[논문]상급종합병원과 종합병원 일반병동의 간호관리료 차등제 간호사 배치기준 및 수가체계 개선방안

조성현; 성지영; 정영선; 유선주; 심원희

doi:10.22650/jkcnr.2022.28.2.122

상급종합병원과 종합병원 일반병동의 간호관리료 차등제 간호사 배치기준 및 수가체계 개선방안
Recommendation for the Amendment of Inpatient Nursing Fee Schedules Based on Nurse Staffing Standards in General Wards of Tertiary Hospitals and General Hospitals 원문보기

임상간호연구 = Journal of Korean Clinical Nursing Research, v.28 no.2, 2022년, pp.122 - 136

조성현 (서울대학교 간호대학.간호과학연구소) , 성지영 (서울대학교 간호대학) , 정영선 (서울아산병원) , 유선주 (국립목포대학교 간호학과) , 심원희 (서울대학교병원)

Abstract ▼ AI-Helper

Purpose: This study attempted to recommend a revision of inpatient nursing fees based on analyzing current and appropriate staffing levels. Methods: Staffing grades and their inpatient nursing fees as of the first quarter of 2022 were analyzed. Nurse managers and staff nurses answered surveys about the current and appropriate staffing levels, working days, and monthly salary. A total of 101 nurse managers and 588 staff nurses working in general wards at tertiary hospitals and general hospitals participated in the study. Results: The results showed that grade 1 staffing was found in 73.3% of tertiary hospitals and 63.7% of general hospitals. The current staffing ratios of tertiary hospitals and general hospitals were 1:9.3 and 1:10.4, respectively. The appropriate staffing ratios according to nurse managers and staff nurses at tertiary hospitals were 1:7.6 and 1:7.0, respectively, and 1:8.7 and 1:8.8 in general hospitals, respectively. The average estimated annual working days of staff nurses were 235.2 days in tertiary hospitals and 240.0 days in general hospitals. The median monthly salary for staff nurses was 4.957 million won in tertiary hospitals and 4.140 million won in general hospitals. The new staffing grade system was suggested from 1:6 (Grade 1) to 1:12 (Grade 5). The new inpatient nursing fee schedules were recommended to be paid based on nursing hours per patient day of each grade. Conclusion: The new staffing grade and inpatient nursing fee schedules are expected to increase staffing levels, improve the quality of nursing care, and provide a better work environment for nurses.

주제어

표/그림 (5)

표 Table 1. Distribution of Nurse Staffing Grades and Inpatient Nursing Fees by Staffing Grade and Type of Patient Rooms (N=370)
표 Table 2. Current Nurse Staffing Reported by Nurse Managers and Appropriate Nurse Staffing Based on the Professional Judgment of Nurse Managers and Staff Nurses
표 Table 3. Monthly Working Days, Days of Annual Leave and Sick Leave, and Estimated Annual Working Days
표 Table 4. Estimated Monthly Salary Based on Monthly National Health Insurance Premiums Paid by Nurses
표 Table 5. Recommendation for Amendment of Nurse Staffing Grades, the Minimum Number of Nurses to be Staffed on General Wards, and Inpatient Nursing Fees by Staffing Grade

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