• Health Policy and Management
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• v.13 no.1
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• pp.69-97
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• 2003

This study focuses on the determinants of the community health service utilization. Theories suggest seven models for community health service utilization, which are divided largely into two groups such as Health Service Supply Model and Health Service Demand Model: Supply Model includes Medical Implements Model, Personnel and Budget Model, Management System Model, Staffs' Behavior Model, Service Quality Model; Demand Model includes Area Model and Clients' Characteristics Model. This paper tests how the above models influence on the community health service utilization. After interviewing some administrative staffs of the Community Health Service Center at Pusan, questionnaires were made and mailed to the staffs of 198 Korean Community Health Service Center as a universe, among which from 98 centers we got response. Analyzing the data from the questionnaires, we found "the number of personnels in the health service center" and "demands for medical service" as important variables to affect the utilization of the community health service center. These two variables are typical factors representing Supply Model and Demand Model each. However, the variables selected from Management System Model, Administrative Behavior Model, Service Quality Model and Area model are not significant in a statistical sense. The paper suggests that to recruit the personnels, especially nurses, and to make out the demands of the clients for health service be the precedent conditions to increase the utilization of the Community Health Service Centers in Korea.ce Centers in Korea.

• The Korean Journal of Health Service Management
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• v.11 no.4
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• pp.239-250
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• 2017

Objectives : The purpose of this study was to analyze the types of hospitals participating and the factors influencing comprehensive nursing service. Methods : Data were gathered from 231 hospitals offering the comprehensive nursing service in 2016. Collected data were analyzed using the multinomial logistic regression with the SPSS 24 version program. Results : First, factors influencing the types participating comprehensive nursing services were identified as hospital type, number of beds, medical doctor and, nurses per bed. Second, if all tertiary hospitals, general hospitals and hospitals participated in the service, approximately 122,022 ~ 166,274 nurses would be needed for the service. Conclusions : Hospitals providing the comprehensive nursing service will be expanded gradually. As such, thoughtful policy considerations are required to successfully establish services, such as improvement in hospitals, required nurse staffing level and demand and supply of nurses. Therefore, it is necessary to control the participation ratio of hospitals in consideration of the various circumstances.

• Perspectives in Nursing Science
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• v.7 no.1
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• pp.23-35
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• 2010

Purpose: The purpose of this paper is to analyze the demand and supply of advanced practice nurses and suggest alternative benefit strategies in the Korean national health insurance. Methods: A revised demand & supply model was used to estimate the excess supply of APNs, and policy making process and key actors in the Korean health insurance were considered to develop a political approach to the APN issue. Results: The social demand for APNs is currently estimated to be less than 50% of its supply and the APN education program fell into difficulties in recruits. No reimbursement mechanism for APN's services in the national health insurance has given no economic incentive to hospital managers who have monopsony power in nursing labor market, which has caused the demand shortage of APNs in hospital industry. Payment for APN's services recognized as one of the most significant strategies to booster the social demand for APN's services should be carefully designed and implemented in the national health insurance. In line with this, key actors in health insurance policy decision-making include government, national assembly, labor unions, NGOs, civic groups, medical associations, and academia. Conclusion: The basic researches for APN's activities and cost-effectiveness analysis in clinical settings are required to support the strategies aforementioned. Constructing a policy network among key actors is able to make the payment strategy feasible, which will increase the socal demand for APNs.

• Journal of Home Health Care Nursing
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• v.29 no.1
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• pp.5-17
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• 2022

Purpose: This study aimed to investigate the role of hospital-based home health nursing in community care by examining the institutional progress of hospital-based home health nursing and the current status of home health nursing in Korea. Methods: Korean research data, national statistical data, government press releases, and related laws were investigated to clarify the role of hospital-based home health nursing in community care. Results: Korean visiting medical care services, including hospital-based home health nursing, was not found to be sufficient nationwide. The supply of home health nursing did not increase due to the nature of the visiting services that required transportation time, poor profitability due to insufficient insurance fees, and increase in acute beds. Conclusion: The nature of the Korean medical environment and visiting medical care makes it challenging to establish a visiting medical supply system for community care. Therefore, hospital-based home health nursing is an important infrastructure for visiting medical care, and will be a valuable resource to link discharged patients returning to the community when moving health care services. Hence, laws and institutional supplementation to expand the role of home health nursing agencies nationwide are needed along with addressing the limitations in the supply of home health nurses.

