed by the medical law. Current nursing productivity of nurses is not desirable unless the quality of care considered. Moreover. nursing manpower staffing based on neither current nurses' productivity nor standard of medical law cannot respond properly to dynamic situation of the medical services. As for the nurse scheduling, the critical problem of it in the hospital is determining the day-to-day shift assignments for each nurse for the specified period in a way that satisfies the given requirements of the hospital. Nurse scheduling, however, involves many factors and requirements, manual scheduling requires much time and effort to produce an adequate schedule. Under these backgrounds, the necessity of more efficient management of nursing manpower occupying 1/3 of total hospital workers has been recognized by many nursing administrators. This study was performed to develop a system computerizing nurse staffing and scheduling based on the patient classification. As a preliminary step for the system development, nursing workload in a secondary hospital was measured from Sep. to Oct. 1994. On the grounds of this result, computerization of nurse staffing and scheduling was proceeded with three options. First one is based on the current medical law. Second one is based on the assigned number of nursing staff. And the last is based on the request by patient classification. Computer languages used in this study were MS Visual Basic 3.0 for the staffing and Access 2.0 for the scheduling, respectively. Prospective users may operate this system easily because icons and mouse are used for easier graphic user interface and reducing the need for typing efforts. This system can help nurse administrators manage nursing manpower efficiently and nurses develop quick and easy schedule generation and allow more time for the patient care.