Association between caregiver type and catastrophic health expenditure among households using inpatient medical services: using Korean health panel

A comparative analysis of nurses' reported number of patients and perceived appropriate number of patients in integrated nursing care services

This study aimed to compare the number of assigned and appropriate patients per nurse in integrated nursing care service wards and analyze factors associated with the gap. For this cross-sectional secondary analysis, data were collected from surveys of 2312 nurses and institutional data from their affiliated 106 hospitals in Korea. We used the Wilcoxon signed-rank test and t-test to compare the number of patients assigned to nurses with the number they considered appropriate. We used ratio analysis for measuring the gap between these numbers, and robust regression to evaluate the factors affecting this gap. The results found an average gap of 1.45, indicating that the reported number of assigned patients per nurse was 1.45 times higher than the appropriate number. Gender, employment type, wage satisfaction, workload, overtime work, and hospital level of care were identified as factors associated with the gap. Findings suggest that the current nurse staffing standard should be revised to consider nurses' professional judgments of appropriate staffing levels and adopt policies that reduce nurses' workload.

Trends in private caregiving cost after implementing a comprehensive nursing service covered by national health insurance: Interrupted time series

BACKGROUND

The Korean government has implemented a comprehensive nursing care service system (CNS) to mitigate the stress faced by caregivers.

OBJECTIVE

This study aimed to assess trends in the estimated average costs of private caregiving and determine the difference in costs between those using CNS and those not using it.

DESIGN

A comparative interrupted time series analysis with a 2-year lag period verified total private caregiving cost trends; biannual differences in costs were evaluated based on using CNS.

PARTICIPANTS

The main unit of analysis was episode. We extracted a total of 6418 episodes of hospitalization in acute care settings that included the use of caregiving services (formal, informal caregiving and CNS).

METHODS

We conducted segmented regression to assess the impact of CNS on total private caregiving costs using data from 2012 to 2018, excluding the years 2015 and 2016 of the Korean Health Panel dataset.

RESULTS

We presented that the immediate mean difference in total private caregiving costs between CNS users and non-users was -444.7 USD two years after the implementation of the CNS policy (95 % CI -714.5 to -174.5, p-value 0.001). Among individuals living in rural areas, two years after the implementation of the CNS policy, there was a significant immediate mean cost difference of -476.9 USD in total private caregiving costs between CNS users and non-users (p-value 0.011). Similarly, for episodes with a Charlson Comorbidity Index (CCI) score of 0 to 1, there was a substantial immediate mean cost difference in total private caregiving costs between CNS users and non-users, amounting to -399.9 USD two years after the CNS policy (p-value 0.008).

CONCLUSIONS

This study evaluated the trend of total private caregiving costs between groups using and not using CNS. After two years of being covered by CNS health insurance, those who utilized CNS paid $433 less for their total private caregiving cost over a 6-month period, compared to those who did not use CNS. The adoption of CNS may be an effective system for relieving the financial burden on inpatients in need of private caregiving services.

TWEETABLE ABSTRACT

Korean Comprehensive Nursing Service reduces private caregiving costs.