J Korean Clin Nurs Res.  2024 Dec;30(3):193-206. 10.22650/JKCNR.2024.30.3.193.

Changes in Nurse Staffing Grades and Nursing Fee Revenues in Response to the Amendment of the Resource-Based Relative Value Scale: General Wards

• Cho SH
• You SJ
• Lee JY
• Go UR

• KMID: 2567597
• DOI: http://doi.org/10.22650/JKCNR.2024.30.3.193

Abstract

Purpose
This study aimed to examine changes in nurse staffing grades and nursing fee revenues following the third amendment of the resource-based relative value scale, implemented in January 2024.
Methods
Revised nurse staffing grades were determined based on the number of patients per nurse (PpN), calculated by dividing the daily patient census by the number of registered nurses working in general wards. Changes in staffing grades were analyzed from the fourth quarter of 2023 to the first quarter of 2024 among 44 tertiary hospitals, 328 general hospitals, and 1,378 non-general hospitals.
Results
In 2024, the previous "best grade" (grade 1) was subdivided into two or three grades. The best grade was redefined as grade S (PpN<1.5) in tertiary and general hospitals and grade A (PpN<2.0) in non-general hospitals. By 2024, 72.4%, 11.8%, and 22.5% of tertiary, general, and non-general hospitals, respectively, achieved the best grade. The estimated additional annual nursing fee revenues per nurse in 2024 (compared to 2023) for hospitals advancing from grade 1 to grade S ranged from 1,088,455 to 11,412,655 KRW in tertiary hospitals and 11,483,834 KRW in general hospitals.
Conclusion
To ensure appropriate nurse staffing levels, nursing fees should be proportionally differentiated based on staffing requirements. Additional revenues should be strategically allocated to enhance nurse compensation, thereby improving workforce sustainability and care quality.

Keyword

General Wards; Nursing Fees; Differentiation; Resource-Based Relative Value Scale; Staffing