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Kim, Kim, Park, Jeong, and Lee: Policy Issues and New Direction for Comprehensive Nursing Service in the National Health Insurance
Original Article

Journal of Korean Academy of Nursing Administration 2017; 23(3): 312-322.

Published online: 30 June 2017

DOI: https://doi.org/10.11111/jkana.2017.23.3.312

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

Jinhyun Kim1, Sungjae Kim2, Euntae Park3, Suyong Jeong3, Eunhee Lee4

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 20 April 2017       Revised 29 May 2017       Accepted 16 June 2017

Copyright © 2017 Korean Academy of Nursing Administration

(open-access):

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.

Abstract

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.

Keywords: Comprehensive nursing care, Nurse staffing, Patient safety, Job satisfaction

Figures and Tables

Table 1

Location, Type and Subjects in Research on Comprehensive Nursing Service

jkana-23-312-i001

*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

Source: National Health Insurance Service (2016).

Table 3

Distribution of Comprehensive Nursing Service in 2016

jkana-23-312-i003

Source: National Health Insurance Service (2016).

Table 4

Criteria for Nurse Staffing Levels

jkana-23-312-i004

Source: National Health Insurance Service (2016).

Table 5

Research Results by Structure, Process, and Outcome

jkana-23-312-i005

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

Notes

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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