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중환자 전문간호행위에 대한 건강보험 상대가치 및 환산지수 개발

 Development of a Resource-based Relative Value Scale and Its Conversion Factor for Advanced Nursing Practices in the National Health Insurance

Journal of Korean Academy of Nursing 2011년 41권 3호 p.302 ~ 312
KMID : 0806120110410030302
김진현 ( Kim Jin-Hyun ) - 서울대학교 간호대학

김명애 ( Kim Myung-Ae ) - 서울대학교병원 간호부
김미원 ( Kim Mi-Won ) - 상명대학교 간호학과
김경숙 ( Kim Kyung-Sook ) - 남서울대학교 간호학과
유정숙 ( Yoo Cheong-Suk ) - 서울대학교병원 간호부

Abstract

Purpose: The purpose of this study was to develop a resource-based relative value scale (RBRVS) and its conversion factor for advanced nursing practices carried out by critical care nurse practitioners (CCNP) in intensive care units.

Methods: The methodology was developed by calculating CCNP’s RBRVS for 32 advanced nursing services based on CCNP’s workload and time spent in the context of national health insurance. A cost analysis was performed to estimate the conversion factor of CCNP’s RBRVS. The share of CCNP’s contribution to fee-for-service in intensive care units was also analyzed.

Results: alculation of the RBRVS of 32 advanced nursing practices showed a range of points from 100.0 to 1,181.4 and an average of 296.1 points. The relevant conversion factor for advanced nursing practices in CCNP were estimated at 37.3-48.4 won. The contribution rate of CCNP’s advanced nursing practices in the relative value scale of the national health insurance was estimated at 0.1-31.3%.

Conslusion: Measuring the economic value of advanced nursing services will be a basis for esta-blishing a reimbursement system for CCNP’s practices and thus encourage a social demand for advanced nurse practitioners.
KeyWords

Nurse practitioners, Advanced practice nursing, Relative value scales, Fees and charges, Conversion factor
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SCI(E) MEDLINE 학술진흥재단(KCI) KoreaMed