• Health Policy and Management
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• v.25 no.2
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• pp.129-139
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• 2015

Background: Policy network theory was proved to be an appropriate analytic tool for the current social welfare policy making process. This study aimed to analyze policy making process related to the nurse expansion and policy output while focusing on the interactions and activities among various policy actors. Methods: In this study, we used reports related to the need for expansion of nursing personnel journals, dissertations, newspaper articles, for hearings and debate policies for securing nurse data, and interviews. We examined three components of policy network, that is, policy actors, interactions, linkage of interest. Results: For that to expand the nurse before the 2000s in expanding the supply of medical supplies have been conducted without much disagreement among policy actors under the government's initiative. However, there was lacked a close relationship between the expanding supply of nurses and inaccurate analysis of supply and demand. As the policy is applied between the various policy actors' needs and claims, conflict was intensified and many policy options had been developed. Government only took a role as a coordinator among policy actors in the 2000's. Also, it was difficult to find sufficient and clear evidence that policy-making process based on fair judgment. Conclusion: Therefore, it is urgently required to determine the policy through a social consensus to address the appropriate policy means and the process by correct analysis of the policy issues.

• Asian Oncology Nursing
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• v.1 no.2
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• pp.191-203
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• 2001

The health of a nurse is very important because her mental and physical health can influence toward nursing patients directly, Especially, Cancer patients are growing annually. Also, terminal cancer patients' nursing and dead place are increasingly using hospital and the period of nursing for cancer patients are increasing. Nursing for cancer patients are different with acute disease. Therefore, I analysed comparing nurses' health working in cancer and general ward so that nurses working at cancer ward could be developed as a professional nurse, and I wanted to establish the foundation of nursing administration and reasonable manpower management to supply good quality of nursing to patients. In my research, I selected 117 nurses working in cancer ward and 134 nurses working in general word to analyse the stress rate and nurse's health comparing nurses working in general ward and cancer ward. The survey was conducted of nurses working in cancer ward nurses in 2 university hospitals, nurses working in a cancer hospital, and general ward nurses working in 3 public hospital. Also, the data was collected from Sep. 13, 2001 to Sep. 28, 2001. As health measuring tool, I used Cornell Medical Index(CMI) which are developed to fit Koreans by Ko Ungrin and Park Hang-bas (1980) using Cornell Medical Services which were designed by Weiser, Brosman, Mittelman, Wechler, Wolff in Cornell University(1945). As working stress measuring tool, I used Questionaries which were designed by Kim Mae-ja and Ku Mi-ok(1984) and then developed by Bae In-sook(1996). For managing the data, I used frequency, percentage, ${\chi}^2$ verification, t-test, and F-test (ANOVA). And in the case of significant data(p<.05). I did Duncan's test for post verification. The mutual relation between health condition and working stress rate have been conducted using Pearson's Correlation Coefficient. Followings are the results of my research. 1. Two groups showed significant differency at age after testing homogeneous character between two groups (${\chi}^2$ =9.919, p=.007). 2. Comparing two group's health condition, cancer ward(average 19.35${\pm}$18.34) were higher than general ward(14.42${\pm}$10.59) and showed statistical significant differency(p=.009). And, comparing two group's mental condition, cancer ward(9.00${\pm}$9.79) were higher than general ward(7.13${\pm}$6.35) and statistically no differency. 3. After comparing two group's working stress rate, the rate of cancer ward nurse's working stress(3.36${\pm}$.50) is higher than general ward nurse (3.32${\pm}$.48). There are no significant differency. However, in the detailed verification test, there were significant differency at inappropriate compensation (t=3.254, p=.001) and medication issue (t=2.170, p=.031). 4. After comparing health condition at general points, physical health condition showed significant differency at age(p=.020), the number of children (p=.015), religion (p=.015), position(p=.005), career(p=.008), working satisfaction(p=.003), activity after office hour(p=.045); and mental health condition showed significant differency at position(p=.010), career (p=.017), working satisfaction (p=.003). 5. After comparing the working stress rate according to general points, there were significant differency at working satisfaction (F=5.285, p=.006), predicted nursing(F=3.822, p=.023). 6. At the relation of health condition and working stress rate between two groups. physical and mental condition showed significant relation with working stress rate. i.e, if a nurse's health condition is not good, she are feeling much more stress than others. After considering all the factors in my research, I found that the health condition and stress rate of cancer ward nurses is much higher than general ward nurses. Considering that cancer ward nurses is necessary to care for increasing cancer patients with mental and physical nursing, the less stress for cancer ward nurses is very important to develop nursing quality and working efficiency by keeping good health condition, specializing cancer ward nurses. Therefore, we need following studies to find the factors which are effecting to cancer ward nurses' health and specialization. Also, we need to improve managing working condition to decrease working stress by improving working condition.

