| Jinhyun Kim | 15 Articles |
Purpose
This study aimed to identify changes in the regional distribution of nurses from 2011 to 2020 and to measure the degree of geographic inequality in the distribution of nurses. Methods National statistics from 2011 to 2020 were used to analyze the distribution of practicing nurses and nursing graduates by region. The degree of geographic inequality in these distributions was measured using the Gini coefficient. Results Between 2011 and 2020, the number of nursing graduates increased significantly in the non-capital regions and medically underserved areas. However, non-capital regions observed a smaller increase in the number of practicing nurses than in the number of nursing graduates produced, while capital regions experienced a larger increase in the number of practicing nurses than in the number of nursing graduates produced. Furthermore, the degree of geographic inequality in the distribution of practicing nurses worsened between 2011 and 2020. Conclusion Effective policies to prevent the outflow of rural nurses are necessary to mitigate geographical inequality in the distribution of nurses.
Purpose
To estimate the number of practicing nurses required to resolve staffing differences between capital and non-capital regions and analyze the relationship between regional differences in staffing and salary. Methods Using public data on population, patients, newly licensed nurses, practicing nurses, and annual salaries, regional differences were analyzed in newly licensed nurses per population, practicing nurses per population, practicing nurses per patient (i.e., staffing level), and salary. The number of additionally required practicing nurses was estimated by multiplying staffing differences by the number of patients in the lower-staffed region. Results During 2002~2022, 71,107 and 243,611 newly licensed nurses were supplied, while the number of practicing nurses increased by 91,886 and 88,070 in the capital and non-capital regions, respectively. The non-capital region had more practicing nurses per population, whereas the capital region had more practicing nurses per patient. In 2020, 31,330 practicing nurses were additionally required in the non-capital region. Salaries were higher in the capital region, and regional salary differences increased during 2011~2020. Regional salary differences were associated with regional staffing differences and the number of additionally required practicing nurses. Conclusion Government and health insurance policies are required to encourage hospitals in the non-capital region to improve staffing and salaries. Citations Citations to this article as recorded by
Purpose
This study aims to propose revised inpatient nursing fee schedules that address three discrepancies between actual nurse staffing levels in general wards and the corresponding patient payment structures. Methods A total of 45 tertiary hospitals, 329 general hospitals, and 1,379 hospitals from publicly released data for 2021~2022 were analyzed. This analysis focused on three primary discrepancies between (1) the staffing grades under which patients were hospitalized and the corresponding grades for which they were charged; (2) the staffing grades determined by bed-to-nurse and patient-to-nurse criteria; and (3) the current differentiation rates of nursing fees and the expected differentiation rates based on the number of nurses required for each grade. Results The first discrepancy occurred in 8.9% of tertiary hospitals, 21.0% of general hospitals, and 26.0% of hospitals. The bed-to-nurse and patient-to-nurse grades differed by 2.23 and 2.29 grades on average in general hospitals and hospitals, respectively. The current differentiation rates were higher than the expected differentiation rates. New nursing fee schedules were suggested to resolve those discrepancies. Conclusion Nursing fees should be charged to reflect the staffing levels under which patients were cared for and proportionate to the number of nurses required to provide the corresponding staffing levels.
Purpose
This study aimed to estimate the unmet demand for INCS and the number of needed beds for fulfillment. Methods: Annual data from the Korea Health Panel (2015~2018), Health Insurance Statistical Yearbook (2015~ 2019), and published statistical data (2015~2019) were used. To measure the unmet demand, the utilization of informal nursing care services, which can be a market substitute for INCS, was used. The number of needed beds was calculated by dividing the demand by the bed occupancy rate multiplied by 365 days. Results: The unmet demand decreased every year and was estimated to be 31~47 million person-day as of 2019. It was the highest in Gyeonggi (6~8 million) and the lowest in Jeju (160~220 thousand), while the fulfilled rate was the highest in Incheon (52~61%) and the lowest in Jeonbuk (6~8%). For each type, general hospitals showed the highest unmet demand (6~10 million), followed by hospitals (5~8 million) and tertiary hospitals (4~7 million). Gyeonggi province (37,212~48,882) and general hospitals (54,955~70,962) were most needed additional INCS beds. Conclusion: Tailored bed expansion strategies are necessary to satisfy each region's and hospital’s demand. Considering the multi-layered causes of unmet demand, a healthcare system reform that increases the regional self-sufficiency of INCS is required. Citations Citations to this article as recorded by
PURPOSE
The purpose of this study was to identify the current issues concerning a mutual recognition agreement (MRA) for nursing professionals, and to suggest policy alternatives in South Korea. METHODS The study was conducted through a literature review. RESULTS The nursing MRA was signed by the European Union, the Association of Southeast Asian Nations, Australia-New Zealand, India-Singapore, and the Caribbean Community. The United States and Japan have not concluded a nursing MRA with other countries, but they have lowered the entry barriers for foreign nurses from certain countries. In order to prepare for a nursing MRA with developed countries such as the United States, Canada and Australia, it is necessary to establish international standards for nursing and to build a verification system for the qualifications of foreign nurses. In addition, there is a need to establish an independent professional licensing authority that assumes responsibility for all the tasks regarding a nursing license. CONCLUSION The findings of this study can be used as basic data for the preparation of a nursing MRA, and can contribute to the establishment of policies for foreign nurses.
