• 간호행정학회지
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• 제8권1호
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• pp.17-29
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• 2002

The purpose of this study was to examine the application of the Activity-based Costing(ABC) system to analyze the cost of nursing services in the delivery room in a major medical center.The results of this study are as follows;1. In order to calculate the cost of nursing activities, 67 activities of staff nurses on a delivery room were identified and classified as direct nursing activities(45.2%), the indirect activities(32.1%), general management activities(13.9%) and others(8.8%).2. Nursing cost in the delivery room was classified into activity cost(29.9%) and common cost(70.1%). Activity cost involved direct activity cost of staff nurses. The common costs were categorized into indirect activity & general management cost of staff nurses, management cost of the head nurse and activity cost of assistants.3. The final cost objects of nursing services in the delivery room were nursing service for women who had normal vaginal deliveries and nursing service for women who had preterm labor.The total cost of nursing service for a woman who had a normal vaginal delivery was 165,710 won (100.0%). The cost incurred through direct activity cost of staff nurses(58,242 won, 35.1%), indirect activity & general management cost of staff nurses (55,643 won, 33.6%), management cost of head nurse (16,211 won, 9.8%), activity cost of assistants (35,614 won, 21.5%).If the number of days of hospitalization was presumed to be 14 days, the total cost of nursing service for woman who had preterm labor would be 1,845,901 won (100.0%). The cost incurred by direct activity cost of staff nurses in the activity cost (341,349 won, 18.5%), indirect activity & general management cost of staff nurses in the common cost(779,002 won, 42.2%), management cost of head nurse(226,954won, 12.3%), activity cost of assistants in the common cost(498,596 won, 27.0%).In this study, the cost of the nursing services in the delivery room was calculated based on the ABC system. The results of this study showed that resources are assigned to the nursing activities in the delivery room and the mechanisms for assigning the cost of activities for nursing services.

• 가정∙방문간호학회지
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• 제7권1호
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• pp.26-38
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• 2000

The purpose of this study was to estimate home care nursing cost for the patient with Cerebrovascular Disease based on a bundle of home care nursing services This study was conducted through four steps. The first step was to investigate home care nursing activities that were offered to the patient with Cerebrovascular Disease(CD) by home care nurse. The second step was to investigate the time spent on home care nursing service and to calculate labor and manufacturing cost. The third step was to calculate home care nursing cost per minute. And at the fourth step, home care nursing cost for a patient with Cerebrovascular Disease based on a bundle of home care nursing service was calculated. The results of the study were as follows: 1) The number of direct home care nursing activities for the patient with CD was 108, and the time of each activity was spent from 1 to 10 minutes. 2) Average time per visit was 51 minute, and the firs visit time were spent 1.6 times higher than 2nd visit time. 3) Nursing cost per minute(cost per visit ${\\}\;22,565\;\div\;$ average time per visit 51 minutes) was ${\\}\;442$. The cost per visit was calculated on Basic visiting cost(nurse's labor cost ${\\}\;15,760$ + management cost ${\\}\;6,805$) divided by average time per visit(51 minutes). 4) Home care nursing cost to the patient with CD based on bundle of home care nursing service was consisted of basic home care nursing cost, the cost of a bundle of service practiced on visit. and transportation fee. Basic home nursing cost(the time spent on basic home nursing service 20 minutes ${\times}$ nursing cost per minute ${\\}\;442$) was ${\\}\;8,840$. The cost of the bundle of home care nursing services to the patient with CD was calculated as self care ${\\}\;2.898$, Tracheostomy care ${\\}\;10,166$, immobility care ${\\}\;6,188$, sore care ${\\}\;6,188$. Foley care ${\\}\;6,630$, and Levin tube or Gastrostomy care ${\\}\;7.514$. Transportation fee which was composed of the labor cost for transportation(${\\}\;5,122$) and the car management cost(${\\}\;3.876$) was ${\\}\;8,998$. Home care nursing cost to the patient with CD based on bundle of home care nursing services consisted of basic home care nursing cost, the cost of a bundle of service practiced on visit, and transportation fee. It will contribute to improve quality of home care service, because of giving appreciate incentives to home care nurses. And it will be more efficient than current cost of hospital based home care. But it need to management than calculation of the current fee-for-services of home care.

