Changes in hospital nursing employment after linking payment to nurse staffing

초록

This study examines the effect of a national legislation linking hospital payment to nurse staffing levels, which was established for Korean hospitals in late 1990s. There are many researches showing that financial incentives have been widely adopted to improve hospital performance. However, little is known about whether the approach is effective in increasing nurse staffing in a hospital. A decade of experience in Korean nursing payment system provides a testable case to examine the effectiveness of the approach. We used time series data on hospital-level nurse staffing and a nationwide survey of hospital nurses to compare before and after the legislation. Results show an increasing trend of RN employment after implementing the reform. The growth of nurse staffing appeared to differ depending on hospital type. Nurse employment is less likely improved in mid and small size general hospitals compared to large size tertiary hospitals. Nurse outcomes including job dissatisfaction, burnout, and intention to leave were not significantly improved among our study sample hospitals. © 2016 SERSC.

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