1.Recommending Revised Inpatient Nursing Fee Schedules Based on Actual Nurse Staffing Levels in General Wards
Sung-Hyun CHO ; Jinhyun KIM ; Jiyeong SEONG ; Ji-Yun LEE
Journal of Korean Academy of Nursing Administration 2023;29(5):540-552
Purpose:
This study aims to propose revised inpatient nursing fee schedules that address three discrepancies between actual nurse staffing levels in general wards and the corresponding patient payment structures.
Methods:
A total of 45 tertiary hospitals, 329 general hospitals, and 1,379 hospitals from publicly released data for 2021~2022 were analyzed. This analysis focused on three primary discrepancies between (1) the staffing grades under which patients were hospitalized and the corresponding grades for which they were charged; (2) the staffing grades determined by bed-to-nurse and patient-to-nurse criteria; and (3) the current differentiation rates of nursing fees and the expected differentiation rates based on the number of nurses required for each grade.
Results:
The first discrepancy occurred in 8.9% of tertiary hospitals, 21.0% of general hospitals, and 26.0% of hospitals. The bed-to-nurse and patient-to-nurse grades differed by 2.23 and 2.29 grades on average in general hospitals and hospitals, respectively. The current differentiation rates were higher than the expected differentiation rates. New nursing fee schedules were suggested to resolve those discrepancies.
Conclusion
Nursing fees should be charged to reflect the staffing levels under which patients were cared for and proportionate to the number of nurses required to provide the corresponding staffing levels.
2.Music Perception Abilities of the Hearing Amplification System Users
Sungmin JO ; Jiyeong YUN ; Jeong-Sug KYONG ; Yerim SHIN ; Jinsook KIM
Journal of Audiology & Otology 2023;27(2):78-87
Background and Objectives:
Recently, the improvement of music perception abilities for emotional stability and high quality of life has become important for the hearing loss group. This study aimed to examine and compare the music perception abilities of the normal hearing (NH) and hearing amplification system (HAS) groups to find the needs and methods of music rehabilitation.
Subjects and Methods:
The data were collected from 15 NH adults (33.1±11.4 years) and 15 HAS adults (38.7±13.4 years), of whom eight wore cochlear implant [CI] systems and seven wore CI and hearing aid systems depending on pitch, melody, rhythm, timbre, emotional reaction, and harmony perception tests. A mismatch negativity test was also conducted, and attitudes toward and satisfaction with listening to music were measured.
Results:
The correction percentages for the NH and HAS groups were 94.0%±6.1% and 75.3%±23.2% in the pitch test; 94.0%±7.1% and 30.3%±25.9% in the melody test; 99.3%±1.8% and 94.0%± 7.6% in the rhythm test; 78.9%±41.8% and 64.4%±48.9% in the timbre test; 96.7%±10.4% and 81.7%±16.3% in the emotional reaction test; and 85.7%±14.1% and 58.4%±13.9% in the harmony test, respectively, showing statistical significance (p<0.05). For the mismatch negativity test, the area of the waveform was smaller in the HAS groups than in the NH groups, with 70 dB of stimulation showing no statistical significance. The response rates for satisfaction with listening to music were 80% and 93.3% for the NH and HAS groups, showing no statistical significance.
Conclusions
Although the HAS group showed lower music perception ability than the NH group overall, they showed a strong desire for music listening. Also, the HAS group revealed a higher degree of satisfaction even when listening to unfamiliar music played with unusual instruments. It is suggested that systematic and constant musical rehabilitation based on musical elements and different listening experiences will improve music perception qualities and abilities for HAS users.
3.The Relevance of the Primary Prevention Criteria for Implantable Cardioverter Defibrillator Implantation in Korean Symptomatic Severe Heart Failure Patients.
JiYeong KIM ; Eue Keun CHOI ; Min Ho LEE ; Do Yoon KANG ; Young Jun SUNG ; Dong Won LEE ; Ilyoung OH ; Yun Shik CHOI ; Seil OH
Korean Circulation Journal 2012;42(3):173-183
BACKGROUND AND OBJECTIVES: Implantable cardioverter defibrillator (ICD) therapy is recommended as the primary tool for prevention of sudden cardiac death (SCD) in symptomatic patients with severe left ventricular dysfunction. There is a paucity of information on whether this recommendation is appropriate for the Korean population with severe heart failure. SUBJECTS AND METHODS: The study group consisted of 275 consecutive patients (mean age 65 years, 71% male) who met the ICD implantation criteria for primary prevention (left ventricular ejection fraction < or =30% and New York Heart Association functional class II or III). We analyzed the clinical characteristics and outcomes of an ischemic cardiomyopathy (ICMP) group (n=131) and a non-ischemic cardiomyopathy (NICMP) group (n=144). The outcomes of these 2 groups were compared with the Multicenter Automatic Defibrillator Implantation Trial II (MADIT-II) conventional and Defibrillators in the Non-ischemic Cardiomyopathy Treatment Evaluation (DEFINITE) standard therapy groups, respectively. RESULTS: Eighty patients (29%) died during a follow-up period of 40+/-17 months. The NICMP group had better all-cause mortality rates than the ICMP group (19% vs. 40%, p<0.001), however both groups had a similar incidence of SCD (7% vs. 10%, p=0.272). The 2-year all-cause mortality and SCD for the ICMP group were similar to those of the MADIT-II conventional therapy group (20% vs. 20%, 7% vs. 10%, respectively, all p>0.05). All-cause mortality and the incidence of SCD in the NICMP group were comparable to those of the DEFINITE standard therapy group (13% vs. 17%, 6% vs. 6%, respectively, all p>0.05). CONCLUSION: Korean patients with severe heart failure in both the ICMP and NICMP groups had all-caused mortality and risk of SCD comparable to patients in the MADIT-II and DEFINITE standard therapy groups. Therefore, the primary prevention criteria for ICD implantation would be appropriate in both Korean ICMP and NICMP patients.
Cardiomyopathies
;
Death, Sudden, Cardiac
;
Defibrillators
;
Defibrillators, Implantable
;
Follow-Up Studies
;
Heart
;
Heart Failure
;
Humans
;
Incidence
;
New York
;
Primary Prevention
;
Stroke Volume
;
Ventricular Dysfunction, Left