PURPOSE
This study was done to estimate supply and demand for nursing workforce to provide community-based primary healthcare in the North Korean region to cost-efficiently narrow the health gap between the two Koreas in case of a Korean reunification. METHODS To understand the nursing education system and current state of nursing workforce in North Korea, the authors interviewed six North Korean defectors who had worked as nurses in North Korea. Based on the interview results and literature review, the supply and demand for the primary healthcare nursing workforce that would be needed after Korean reunification were estimated RESULTS: Currently, a total of 2,100 to 2,700 North Korean nurses were estimated to have graduated from nursing schools with a 2 year curriculum or completed 6-month military nurse training courses every year. The projected number of nurses in demand to provide primary health care ranged from 84,160 to 105,200 and the shortage would be between 31,586 and 52,626. CONCLUSION An active utilization of the North Korean nursing workforce to improve the health of North Koreans after reunification will be the best way to reduce the reunification cost which will be inflicted mainly on South Korea. Citations Citations to this article as recorded by
PURPOSE
This study was done to evaluate the adequacy of nurse staffing in integrated nursing care. METHODS Statistical data on integrated nursing care from the National Health Insurance Corporation was used in this study. We extracted hospital data and patient data related to patient needs for nursing care. We analyzed the differences in patient needs by staffing level of each type of medical institution. RESULTS Approximately 70% of medical institutions provided nursing care by the mid level of nurse staffing, which was 1:6, 1:10 and 1:12 in the tertiary hospital, general hospital and semi-hospital, respectively. The patients' characteristics were significantly different by hospital type. Especially, the distribution of the main diagnosis was completely different between the tertiary hospital and semi-hospital. In the tertiary hospital, the patient needs measured by severity and activities of daily living dependency were higher at higher staffing level than at lower staffing level. However, the nurse staffing was less relevant to the patient needs in the general hospital and semi-hospital. CONCLUSION To provide high-quality nursing care, accurate workload forecasting is required at the start, and then the standard nurse staffing level can established based on workload forecasting. Citations Citations to this article as recorded by
PURPOSE
This study was done to identify issues surrounding comprehensive nursing care within the national health insurance, analyze results and problems within national health insurance and to suggest new policy directions for stability. METHODS A literature search was performed using RISS, KISS, PUBMED databases. Eighteen studies were analyzed. RESULTS For implementation of comprehensive nursing care, there was improvement in nursing and in facilities. By improvement of structure, this new system showed positive outcomes in term of patient satisfaction and indicators related to patient safety. However, issues related to overload, job stress and evaluation of the system remain. In order to establish this system, staffing levels for nurses and nurse aids need to be adjusted to appropriate levels that reflect requirements for nursing. In addition, range of work needs to be determined clearly. Lastly, regular and systematic evaluation is needed to provide safe quality services to patients and to prevent waste of financial resources. CONCLUSION Comprehensive nursing care needs to be implemented in ways that patients can be provided with safe and high quality service. There is a need to resolve several issues to allow this new system to function. Citations Citations to this article as recorded by
PURPOSE
The purpose of this study was to explore the experiences of clinical nurses over 40 years of age who were shift workers. METHODS Data were collected from in-depth interviews with 10 clinical nurses over 40 years of age who had at least 10 years of clinical experience and who worked in 5 acute care hospitals. The data were analyzed using Braun & Clark's thematic analysis. RESULTS One main theme, 3 themes, and 9 subthemes were derived. The main theme was "Sustaining a position still in conflict", and themes were as follows; "Being trained as a professional nurse", "Having unfavorable working conditions and damaged self-esteem", "Trying hard to get a sense of value as an experienced nurse" CONCLUSION: The results of this study show the issues of age and generational diversities in nurses in acute care hospitals. It is necessary to explore various ways to utilize the experience of older clinical nurses for the integrity of nursing organization and the development of the nursing profession. Citations Citations to this article as recorded by
PURPOSE