• 한국보건간호학회지
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• 제3권2호
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• pp.5-46
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• 1989

The current medical payment Insurance Rates in Korea stipulate charges for medical treatment by the doctor, pharmaceutist, medical technician and maternity nurse. But unfortunately didn't specify those charges for nursing done by the professional nurse. Only basic nursing fee is accounted insufficiently in current medical insurance fee schedule. therefore, Being face with covering entire people by medical insurance by 1991, It seems that the problems pertaining to operating the hospital and medical insurance system would be incessantly expanded in that no mention is made of medical charges rendered by major medical producer service in the current system, For that reason, this study made an attempt to clarify the importance the professional nursing puts of the current medical payment. The purpose of this study was to accounting nursing fee which diveded into the current medical fee schedule. (Method) 1. Data collection; Importance and difficulties in nursing activities was conducted in 'S' National University Hospital. Total nursing activities were selected 72 items which included direct care and indirect care. This study was conducted to evaluating the degree of importance and difficulties according to nursing activities through questionnaire to 204 RN. and so relative difficulties (acuity) were computered because the nursing cost level of each nursing service was differently established by the equivalent coefficient according to degree of relative difficulty and time required. 2. Calculation of cost according to nursing activities; After 47 nursing activities were selected in General surgery nursing units, calculation of nursing cost was as follows Cost of Nursing activity = (relative difficulty X Average hourly wage and benefits of nurse) + material cost of nursing -t- Average nursing administration cost So, Calculated cost by nursing activities was compared to current non-insured and insurance rate. 3. Calculation of nursing cost by K - DRG ; Total of 578 patients who were hospitalized in General Surgery units from January to March 1988 ware classified by K - DRG After estimation of total nursing cost based on the K-DRG, verified the appropriateness of basic nursing fee in medical insurance rate (Results) 1. Analysis of degree of importance and difficulties were 4.16 and 3.67 based on 5 point scale. This score were judged that it is worthy specifying the nursing fee 2. The nursing cost of 47 nursing service items in general surgery patients showed that the average cost of nursing activity was \1374.5 and The lowest cost was \217 of 'oral administration nursing' item, The highest cost was \11,025 of 'saline enematill clear' item 3. The result of comparison between the calculated cost by nursing activities against the current non-insured and insurance rate showed that 13 items(27.7%) involved to payment of insurance rate, 9 items(19.1%) involved to non-insured rate, remainder 25 items (53.2%) were not charged anywhere of total 47 nursing activities 4. When calculated cost by nursing activities was 100. current insurance rate was 62.3, non-insured rate was 176.6. Therefore this showed that most of non-insured rate were higher than calculated nursing cost. The insurance rate, however, were lower than it. Reim-bursement was imputed to non-insured patients. So the current rate system became estrainged from cost system. When Remainder 25 items of nursing activities compared' to \1390 of daily basic nursing fee per patient belonged to payment as a insurance fee schedule, basic nursing fee schedule was 1-2% of calculated cost of nursing activities. Therefore it showed that nursing fee was not counted adequately in it. 5. Nursing cost by K-DRG estimated in chart review based on counting number of nursing activities and length of stay The result showed that average amount of total nursing cost was \183828.1 Comparison of nursing cost calculated by K- DRG and basic nursing fee schedule showed that only 12.3% of nursing cost was charged (Conclusion) From the above research result, It is fact that nursing prime cost should be estimated more accurately and included adequately in current medical payment system. The payment system of nursing activities should be introduced not only nursing activities of drug administration and injection fee belonged to insurance fee schedule but also most nursing activities belonged not to mekical fee schedule. Even if introducing payment system of nursing activities, It should be estimated scientific method of Accounting nursing cost So nurses could offer nursing care of good quality, thereby they could make a great contribution not merely to the convalescence of the patient but to the promotion of the people's health.

• 간호행정학회지
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• 제23권2호
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• pp.139-150
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• 2017

Purpose: The purpose of this study was to identify nursing service costs associated with all health care costs incurred by the institution. Methods: This study was an empirical case study research in which the nursing cost was separated from total medical cost. The nursing cost index was calculated through a cost allocation method after summarizing costs for personnel, raw materials and administration of each department in one public hospital. The 2014 budget plan, published in 'Public Hospitals Alert', was used as data and the data were analyzed using the Microsoft Office EXCEL 2013 program. Results: When comparing total medical costs and nursing costs, the nursing cost were 27.14% of the total medical cost. The nursing cost per nurse per hour was calculated as \29,128 The nursing cost per inpatient per day was calculated as \157,970, and the administration cost per patient was calculated as \133,710. Conclusion: The results of the research present the process of cost allocation of specific cost elements in the hospital and evidence for administrative costs which in the past have been only vaguely formulated. These are the significant implications of this study.

• 간호행정학회지
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• 제9권1호
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• pp.113-128
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• 2003

Purpose : The aim of this study is to review cost analysis methodological issues in the nursing literature. Method : The subjects of this study were articles published in Korea from 1961 to August, 2002. They were searched by key words 'cost' and 'nursing' from various DB(National Assembly Library, The National Library of Korea, RICH etc). Finally, 31 articles were collected. Results : 1) The major type of cost analysis was a cost comparison study. 2) The important methodological weaknesses were as followers: First, many studies did not describe a cost analysis framework or a cost analysis assumption. Second, a few studies described selection criteria of cost items and effectiveness items. Third, many studies did not do a sensitivity analysis. Conclusion : With these results, it will be possible to develop a more proper cost analysis methodological framework and also to make an evaluation criteria for cost analysis nursing study.

