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

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.

Examining the inclusion of patients and their family members in infection prevention and control policies and guidelines across Bangladesh, Indonesia, and South Korea

“…35 Because the importance of including patients' families in IPC measures was addressed in the WHO recommendation in the response to MERS, we reviewed the newly developed guideline from Korea with attention to the role of family members in the care and IPC program. Despite the emphasis on the HAI risks of family members and private carers during MERS outbreak, 27,[132][133][134] neither the WHO recommendations nor the roles of family members or private carers who provide physical care to patients while staying next to patients were documented in the guideline. Without recognition of caring roles of family members and/or private carers in the guideline/ policy, family carers could not be included in the IPC strategies, posing a risk of HAI transmission.…”

“…7,27 In fact, an "integrated nursing and care service," which began as a pilot project in July 2013, has been converted into a health insurance business since MERS in 2015, and its legal basis was established by the new regulation on the integrated nursing and care service in the hospital setting revised in December 2015. 132,134 There are 2 major changes noted with the new system. 7,23,132,136,137 First, family caregivers and privately hired carers are not to stay in the hospital for patients who meet the criteria for the new system: eligible patients and selected wards.…”

“…132,134 There are 2 major changes noted with the new system. 7,23,132,136,137 First, family caregivers and privately hired carers are not to stay in the hospital for patients who meet the criteria for the new system: eligible patients and selected wards. This is to reduce the risk of overcrowding conditions in the patient room so that risk of HAI decreases accordingly.…”

Multilevel factors influencing falls of patients in hospital: The impact of nurse staffing

“…To decrease the care-giving burden and improve the quality of care, in 2013 the Korean government implemented an inte- (Kim, Kim, Park, Jeong, & Lee, 2017). Hospitals in Korea are classified into tertiary hospitals, general hospitals and semi-hospitals according to hospital size and specialty.…”

“…Patients can be admitted to the integrated care unit regardless of the medical department and patients who want to be admitted to the integrated care unit pay more than patients admitted to general nursing units. Standards for nurse staffing level in integrated care units have been differ according to the various types and characteristics of the hospitals (Kim, Kim, Park, Jeong, & Lee, ). Hospitals in Korea are classified into tertiary hospitals, general hospitals and semi‐hospitals according to hospital size and specialty.…”