1.An Analysis of Cost and Profit of a Nursing Unit using Performance-Based Costing: Case of a General Surgical Ward in a General Hospital.
Journal of Korean Academy of Nursing 2008;38(1):161-171
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 won 119,913,334.5. The cost volume of the allocated medical department was won 91,588,200.3, and the ward consumed cost was won 28,325,134.2. The revenue of the surgical nursing ward was won 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 won 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.
Costs and Cost Analysis
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General Surgery/*economics
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Hospitals, General/*economics
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Humans
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Nursing Service, Hospital/*economics
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Task Performance and Analysis
2.Analysis of Cost and Efficiency of a Medical Nursing Unit Using Time-Driven Activity-Based Costing.
Ji Young LIM ; Mi Ja KIM ; Chang Gi PARK
Journal of Korean Academy of Nursing 2011;41(4):500-509
PURPOSE: Time-driven activity-based costing was applied to analyze the nursing activity cost and efficiency of a medical unit. METHODS: Data were collected at a medical unit of a general hospital. Nursing activities were measured using a nursing activities inventory and classified as 6 domains using Easley-Storfjell Instrument. Descriptive statistics were used to identify general characteristics of the unit, nursing activities and activity time, and stochastic frontier model was adopted to estimate true activity time. RESULTS: The average efficiency of the medical unit using theoretical resource capacity was 77%, however the efficiency using practical resource capacity was 96%. According to these results, the portion of non-added value time was estimated 23% and 4% each. The sums of total nursing activity costs were estimated 109,860,977 won in traditional activity-based costing and 84,427,126 won in time-driven activity-based costing. The difference in the two cost calculating methods was 25,433,851 won. CONCLUSION: These results indicate that the time-driven activity-based costing provides useful and more realistic information about the efficiency of unit operation compared to traditional activity-based costing. So time-driven activity-based costing is recommended as a performance evaluation framework for nursing departments based on cost management.
Costs and Cost Analysis
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Hospitals, General/economics
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Humans
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Internal Medicine/*economics
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Nursing Service, Hospital/*economics
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Task Performance and Analysis
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Time Factors
3.A Proposal to Improve Nursing Fee Differentiation Policy for General Hospitals Using Profitability-Analysis in the National Health Insurance.
Journal of Korean Academy of Nursing 2012;42(3):351-360
PURPOSE: The purpose of this study was to propose optimal hospitalization fees for nurse staffing levels and to improve the current nursing fee policy. METHODS: A break-even analysis was used to evaluate the impact of a nursing fee policy on hospital's financial performance. Variables considered included the number of beds, bed occupancy rate, annual total patient days, hospitalization fees for nurse staffing levels, the initial annual nurses' salary, and the ratio of overhead costs to nursing labor costs. Data were collected as secondary data from annual reports of the Hospital Nursing Association and national health insurance. RESULTS: The hospitalization fees according to nurse staffing levels in general hospitals are required to sustain or decrease in grades 1, 2, 3, 4, and 7, and increase in grades 5 and 6. It is suggested that the range between grade 2 and 3 be sustained at the current level, the range between grade 4 and 5 be widen or merged into one, and the range between grade 6 and 7 be divided into several grades. CONCLUSION: Readjusting hospitalization fees for nurse staffing level will improve nurse-patient ratio and enhance the quality of nursing care in hospitals. Follow-up studies including tertiary hospitals and small hospitals are recommended.
Bed Occupancy/economics
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Costs and Cost Analysis
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Hospitals, General/*economics
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Humans
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National Health Programs/*economics
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Nurse-Patient Relations
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Nursing Care
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Nursing Staff, Hospital/economics
4.Effects of Nurses' Social Capital on Turnover Intention: Focused on the Mediating Effects Organizational Commitment and Organizational Cynicism.
Jeongwon HAN ; Heeyoung WOO ; Eunsil JU ; Sohee LIM ; Sangsook HAN
Journal of Korean Academy of Nursing 2013;43(4):517-525
PURPOSE: The purpose of this study was to investigate the casual relationship between nurses' social capital and turnover intention and to verify the goodness of fit between a hypothetical model and actual data in order to suggest the best model. METHODS: This survey was conducted with 315 nurses working in general hospitals in Seoul. Data were collected from December 1 to December 30, 2011, and analyzed using SPSS Windows 18.0 and AMOS 16.0. RESULTS: Nurses' social capital was found to have a direct effect on reducting organization cynicism and increasing organizational commitment. Nurses' organizational cynicism and organizational commitment were found to have a direct effect on turnover intention, but social capital did not have a direct effect on turnover intention. However, social capital had a partial and indirect effect on turnover intention through mediating organizational cynicism and organizational commitment. CONCLUSION: Results of this study indicate that nurse managers should put increased effort in reducing nurses' organizational cynicism and improving their organizational commitment, two contrary parameters. At the same time managers need to develop plans to establish social capital more efficiently so that nurses have lower turnover intention.
Adult
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Female
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Hospitals, General
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Humans
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Intention
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Nursing Staff, Hospital/economics/*psychology
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*Organizational Culture
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*Personnel Turnover
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Questionnaires
5.Healthcare Spending and Performance of Specialty Hospitals: Nationwide Evidence from Colorectal-Anal Specialty Hospitals in South Korea.
Sun Jung KIM ; Sang Gyu LEE ; Tae Hyun KIM ; Eun Cheol PARK
Yonsei Medical Journal 2015;56(6):1721-1730
PURPOSE: Aim of this study is to investigate the characteristics and performance of colorectal-anal specialty vs. general hospitals for South Korean inpatients with colorectal-anal diseases, and assesses the short-term designation effect of the government's specialty hospital. MATERIALS AND METHODS: Nationwide all colorectal-anal disease inpatient claims (n=292158) for 2010-2012 were used to investigate length of stay and inpatient charges for surgical and medical procedures in specialty vs. general hospitals. The patients' claim data were matched to hospital data, and multi-level linear mixed models to account for clustering of patients within hospitals were performed. RESULTS: Inpatient charges at colorectal-anal specialty hospitals were 27% greater per case and 92% greater per day than those at small general hospitals, but the average length of stay was 49% shorter. Colorectal-anal specialty hospitals had shorter length of stay and a higher inpatient charges per day for both surgical and medical procedures, but per case charges were not significantly different. A "specialty" designation effect also found that the colorectal-anal specialty hospitals may have consciously attempted to reduce their length of stay and inpatient charges. Both hospital and patient level factors had significant roles in determining length of stay and inpatient charges. CONCLUSION: Colorectal-anal specialty hospitals have shorter length of stay and higher inpatient charges per day than small general hospitals. A "specialty" designation by government influence performance and healthcare spending of hospitals as well. In order to maintain prosperous specialty hospital system, investigation into additional factors that affect performance, such as quality of care and patient satisfaction should be carried out.
Adult
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Aged
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Anus Diseases/economics/*therapy
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Colonic Diseases/economics/*therapy
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Efficiency, Organizational
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Female
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Hospital Charges/*statistics & numerical data
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Hospitals, General/organization & administration
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Hospitals, Special/organization & administration
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Humans
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Inpatients/*statistics & numerical data
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Length of Stay/economics/*statistics & numerical data
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Male
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Middle Aged
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Outcome Assessment (Health Care)/economics/methods/*statistics & numerical data
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Rectal Diseases/economics/*therapy
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Republic of Korea