• The Korean Nurse
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• v.33 no.1
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• pp.65-79
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• 1994

The purpose of this study was to describe the job retainment factors and the level of job satisfaction, and to identify the relationship between job retainment and the level of job satisfaction among the registered nurses working in hospitals. Four hundred eight registered nurses currently employed at 8 hospitals in Seoul were surveyed for the study. The 39 item, 5 point likert scale questionnare was developed by the researcher. The internal consistency of job satisfaction was. 86 and that of job retainment was. 90 in Cronbach's alpha test. The data sas collected from July 15 to July 30, 1993. The SPSS/PC+statistical program was used for data analysis. The descriptive analysis of the characteristics of the subjects, the level of job satisfaction and the job retainment factors was done. The relationship between the job satisfaction level and the job retainment factors was tested with. the Pearson Correlation Coefficient analysis, and thd differences of job retainment scores among the sample was tested with t-test and ANDVA. The results of the study were summarized. 1. The mean age of the subjects was 29.7 years, 41.7% of them were married. 71.1% of them were 3 years course graduates, 71.8% of them were staff nurses, and the mean duration of experience was 6 years. 2. The factors related to professionalism(3.43), society(3.31), and interpersonal relationship(3.29) were significant in job retainment. The maximum score was 5.0 Two other factors, personal(3.05) and organization(2.83) factors, also showed relatively high scores. 3. The factors to the job satisfaction showed similar pattern as job retainment: professionalism (3.47), society (3.33), finance(3.31), interpersonal relationship(3.02), and organization(2.72). 4. Society related factors(r=.7420, p<.00l) and professionalism(r=.7249, p<.00l) had high correlation with job retainment. Personal(r=.6372, p<.001) and organizational(r=.3597, p<.001) factors had moderate relationship to job retainment. Finance(r=.3597, p<.00l) had significant but weak relationship to job retainment. 5. Age, marital status, job position, departmental involvement, experience, and continuity of employment of the sample showed significant differences in job retainment. However, the period of job retainment, number of children, educational level, type of hospital, previous employment experience were not significant. 6. lndiviuals older than 40 years of age, who were married, who held the position of charge or head nurse position, who worked in central supply or nursing administration showed significantly high job retainment score. This research indicates that the professionalism is the most significant factor in job retainment. In order to retain more experienced nurses, it is important to improve the profesionalism among nurses.

• Journal of Korean Academy of Nursing
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• v.5 no.1
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• pp.70-78
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• 1975

The investigators conducted this survey to find out prevalence of diseases and symptoms of the 812 nurses who were working at the 12 Seoul city and University's hospital in Seoul by retrospective study The results of survey were summarized as follows: 1. Distribution of Prevalence Rate of Diseases and Symptoms. 1) An average prevalence rate of diseases and Symptoms of the nurses/100 persons was 64.3 cases at Present October I.1972 2) The total number of diseases and Symptoms was 522 cases at present Oct, I 1972 for the survey nurses. The prevalence rate of following diseases/100 persons were as, foot sore-11, 3. myopia-9.7, neuralgia-9.6, anemia-9.1, insomnia-8.6 cases and the corrected number percent of prevalence rate of diseases and symptoms of the above diseases into 100 denominator were as follows : foot sore-17.6% , myopia-15.4%, neuralgia-14.9%, anemia-14.2% insomnia-13.2%. 3) The prevalence rate of diseases and symptoms/100 person for the age group of 45 and over was 140.0 cases and the age of 35-39 years was 27.3 cases. 4) The prevalence rate of diseases and symptoms/100 persons by the rotation system of nurses'duty/day were as follows: two shift system rotation-86.7 cases, three shift system rotation-67.9 cases and day duty only was 56.2 cases, 5) The prevalence rate of diseases and symptoms/100 person by the basic nursing education background seemed to be lower occurrence against to the higher education and it was 94.4 cases at the Technical Nursing High School graduates. 6) The prevalence rate of diseases and symptoms/100 persons by the marital status of the nurses were as follows; single-64.8 cases, married-48, 7 cases, and widowed-28.6 cases. II. Relationship Between working Experience and prevalence of the Disease and symptoms. 1) There were no relationship by statistical test between prevalence of eye disease and experience at the eye ward(p〉0.05), skin disease and experience at the dermatology ward (p〉0.05), foot sore and experience at the operating room (p〉0.05), varicose vein and experience at the operating room (p〉0.05), sore finger and experience at the central supply room (p〉0.05), infectious disease and experience at the isolation ward(p〉0.05). 2) There was significant relationship by statistical test between pulmonary tuberculosis and experience at the tuberculosis ward (p〉0.05) prevalence of pulmonary tuberculosis was five times in experienced group than non experienced group.

