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Original Article

Policy Issues and New Direction for Comprehensive Nursing Service in the National Health Insurance

Journal of Korean Academy of Nursing Administration 2017;23(3):312-322.
Published online: June 30, 2017

1College of Nursing · Research Institute of Nursing Science, Seoul National University, Korea.

2Department of Nursing, Kyungbok University, Korea.

3College of Nursing, Seoul National University, Korea.

4Division of Nursing · Research Institute of Nursing Science, Hallym University, Korea.

Corresponding author: Lee, Eunhee. Division of Nursing · Research Institute of Nursing Science, Hallym University, 1 Hallymdaehak-gil, Chuncheon 24252, Korea. Tel: +82-33-248-2727, Fax: +82-33-248-2734, ehlee@hallym.ac.kr
• Received: April 20, 2017   • Revised: May 29, 2017   • Accepted: June 16, 2017

Copyright © 2017 Korean Academy of Nursing Administration

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • 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.

This work was supported by Mid-career Researcher Program through the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIP) (No. 2016R1A2B4015298).

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Table 1

Location, Type and Subjects in Research on Comprehensive Nursing Service

jkana-23-312-i001.jpg

*Two organizational reports were evaluated both patients'and nurses' outcomes.

Table 2

Trends for Comprehensive Nursing Service Pilots from 2013 to 2016

jkana-23-312-i002.jpg

Source: National Health Insurance Service (2016).

Table 3

Distribution of Comprehensive Nursing Service in 2016

jkana-23-312-i003.jpg

Source: National Health Insurance Service (2016).

Table 4

Criteria for Nurse Staffing Levels

jkana-23-312-i004.jpg

Source: National Health Insurance Service (2016).

Table 5

Research Results by Structure, Process, and Outcome

jkana-23-312-i005.jpg

NHPPD=Nursing hours per patient day; RN=Registered nurse; OR=Odds ratio; LOS=Length of stay.

Figure & Data

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    Policy Issues and New Direction for Comprehensive Nursing Service in the National Health Insurance
    Policy Issues and New Direction for Comprehensive Nursing Service in the National Health Insurance

    Location, Type and Subjects in Research on Comprehensive Nursing Service

    *Two organizational reports were evaluated both patients'and nurses' outcomes.

    Trends for Comprehensive Nursing Service Pilots from 2013 to 2016

    Source: National Health Insurance Service (2016).

    Distribution of Comprehensive Nursing Service in 2016

    Source: National Health Insurance Service (2016).

    Criteria for Nurse Staffing Levels

    Source: National Health Insurance Service (2016).

    Research Results by Structure, Process, and Outcome

    NHPPD=Nursing hours per patient day; RN=Registered nurse; OR=Odds ratio; LOS=Length of stay.

    Table 1 Location, Type and Subjects in Research on Comprehensive Nursing Service

    *Two organizational reports were evaluated both patients'and nurses' outcomes.

    Table 2 Trends for Comprehensive Nursing Service Pilots from 2013 to 2016

    Source: National Health Insurance Service (2016).

    Table 3 Distribution of Comprehensive Nursing Service in 2016

    Source: National Health Insurance Service (2016).

    Table 4 Criteria for Nurse Staffing Levels

    Source: National Health Insurance Service (2016).

    Table 5 Research Results by Structure, Process, and Outcome

    NHPPD=Nursing hours per patient day; RN=Registered nurse; OR=Odds ratio; LOS=Length of stay.

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