잠시만 기다려 주세요. 로딩중입니다.

적정 간호인력 등급별 입원료 추정 모델을 이용한 간호관리료 차등제 정책개선 재정부담 추계

Financial Projection of the Nursing Fee Differentiation Policy Improvement Proposal in the National Health Insurance: Using a Break-even Analysis Model for the Optimal Nursing Fee

간호행정학회지 2013년 19권 5호 p.565 ~ 577
김성재, 김진현,
소속 상세정보
김성재 ( Kim Sung-Jae ) - 서울대학교 간호대학
김진현 ( Kim Jin-Hyun ) - 서울대학교 간호대학

Abstract


Purpose: This study was done to propose an improvement in the Nursing Fee Differentiation Policy to alleviate polarization of nursing staffing level among hospitals and to rectify the confusion of legally mandated standards between the Korean Medical Law and National Health Insurance Act.

Methods: The policy regulation was reconstructed related to nurse staffing standards and nurse-to-patients ratios. Data on nurse staffing grades were obtained from database of the Health Insurance Review & Assessment Service (HIRA) for the third quarter of 2010 for 44 tertiary hospitals, 274 general hospitals, and 1,262 hospitals. A break-even analysis was used to estimate financial burden of the revised policy improvement proposal. An industrial engineering method was used to calculate Nurse-to-Patients ratios per shift.

Results: Twelve tertiary hospitals were downgraded. 74 general hospitals and 102 hospitals were upgraded after application of the regulation. Finances for total hospitalization expenditures changed from -3.55% to +3.14%.

Conclusion: The results indicate that the proposed policy would decrease polarization between tertiary hospitals and small hospitals, and would not put a major strain on the finances of the Korean National Health Insurance. Therefore, it is suggested that government stake-holders and many interest groups consider this policy proposal and build a consensus.

키워드

입원료; 간호사 확보수준; 간호사수 대 환자수 비; 경영수지분석; 간호관리료 차등제
Hospital charges; Nursing staff; Nurse-patient relations; Financial management; Nursing administration research

원문 및 링크아웃 정보

  

등재저널 정보

KCI
KoreaMed