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
The purpose of this study was to examine trends in number of nursing staff and skill mix.
METHODS
Nursing staff and skill mix were measured using the number of nursing staff including nurse aids and registered nurses per bed. Descriptive and panel data regression analyses were conducted using data on long-term care hospitals which included yearly series data from 2006 to 2010 for 119 hospitals.
RESULTS
The number of nursing staff per bed increased significantly but percentage of registered nurses decreased significantly from 2007 to 2010. The regression model explained this variation as much as 35% and 44%.
CONCLUSION
The results showed that in long-term care hospitals there were more nurse aids employed instead of registered nurses after the implemention of differentiated inpatient nursing fees. Thus clarifying the job descriptions for nurses and nurse aids is needed and appropriate hospital incentive policies should be implemented.

Citations

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