Sungjae Kim; Jinhyun Kim

doi:10.4040/jkan.2012.42.3.351

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Original Article
A Proposal to Improve Nursing Fee Differentiation Policy for General Hospitals Using Profitability-Analysis in the National Health Insurance: Sungjae Kim, Jinhyun Kim; Journal of Korean Academy of Nursing 2012;42(3):351-360.
DOI: https://doi.org/10.4040/jkan.2012.42.3.351
Published online: June 29, 2012

¹Doctoral Student, Department of Nursing, Seoul National University & Research Worker, The Research Institute of Nursing Science, Seoul, Republic of Korea.

²Associate professor, Department of Nursing, Seoul National University & Research Worker, The Research Institute of Nursing Science, Seoul, Republic of Korea.

Address reprint requests to: Kim, Jinhyun. College of Nursing, Seoul National University, 28 Yeongeon-dong, Jongro-gu, Seoul 110-744, Republic of Korea. Tel: +82-11-590-7582, Fax: +82-2-747-3948, jinhyun@snu.ac.kr

• Received: October 7, 2011 • Accepted: May 25, 2012

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Abstract
NOTES
REFERENCES

Abstract

Purpose
The purpose of this study was to propose optimal hospitalization fees for nurse staffing levels and to improve the current nursing fee policy.
Methods
A break-even analysis was used to evaluate the impact of a nursing fee policy on hospital's financial performance. Variables considered included the number of beds, bed occupancy rate, annual total patient days, hospitalization fees for nurse staffing levels, the initial annual nurses' salary, and the ratio of overhead costs to nursing labor costs. Data were collected as secondary data from annual reports of the Hospital Nursing Association and national health insurance.
Results
The hospitalization fees according to nurse staffing levels in general hospitals are required to sustain or decrease in grades 1, 2, 3, 4, and 7, and increase in grades 5 and 6. It is suggested that the range between grade 2 and 3 be sustained at the current level, the range between grade 4 and 5 be widen or merged into one, and the range between grade 6 and 7 be divided into several grades.
Conclusion
Readjusting hospitalization fees for nurse staffing level will improve nurse-patient ratio and enhance the quality of nursing care in hospitals. Follow-up studies including tertiary hospitals and small hospitals are recommended.
Keywords: Hospital charges; Nursing staff; Nurse-patient relations; Financial management

This article is a revision of the first author's master's thesis from Seoul National University.

REFERENCES

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Figure 1

A break-even analysis model for the optimal nursing fee scheduling.

Table 1

The Number of General Hospitals, Beds, RNs and Annual Total Patient Days

Data from health insurance medical expenditure in 2009 (Health Insurance Review & Assessment Service, 2009); Data from Hospital Nurses Association in 2009 (Chae et al., 2009).

KRW=Korea Won; RN=Registered nurse.

^*Annual total patient days=beds×utilization rate×365.

Table 2

Break-even Points of Beds-to-RN and Bed Occupancy Rate for Corresponding Grades (Unit: ratio, %)

Table 3

Optimal Hospitalization Fees for Nurse Staffing Levels in General Hospitals (Unit: won)

^*Fee per day=Hospitalization fee per a day=medical management fee(40%)+nursing management fee(25%)+hospital management fee (35%).

Figure & Data

REFERENCES

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A Proposal to Improve Nursing Fee Differentiation Policy for General Hospitals Using Profitability-Analysis in the National Health Insurance

J Korean Acad Nurs. 2012;42(3):351-360. Published online June 29, 2012

DOI: https://doi.org/10.4040/jkan.2012.42.3.351

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A Proposal to Improve Nursing Fee Differentiation Policy for General Hospitals Using Profitability-Analysis in the National Health Insurance

Figure 1 A break-even analysis model for the optimal nursing fee scheduling.

Figure 1

A Proposal to Improve Nursing Fee Differentiation Policy for General Hospitals Using Profitability-Analysis in the National Health Insurance

Table 1

The Number of General Hospitals, Beds, RNs and Annual Total Patient Days

Data from health insurance medical expenditure in 2009 (Health Insurance Review & Assessment Service, 2009); Data from Hospital Nurses Association in 2009 (Chae et al., 2009).

KRW=Korea Won; RN=Registered nurse.

^*Annual total patient days=beds×utilization rate×365.

Table 2

Break-even Points of Beds-to-RN and Bed Occupancy Rate for Corresponding Grades (Unit: ratio, %)

Table 3

Optimal Hospitalization Fees for Nurse Staffing Levels in General Hospitals (Unit: won)

^*Fee per day=Hospitalization fee per a day=medical management fee(40%)+nursing management fee(25%)+hospital management fee (35%).

Table 1 The Number of General Hospitals, Beds, RNs and Annual Total Patient Days

Data from health insurance medical expenditure in 2009 (Health Insurance Review & Assessment Service, 2009); Data from Hospital Nurses Association in 2009 (Chae et al., 2009).

KRW=Korea Won; RN=Registered nurse.

^*Annual total patient days=beds×utilization rate×365.

Table 2 Break-even Points of Beds-to-RN and Bed Occupancy Rate for Corresponding Grades (Unit: ratio, %)

Table 3 Optimal Hospitalization Fees for Nurse Staffing Levels in General Hospitals (Unit: won)

^*Fee per day=Hospitalization fee per a day=medical management fee(40%)+nursing management fee(25%)+hospital management fee (35%).