• 가정∙방문간호학회지
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• 제6권
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• pp.19-32
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• 1999

The purpose of this study was to develop of home nursing care classification and home health care costs of the free-standing home nursing care agency. This study was done through 3 steps The First stage, home nursing care classification was identified and classified by literature, review-committee and expert meeting. The second stage, cost elements for home nursing care visit were identified and accounted. That were divided into direct nursing care cost, indirect nursing care cost, management cost and transportation cost. Third stage, total cost of per visit was produced. Data were collected from 810 visits of 120 patients received home dare and from January. 1999 to November, 1999, and analysed with EXCEL program. The obtained results are as follows : 1. Home nursing care classification was consisted of 6 high level classification domain and 10 low level classification domain and 163 home nursing care behavior. 2. The cost of home nursing care per visit was 30,638 won which were direct and indirect nursing care cost(16.305won), management cost(5,255won) and transportation cost (9,098won). In conclusion. Home nursing behavior care classification developed in this study would be used as home health care standard. And the home nursing care costs can be used as a fundamental data for the further development of home health care costs in Korea.

• 임상간호연구
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• 제18권2호
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• pp.183-195
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• 2012

Purpose: This study was performed to identify the variations of nursing care cost depending on nursing care requirement and calculate nursing care cost per one day and one care requirement point. Methods: Nursing care requirement was measured by classifying 3,855 patients according to KPCS-1(Korean Patient Classification System for nurses-1). Nursing care cost was calculated from personnel expenses and nursing care requirement. Nursing cost factors were identified by multiple regression analysis. Results: Average nursing cost per patient per day was 33,588 won, Average nursing care cost per 1 patient classification score was 3,558 won. The nursing cost per 1 patient classification score was different depending on the types and levels of the hospitals. The 4th patient classification group revealed the highest nursing care cost. Nursing cost factors included the number of beds in the hospitals, seniority, number of nurses and first grade in nurse personnel accreditation ($adj-R^2$ 74.0%. p<.05). Conclusion: Nursing care requirements expressed by patient classification scores don't directly correlate with nursing care cost. Further research is needed to evaluate validity and reliability for refining KPCS-1 and to apply variable criteria to nurse personnel accreditation.

• 대한간호학회지
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• 제38권1호
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• pp.161-171
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• 2008

Purpose: The aim of this study was to analysize net income of a surgical nursing ward in a general hospital. Method: Data collection and analysis was conducted using a performance-based costing and activity-based costing method. Result: Direct nursing activities in the surgical ward were 68, indirect nursing activities were 10. The total cost volume of the surgical ward was calculated at \119,913,334.5. The cost volume of the allocated medical department was \91,588,200.3, and the ward consumed cost was \28,325,134.2. The revenue of the surgical nursing ward was \33,269,925.0. The expense of a surgical nursing ward was \28,325,134.2. Therefore, the net income of a surgical nursing ward was \4,944,790.8. Conclusion: We suggest that to develop a more refined nursing cost calculation model, a standard nursing cost calculation system needs to be developed.

• 간호행정학회지
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• 제16권3호
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• pp.295-305
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• 2010

Purpose: This study was conducted to evaluate the economic efficiency of a community-based nursing care center to help policy makers determine whether or not to invest in similar facilities. Methods: The subjects were 101 elderly people over 65 years who participated in a health management program from February 1 to July 31, 2007. Direct cost was estimated with center operations cost, medical cost for out-patients and pharmacy cost. Indirect cost was measured by transportation cost. Direct benefit was calculated by saved medical cost for out-patients, saved pharmacy cost, saved transportation cost, and reducing hospital charges. Indirect benefit was estimated with prevention of severe complications. Economic efficiency was evaluated by cost-benefit ratio and net benefit. Results: Operating a community-based nursing care center was found to be cost-effective. Specifically, the cost of operating the center evaluated here was estimated at 135 million won while the benefit was estimated at 187 million won. Benefit-cost ratio was 1.38. Conclusion: The Community-based nursing care center that was described here could be a useful health care delivery system for reducing medical expenditures.

• 간호행정학회지
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• 제13권4호
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• pp.407-420
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• 2007

Purpose: The objective of this literature review study was to identify research's trends and methodological issues of cost analysis on nursing services. Methods: Researches which analyzed nursing services cost, were selected from journal articles and master or doctoral dissertation studies. The total numbers of the collected studies were 23. Results: The number of studies on nursing services cost has been increased rapidly since middle-1990. The 5 methodological frameworks to classify the cost analysis researches was found. 4 researches were using the traditional costing method. 6 researches were using the clinical patient classification systems. 4 researches were using the Korean Diagnosis Related Group (KDRG). 5 researches were using the Resource Based Relative Value Scale (RBRVS). 4 researches were using the Activity Based Costing (ABC). Conclusion: These results will be used to provide the basic data for developing a more refined cost analysis method on nursing services. For further studies, we will suggest that the consent criteria of cost items need to measure nursing services be developed and the conducting cost analysis on nursing services be networked a hospital's cost management system.