Eulji University, South Korea
Title: Pay for performance in Korean hospital nursing
Sukyong Seo has completed her Ph.D. from UC Berkeley, USA. Having worked for Kaiser Permanente Care Management Institute as analyst, she is currently assistant professor of community health nursing in Eulji University, South Korea. She has published many papers on nursing shortages and provider payment system.
Objective: This study examines the effect of a national legislation paying hospitals depending on nurse staffing levels to increase hospitals’ use of nursing resources in Korea. Background: The concept of pay-for-performance (P4P) has been adopted in health care as a means to alter financial incentives of providers. The rationale is that if quality of care becomes a direct component of their ﬁnancial success, providers will shift more resources towards quality improvement. Although P4P has been widely adopted to improve hospital care quality, little is known about whether the approach is effective in increasing quality in nursing services and nurse staffing. A decade of experience in Korean nursing payment system provides a testable case to examine the effectiveness of the approach. Methods: Time series data on hospital-level nurse staffing and a nationwide survey of nurses (N=2,387) were used to compare before and after the hospital payment reform. Results: We found an increasing trend of hospital RN staffing after implementing the reform. However, the effects differ depending on hospital type. Nurses work conditions including job dissatisfaction, burnout and intention to leave were not significantly improved. Conclusions: Linking reimbursement rates to nursing resources can be more effective in improving staffing levels, if considering hospitals in poor financial shape.