• 간호행정학회지
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• 제8권2호
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• pp.309-321
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• 2002

Purpose: A cost analysis for nursing services in operative nursing unit, emergency nursing unit, and ambulatory nursing unit was performed using patient classification system by nursing intensity in order to determine an appropriate nursing fee schedule. Method: The data were collected from 4 secondary hospitals and 5 tertiary hospitals from November 14th 2000 to January 15th 2001. The study was conducted through four phases as follows: 1) Nursing hours of each nursing service in special nursing units were measured using three kinds of patient classification systems by nursing intensity. 2) The nursing cost of nursing services in operative nursing unit, emergency nursing unit, and ambulatory nursing units was estimated based on patient classification system by nursing intensity. Results: As a result, nursing hours by nursing intensity of each special nursing unit were measured, and every nursing cost by nursing intensity in operation room and emergency room was estimated, meanwhile, the cost of nursing services in ambulatory care units was estimated only per visit as shown in chapter 4. Conclusion: Future research on nursing cost should be extended to other special nursing units such as various intensive nursing care units, delivery room, and so on. In addition, the patient classification system should be refined for its appropriateness to apply all levels of medical institutions.

• 대한간호학회지
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• 제36권3호
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• pp.503-513
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• 2006

Purpose: This study focused on analysing costs per home health care nursing visit based on home health care nursing activities in medical institutes. Method: The data was collected in three stages. First, the cost elements of home health care nursing services were collected and 31 home care nurses participated. Second, the workload and caseload of home care nursing activities were measured by the Easley-Storfjell Instrument(1997). Third, the opinions on improving the home health care nursing reimbursement system were collected by a nation-wide mailing survey from a total of 125 home care agencies. Result: The cost of home health care nursing per visit was calculated as 50,626\. This was composed of a basic visiting fee of $35,090{\\}({\fallingdotseq}355$)$ and travel fee of $15,536{\\}({\fallingdotseq}15$)$. The major problems of the home care nursing payment system were the low level of the cost per visit, no distinction between first visit and revisits, and the limitations in health insurance coverage for home health care nursing services. Conclusion: This study's results will contribute as a baseline for establishing policies for improvement of the home health care nursing cost and for applying a community-based visiting nursing service cost.

• 가정∙방문간호학회지
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• 제10권2호
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• pp.113-122
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• 2003

Purpose: This is a simple survey for discussion about cost analysis methodological issues in home care nursing service studies. Method: The subject of this study were articles published in Korea from 1961 to August, 2002, and searched by key word 'cost' and 'nursing' from various DB(National Assembly Library, The National Library of Korea, RICH etc). Finally, 13 articles were collected. Result: 1) The major type of cost analysis studies was a cost comparison or a simple cost study. 2) The important methodological weaknesses were as followers; (1) few studies were suggested cost analysis framework or analytic perspective, (2) it ,was not enough to describe for basis of selection of cost/effectiveness items, (3) few studies were done by sensitivity analysis. Conclusion: These above results will be used to develop a more proper cost analysis methodological framework in home care nursing services and also to contribute as a guideline for further studies.

• 간호행정학회지
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• 제19권4호
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• pp.449-461
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• 2013

Purpose: The purpose of this study was to explore the relationship between cost and revenue for inpatient nursing activities in general wards. Methods: Data were collected from 12 medical-surgical wards in one general hospital from January 1 to December 31, 2010. The nursing activities were categorized into 2 groups according to nursing service payment type in terms of the Korea health insurance system. Descriptive statistics were used to identify nursing activities and nursing activity costs. Results: Of 140 nursing activities identified as performed in general wards, payment for 69 items was included in nursing management fees. The percentage of each cost for the nursing units was 90% for labor, 4% for materials, and 6% for operating expenses. The cost for medical support nursing service accounted for 38% of costs and nursing management fees, 62%. The average profit and loss was -237,257,000 won. The cost recovery rate for nursing service was only 44%. Conclusion: The results indicate a need to measure the economic value of nursing activities performed in general wards and use it as a basis for establishing an adequate reimbursement system for nursing service.

• 대한간호학회지
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• 제30권6호
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• pp.1580-1591
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• 2000

This study was conducted to assess the amount of nursing services for psychiatric inpatients and to estimate psychiatric nursing costs by using the RBRVS. Full details of medical services, including physician and nursing services, for psychiatric inpatients were surveyed and data of general characteristics of hospitals and patients were also collected. The cost of nursing activities was estimated by the multiple conversion factor which was drawn from the Korean RBRVS Development Project to the RBRVS score of each nursing activities, which was drawn from the results of Korean Nurses Association (KNA)'s projects about nursing RBRVS development and cost of nursing activities. The data about 89 inpatients from 3 general hospitals with psychiatric departments were analyzed. The total cost of nursing activities for each patient per admission day was from KRW 22,185 to KRW 27,954 by hospital, and KRW 25,220 in average. The percent of nursing cost to the total cost of medical services was from 36% to 48% by characteristics of patients and 41.4% in average. The cost of nursing activities estimated in this study was between the existing NHI fee schedule and the one suggested by KNA. It is considered as appropriate and acceptable level compared to the total amount of medical services. In the process of KNA's activities to get nursing fee in NHI fee schedule, results of additional studies to estimate the cost of nursing activities balanced with total cost of medical services in every departments should be found and utilized.

