Journal of Korean Academy of Nursing (대한간호학회지)

Korean Society of Nursing Science (한국간호과학회)
권호 표지

Analysis of Direct Nursing Activity and Patient Outcomes Related to Graded Fee of Nursing Management for Inpatient

입원환자 간호관리료 차등제에 따른 직접간호활동 및 환자결과 비교

  • 박성희 (건강보험심사평가원 조사연구실)
  • Published : 2003.02.01
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: The purpose of this study is to examine the difference of direct nursing activity and patient outcomes as mortality rate, complication rate, readmission rate and length of stay related to graded fee of nursing management for inpatient. Method: The subjects of this study were 44 general hospitals with more than 500 beds. Data totaled to 86,044 claims provided to inpatients in Jan. 2001 requested by an electronic data interchange from a Health Insurance Review Agency. The data was analyzed by SPSS win(ver.10.0) and statistical methods used were frequency, one-way ANOVA, $X^2$-Test and regression. Result: Synthetic judgment through performance index and 95% confidence interval, direct nursing activity showed to provided adequate quality of nursing care on 2nd, 3rd, 4th and 6th nursing degree. Also, patient outcomes showed difference by graded fee of nursing management for inpatient. Mortality rate of 2nd was the lowest with P.I. 67.9, 3rd, 5th, 6th, 4th in order. In case of complication rate, 2nd, 3rd and 4th were lower than other nursing degree. Readmission rate of 4th and 5th was the lowest. Length of stay of 2nd was the shortest with P.I. 88.3, 3rd, 4th, 5th, 4th, 6th in order. Conclusion: The findings from this study showed that, the higher nurse-to-patient ratio, the greater amount of direct nursing care activity for the patient. Also, the more direct nursing activities influenced a lower mortality rate, complication rate and readmission rate, shorter length of stay.

Keywords

References

  1. Benzon, J., Echevarria, K. H., & Smith, G. B. (1999). Nursing outcome indicator : Preventing falls for elderly people. Outcome Manag Nur Pract, 3(3), 112-116
  2. Blegen, M. A., Goode, C. J., & Reed, L. (1998). Nurse staffing and patient outcomes. Nus Res, 47(1), 43-50
  3. Corrigan, J. M., & Martin, J. B. (1992). Characteristics of multiple admissions. JAMA, 62(3), 37-45
  4. DesHamais, S. I., Forthman, M. T., Horna-Lowry, J. M., & Wooster, L. D. (1997). Risk-adjusted quality outcome measures : Indexes for benchmarking rates of mortality, complications, and readmissions. Qual Manag Health Care, 5(2), 80-87
  5. Douglas, D., & Robb, A. (1995). Clarifying outcomes in clinical practice. Nurs Stand, 9(24), 29-3
  6. Epstein, A. M., Bogen, J. Dreyer, P., & Thorpe, K. E. (1991). Trends in length of stay and rates readmission in Massachusetts : Implications for monitoring quality of care. Inquiry, 28(1), 19-2
  7. Gordon, S. (1997). What nurses stand for. The Atlantic Monthly, 279(2), 80-88
  8. Green, J., & Wintfield, N. (1995). Report cards on cardiac surgeon. N Engl J Medi, 332, 1229-1232 https://doi.org/10.1056/NEJM199505043321812
  9. Grimaldi, P. L. (1997). Report cards can improve choice. Nurs Manage, 28(5), 26-29
  10. Hollway, J. J., & Thomas, J. W. (1989). Factors influencing readmission risk : Implications for quality monitoring. Health Care Finane Rev, 11, 19-32
  11. Huston, C. J. (1999). Outcomes Measurement in Health care : New imperatives for professional nursing practice. Nurs Case Manag, 4(4), 188
  12. Iezzoni, L. I. (1994). Risk Acijustment for Measuring Health Care Outcomes. Michigan : Health Administrative Press. Ann Arbor
  13. lezzoni, L. I., Ash, A. S., Schwartz, M., & Mackieman, Y, D. (1997). Differences in procedure use, in-hospital mortality, and illness severity by gender for acute myocardial infarctionpatients : Are answers affected by data source and severity measure? Med Care, 35(1), 158-171
  14. Jennings, B. M. (1991). Patient outcomes research: Seizing the opportunity. Adv Nurs Sci, 14(2), 59-72
  15. Korea National Statistical Office. (1993). Korean standard classification of disease
  16. Kwon, Y. D. (1998). Severity-adjusted mortality coronary artery bypass graft surgery in Unpublished doctoral dissertation, Seoul National University. Seoul, Korea
  17. Lang, N. M., & Marek, K. D. (1990). The classification of patient outcomes. J Prof Nurs, 6, 153-163
  18. Ludke, R. L., Booth, B. M., & Lewis-Beck, J. A. (1993). Relationship between early readmission and hospital quality of care indicators. Inquiry, 30(1), 95-103
  19. Maas, M. L., Johnson, M., & Moorhead, S. (1996). Classifying nursing-sensitive patient outcomes. J Nurs Scholarsh, 28(4), 295-301
  20. Marek, K. D. (1989). Outcome measurement in nursing. J Nur Qual Assur, 4(1), 1-9
  21. Micek, W. T., Berry, L., Gilski, D., Kallenbach, A., Link, D., & Scharer, K. (1996). Patient outcomes : The link between nursing diagnoses and interventions. J Nurs Adm, 26(11), 29-35
  22. Ministry of Health and Welfare (1999). Medical fees of Health insurance in Korea
  23. Park, C. J., & Lee, K. H. (1994). A Study on the perception Level of Nursing Activities of Staffing the Nursing Unit. J Korean Acad of Fund Nurs, 1(2)
  24. Park. J. H., & Song, M. S. (1990). Determination of Nursing Costs for Hospitalized Patients Based on the Patient Classification System. J Korean Acad Nurs, 20(1), 16-37
  25. Simpson, R. L. (1997). The nursing management minimum data set initiative needs you!. Nurs Manage, 28(6), 20-21
  26. Thomas, J. W., & Holloway, J. J. (1991). Investigating early readmission as an indicator for quality of care studies. Med Care, 29(4), 377-394