This study was done to identify determinants of registered nurse (RN) skill mix and staffing level focused on hospital characteristics. METHODS Data were obtained from health insurance claims data and hospital reporting system in the Health Insurance Review and Assessment Service (HIRA) for the year 2010. Data from 2,998 hospitals were analysed using t-test, ANOVA, Pearson correlation, and regression analysis. RESULTS The RN skill mix and staffing level were positively related to hospital size and the percentage of inpatients to total patients. RN skill mix and staffing level were statistically different across regions. Including nursing aides (NA), however, there was no difference in staffing levels across regions. Medically vulnerable regions, bed operation rate, and the number of patients per doctor were also related to RN skill mix and staffing level. CONCLUSION The statically significant determinants of RN skill mix and staffing level included hospital size, region, bed operation rate, percentage of inpatients, doctor-patient ratio. Further study needs to be done to investigate factors including RN supply and wages. Citations Citations to this article as recorded by
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. Citations Citations to this article as recorded by
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. Citations Citations to this article as recorded by
PURPOSE
The purpose of this study was to explore the current status of education for nursing management in Korea. METHODS A descriptive study was done using a questionnaire developed by the investigators. The data were collected by survey from 96 out of 129 nursing schools, between December 2010 and February 2011. RESULTS For 22.9% of nursing schools, there was no faculty for nursing management. The credits and subjects included in nursing management varied among the nursing schools. Lectures in subjects related to nursing management were given not only by nursing management faculty but also by faculty with other majors. There were more faculty and credits for nursing management courses in 4-year nursing schools than in 3-year schools. CONCLUSION To improve the quality of education in nursing management, there is a need to standardized courses and provide nursing faculty who have majored in nursing management. Citations Citations to this article as recorded by
PURPOSE
The purpose of this study was to identify the major trends of research in the Journal of Korean Nursing Administration from 2007 to 2009. METHOD Research designs, participants, research domains, and key words were analyzed from the Journal of Korean Nursing Administration. RESULTS Job satisfaction, organizational commitment, job stress, turnover intention, nursing performance, self-efficiency, leadership, empowerment, nursing informatics, and quality control were the major key words commonly listed in the journal articles. Of the research in the Nursing Administration Journal, quantitative methods were used in 94.5% of the research studies and qualitative methods in only 5.5%. The major participants in the research were nurses, nurse managers, and patients. Statistical methods like ANOVA, correlation, t-test, regression, chi-square test, LISREL were the dominant method of analysis used in the research. The primary domains in the journal articles were directing, organizing, control, planning, and informatics. CONCLUSION Through this study, the trend of research in nursing administration can be identified. We recommend that collaboration, nurse work environment, evidence-based practice, scheduling, coaching, patient falls and safety, and positive culture should be included as topics for the future research. Citations Citations to this article as recorded by
PURPOSE
The purpose of this study was to compare the costs and benefits of home nursing care services between public health centers (PHC) and private hospitals. METHOD Participants were 105 patients who had received home nursing care services from a private hospital or public health center. From a societal perspective, the researcher identified the costs and benefits of the services using performance data and calculated the net benefit and benefit/cost ratio. RESULT The net benefit of the home nursing care service based in the PHC was 165.9 million won and benefit/cost ratio was 2.0, while the net benefit of the home nursing care services by the private hospital was 141.1 million won and benefit/cost ratio was 1.7. Both types of programs were economically validated. CONCLUSION Home nursing care services were basically efficient as the results showed a positive net benefit. A cost-benefit analysis indicated that the PHC-based home nursing care services were more efficient than that of the private hospital. With limited human resources and management standards in public health centers, results suggest the need for a more systematic management of the home nursing care service to improve the health of this vulnerable community population. Citations Citations to this article as recorded by
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