• 간호행정학회지
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• 제16권4호
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• pp.399-408
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• 2010

Purpose: The purpose of this study was to compare the cost using different methods of costing nursing activities for patients with chronic otitis media having surgery. Method: Data were collected from 30 patients who had mastoidectomy and tympanoplasty. To compare the cost, the researchers used three different costing methods; consumed time, resource based relative value scale (RBRVS), and critical pathway (CP). Results: Twenty-six nursing activities for surgical patients with chronic otitis media were found. Total cost was 83,843.7 won using RBRVS. The costliest activity was recording at 9,734.4 won, followed by confirmation of doctors' orders at 9,302.4 won, and injection with infusion pump at 9,072.0 won. There was a difference in nursing activities performed according to the length of hospital stay, and the cost was highest on the surgery day at 13,417.8 won. Comparatively, the total cost was 72,014.4 won using CP. Conclusions: Nursing activities are performed in various forms according to the disease and patient's condition, and different nursing activities are executed according to the length of hospital stay. In order to measure the load of nursing activities and distribute it appropriately, it is necessary to analyze the cost of nursing activities by the process of nursing services performed.

• 간호행정학회지
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• 제4권2호
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• pp.351-361
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• 1998

The purpose of this study was to explore whether there is a point within the range of physical impairment after which the cost of home care exceeds the cost of nursing home care among the elderly who require long-term care. The provision of long-term care for the elderly is a major health policy issue, in part due to the aging of the American population and dramatic increase in health care costs. The framework for this study was guided by Pollak's(1973)model of costs of alternative care settings for the elderly. This study used a retrospective, descriptive correlational design. Physical impairment was measured by the modified Index of Activities of Daily Living(Katz et al. 1963). Cost of care was measured by the average cost per patient per day. The sample for this study included 67 patients receiving long-term care at home from the Long-term Home Health Care Programs (LTHHCPs) and 67 patients receiving long-term care in nursing homes. Data were collected on patient characteristics. including activities of daily living and cognitive impairment. and on the number of physician visits. emergency room visits. and hospitalization from the patient records. For each patient. Medicaid cost data for home care services/or nursing home services were collected from the financial department of each home care agency or nursing home. The living costs and informal care costs were estimated for home care patients. The results indicated that the home care sample and the nursing home sample were similar in terms of gender. ethnic background. and marital status. The elderly patients in the home care sample were: however. younger and less physically impaired than those in the nursing home sample. The hypotheses of this study were supported: For elderly persons with physical impairment scores below 12(possible range of 0 to 14), cost of care was lower in home care than in the nursing home care setting. However, for elderly persons with physical impairment scores above 12. the cost of care was higher in home care than in the nursing home care setting. Thus. in this sample for elderly patients with extreme physical impairment, the cost of home care exceeded the cost of nursing home care.

• 대한간호학회지
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• 제49권5호
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• pp.586-600
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• 2019

Purpose: This study aimed to develop a web-based cost management program for visiting nursing centers (CMP-VNC), using time-driven activity-based costing (TD-ABC), and to analyze effects of the program. Methods: The CMP-VNC was developed using the combined prototyping approach and system developing life cycle method following four stages: need analysis with comprehensive literature reviews and focus group interviews, design and development of program algorithm, evaluation of the developed program validity using experts and users group, and application and effects analysis. The non-equivalent control group pretest-posttest design was used to analyze the effects of the program. The program demonstration was conducted for four weeks with 60 visiting nurses in 35 visiting centers. Results: The web-based program was developed. It has five interfaces with basic and special functions using TD-ABC, namely, input, visiting nursing activity, visiting nursing activity cost, cost efficiency, and cost calculation report. The experimental group showed significantly higher cost perception and cost confidence than control group. Conclusion: We found that the CMP-VNC can be an effective tool to increase visiting nurses' competency of costing and enhance efficiencies of visiting nursing centers.

• 대한간호학회지
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• 제22권2호
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• pp.185-206
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• 1992

In this study nursing activities were examined to determine the nursing cost. A professional nursing group developed a tool for the investigation. 128 nursing activities were identified by the tool in 16 nursing care areas as referenced in the literature. Each activity was examined for four essential factors to define nursing cost ; time consumed for the care, level of professional skill, degree of independency and performer of the care. The activity was rated by a five point Likert scale. This investigation was conducted with the nursing staffing working in the 21 university hospitals in Korea and having more than four years experience especially in medical or surgical wards. The participating nursing staff were screened on the basic of the recommendation of the nursing director. The data were gathered from June 12th to August 12th, 1989. All the data were analyzed for mean, standard deviation, percent, and correlation coefficients between items. The results are summarized as follows : 1. Direct nursing care was classified into 16 large areas and 128 small activities. 2. No significant correlation was found between the study items of each activity. 3. Among 128 nursing activities, Those performed less than 50% of the time by a nurse were excluded from the nursing cost. Also excluded activities which were given less than 9 marks in all three items, time consumed, level of professional skill, and degree of independency. As a result, 83 activities in 14 nursing care areas were selected for the proposal to estimate nursing cost.

• 가정∙방문간호학회지
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• 제26권1호
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• pp.81-90
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• 2019

Purpose: In accordance with changes in the healthcare environment, it is necessary to understand managerial cost accounting for nurses. This study aimed to develop educational components of managerial cost accounting for nurses. Methods: This study is comprised of a comprehensive literature review, nominal group technique using focus group interview, audit by an expert group, and priority analysis. Results: The comprehensive literature review identified 15 educational components of managerial cost accounting. In the nominal group technique, the participants finally agreed on eight educational components of managerial cost accounting for nurses. The average content validity index of these components was 0.99. "Activity-based costing" scored the highest for relative importance (15.7%). Conclusions: These results can be used to develop an education program to strengthen nurses' managerial cost accounting competencies. Furthermore, it will be helpful to use a basis for the development of cost management curricula for nursing students and on-the-job training courses of nurse managers and executives.