Estimation of nursing costs for Hospitalized Patients Based on the KDRG Classification

Abstract

A cost analysis for hospitalized patients was per-formed based on the KDRG classification in order to determine an appropriate nursing fee under the PPS(Prospective Payment System). The data was collected from 20 nursing units of three tertiary hospitals and two secondary hospitals from August 26 to September 15. 1996. The study consisted of 148 inpatients diagnosed for le~1s procedures(KDRG 03900), tonsillectomy & /or adenoidectomy(KDRG 16100). Cesarean section(1<:DRG 37000). or vaginal delivery(KDRG 3730 0) without any complications. The direct or indirect nursing hours of each patie nts were measured. Then, direct or indirect nursing e~cpenditures of four nursing units, operating room and delivery room were computed. Finally the resources used including average total nursing hours, average length of stay and average nursing cost of each KDRG were estimated as follows: 1) The average .total nursing hours were 640 minutes for lens procedures, 403 minutes for tonsillectomy &/or adenoidectomy. 934 minutes for appendectomy with complicated principal diagnosis. 1,094 minutes for Cesarean section and 631 minutes for vaginal delivery. Significant differences were found in average total nursing hours among hospitals. 2) The average length of stay in lens procedures were 5 days. 4 days for tonsillectomy &/or adenoidectomy. 6days fot appendectomy with complicated principal diagnosis. 8 days for Cesarean section and 3 days foi vaginal delivery. All results were within normal determined by the Ministry of Health and Welfare although significant differences existed among hospitals, especially with average length of stay for leng procedures between tertiary hospitals and secondary hospitals which was greater than for those of others. 3) Tlie average nursing cost were 87,146 Won for len:~ procedures. 69,600 Won for tonsillectomy &/or adenoidectomy, 128,337 Won for appendectomy with complicated principal diagnosis, 151,769 Won foi Cesarean section and 85,403 Won for vaginal delivery. These costs were 7.6%, 13.0%, 13.0 %. 16.CI% and 22.0%, respectively, of the official price fi:Ked by the Ministry of Health and Welfare under the prospective payment system. Research for the analysis of nursing costs ac-cording to the severity of illness for those KDRGs shoud >r~e carried out within the period of the PPS pilot project. In addition, a proper nursing fee schedule for a new reimbursement system based upon the result of the abo~re research should be prepared in the near future.