Development of Reimbursement Models for the Deployment of Advanced Practice Nurses in Korea: Focusing on General Wards and Intensive Care Units
10.22650/JKCNR.2025.31.3.220
- Author:
Min Young KIM
1
;
Su Jung CHOI
;
Eunhee LEE
;
Jae Won HYUN
;
Young-Ah KANG
;
Jeong-Hee PARK
Author Information
1. College of Nursing Health and Nursing Research Institute, Jeju National University
- From:
Journal of Korean Clinical Nursing Research
2025;31(3):220-233
- CountryRepublic of Korea
- Language:English
-
Abstract:
Purpose:This study aimed to develop reimbursement models for advanced practice nurses (APNs) in Korea by analyzing APN workload, estimating optimal patient-to-APN ratios, and calculating APN employment costs.
Methods:A descriptive study was conducted with 116 APNs working from general wards and intensive care units (ICUs) at three tertiary hospitals. Data were collected from March to May 2025 using structured questionnaires and activity diaries. APN workload was classified into 15 task categories comprising 79 sub-activities and additionally unclassified miscellaneous activities. Time spent per patient was used to estimate optimal patient loads, and employment costs were calculated using salary and administrative expense data. Daily reimbursement per patient was derived by dividing operating costs by the optimal caseload.
Results:Participants were predominantly female (99.1%), with a mean age of 38.9 years and an average of 15.9 years of clinical experience.APNs devoted the greatest share of their time to patient assessment and prescription-related activities. The optimal patient load was 10~15 per APN in general wards and 5~10 in ICUs. Based on these workload-derived ratios, the estimated reimbursement ranged from KRW 12,333 to 114,659 per patient per day in general wards and KRW 49,330 to 229,318 per patient per day in ICUs.
Conclusion:By linking workload, staffing needs, and employment costs, this study offers an empirical foundation for designing equitable APN reimbursement models.These findings support policy efforts to secure appropriate APN compensation, enhance workforce stability, and strengthen team-based care. Implementation through pilot reimbursement programs is recommended to evaluate their feasibility and economic impact.