• Journal of Korean Academy of Nursing Administration
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• v.1 no.2
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• pp.246-267
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• 1995

Recently the request of the patients to participate in the medical courses has been expanding due to the elevated sense of right on the people's health, merchandised medical treatment by mass supply, human right declaration of the patients, generalized medical informations by the mass media and the change of human relation between the medical personnels and the patients. Under these phenomena the patients have been in the thought of solving such accidents only by regulation of the laws which they think to be all powerful, Such trends are same in the area of nursing service. Also today the accident by the nurses have been increasing by the area of the nurses having been expanded and their independent roles having been increased. Such nursing accidents are the important subject which the professional occupation of the nurse has been facing but legal protective capability of the nurses has been very weak. Therefore this study has examined the degree of the experience of the nursing accident that happens in the clinical nursing scenes in the general hospital to provide the basic materials for the protection and the counter measures of the nursing accident. The following is the conclusion based by the above examination. 1) The experience degree of the whole nursing accidents has been appeared as 1.90 in average. And the degree according to service area has been 1.77 in the area of supervising management of patients, 1.54 in the area of the same management of patients by head-nurses, 1.84 in the area of doctors' treatment performances, 14 in the enforcement and education areas of the nursing technology, 2.04 in the area of observing patients and judgement and 2.07 in the area of nursing records and maintaining confidentials. Accordingly there has been higher degree of accidental experiences in the independent service areas of the patients than in the dependent ones directed by the doctors. 2) The perception of the nurses showed that the cause of the nursing accident has been due to the heavy work of the nurses with the 60.4% of the response rate, the highest rate. They report the accident to the head nurse first by 2/3 nurses after accident. And the hour of the accident has been frequently happened regardless of service hours with 48.1% in response rate, the highest rate, and the nursing accident happens in the night more than the daytime with the rate of 37.5% at night while 14. 4% daytime. 3) The nurses are in the perception that the patients are responsible for the accident with 48.2% response rate while 43.9% rate in response showed that it has been caused by many people. They are in the perception that 41.7% when the nursing power was lacking, 46.7% lower recognition of actual state about indivitual patient in the section of technical speciality and 35.8% when the patients were not cooperative and 37.8% when the wards were dirty and in disorder. 4) the attitude of the patients after the various nursing accidents has been violent words in 72.7%, violence in 17.4% and 3.9% in attending the court by the sue of the patient's side(18 nurses). 5) The action of the hospital has been : requesting the submission of the story of the accident in 22.8%, the report of the accidents in 14.4%, thus the written statement disposal was most, 4.5% was the transfer to the other departments when the accident was larger or the patients' guardians protested strongly and 0.6% of the dismissals of the nurses. 6) In regard to the responsiblity of the nurse accidents, 78.9% was the highest rate of supplying the nursing manpowers, 48.4% of mutual cooperation of the medical personnels, 37.2% of strengthening the education for the nurses and hospital facilities reformation in 32.7%. 7) The review of relation between the general characters of the object of the study and the degree of experience of nursing accidents showed the significant differences in ages (F=4.04, p=0.000).

• Journal of Korean Clinical Nursing Research
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• v.19 no.3
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• pp.321-332
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• 2013

Purpose: Korean health insurance extended application of the Diagnosis Related Groups (DRG) payment system to tertiary and general hospitals from July, 2013. This study was done to develop a DRG fee adjustment mechanism applied to levels of nurse staffing to assure quality nursing service. Methods: Nurse stafffing grades among hospitals in Korea were analyzed. Differences and ratio of inpatient costs by nurse staffing grades in DRG fees and differences of DRG fee between tertiary and general hospitals were compared. Results: In 2013, nurse staffing grades in tertiary and general hospitals had improved, but other hospital nurse staffing grades remained at the 2001 level. Gaps of inpatient costs between first and seventh nurse staffing grades were over 10% in 4 out of 7 DRG diagnosis; However differences of DRG fee between tertiary and general hospitals were only 4.51% and 4.72% respectively. A DRG fee adjustment mechanism was developed that included nurse staffing grades and hospitalization days as factors of the formula. Conclusion: Current DRG fees motivate hospitals to decrease nurse staffing grades because cost reduction is bigger than compensation. This DRG fee adjustment mechanism reflects nurse staffing supply to motivate hospitals to hire more nurses as a reasonable compensation system.