Factors Associated with the Utilization of Comprehensive Nursing Services in Hospitals among Elderly Inpatients after Surgery

Abstract

Purpose The aims of this study were to compare patient characteristics and healthcare utilization of the comprehensive nursing service (CNS) and general ward groups among elderly patients after surgery and to identify the factors associated with CNS use. Methods This secondary data analysis was conducted using the 2016 inpatient claims data of the Health Insurance Review and Assessment Service-National Inpatients Sample (HIRA-NIS). Elderly CNS patients were defined as those with at least one hospitalization record based on a CNS code. Independent t-tests, chi-squared tests, and hierarchical logistic regression analyses were performed by employing the Anderson behavioral model. Results A total of 81,840 elderly patients with a history of surgery (6,374 in the CNS group vs. 75,466 in the general ward group) were identified using the 2016 HIRA-NIS data. The average number of hospital days was greater (14.25 vs. 13.07) and the average cost per hospitalization was higher (Korean won 4,567,915 vs. 3,374,410) for the CNS group. Factors associated with the utilization of CNS included age, gender, department type, major diagnosis, admission route, intensive care unit entrance, medical assistance type, and healthcare institution type, location, and the number of doctors and nurses per 50 beds (all p<.001). Conclusion Based on our study findings, it is necessary to meet patients’ needs by focusing on dominant users and consider institutional characteristics that reflect the target group to apply the CNS policy more effectively. 주요어: ë ¸ì¸, ìˆ˜ìˆ , 간호서비스, 환자건강관리수용 Key Words: Aged, General surgery, Nursing services, Patient acceptance of health care