Hastaneler için Hemşirelik Maliyetlerini Belirleme Metotlarına Teorik Bir Yaklaşım

Yıl 2018, Cilt: 21 Sayı: 3, 539 - 550, 28.09.2018

Keziban Avcı

Öz

Hemşirelik bakım maliyetleri hastane maliyetlerinin büyük bir bölümünü oluşturmaktadır. Geleneksel olarak hastane maliyetleri içerisindeki hemşirelik bakım maliyetleri hasta odalarının özelliklerine ya da bordrolardaki değişime göre belirlenmektedir. Bu metotta tüm hastaların eşit hemşirelik bakımı aldığı varsayıldığı için bakım maliyetlerindeki değişim dikkate alınmaz ve günlük maliyetlerdeki azalma verimlilik olarak düşünülmektedir. Hemşirelik maliyetlerinin doğru olarak ölçülmesi durumunda ise bakım sürecindeki her hasta için değişen hemşirelik bakımı dikkate alınmaktadır. Bu çalışmada hastaneler için hemşirelik maliyetlerini belirleme metotlarının literatür doğrultusunda değerlendirilmesi amaçlanmıştır. Hemşirelik maliyetlerinin doğru belirlenmesi durumunda hasta, ünite ve hastane düzeyinde hemşirelik maliyetleri belirlenecek, kıyaslamalar ve iyileştirmeler yapılabilecektir.

Anahtar Kelimeler

Hemşirelik maliyeti, Hastane maliyeti, Hasta bakım maliyeti

Kaynakça

• 1. Buppert C. (2013) How Many Relative Value Units Should an NP Produce? The Journal for Nurse Practitioners 9(7): 470–472. 2. Carroll N. and Lord J. C. (2016) The Growing Importance of Cost Accounting for Hospitals. Journal of Health Care Finance 43(2):172-185. 3. Chiang B. (2009) Estimating Nursing Costs-A Methodological Review. International Journal of Nursing Studies 46(1): 716–722. 4. Cho S., Ketefian S., Barkauskas V. H. and Smith D. G. (2003) The Effects of Nurse Staffing on Adverse Events, Morbidity, Mortality and Medical Costs. Nursing Research 52(2):71–79. 5. Dowless R. M. (2007) Procedure Costing Flexibility. Healthcare Financial Management 61(6): 103–104. 6. Duffield C., Roche M. and Merrick E. T. (2006) Methods of Measuring Nursing Workload in Australia. Collegian 13(1): 16-22. 7. Fedor F. P. (2004) Changing Views About Usual Charges. Healthcare Financial Management 58(1): 32–36. 8. Finkler S. A. and Ward D. M. (1999) Essentials of Cost Accounting for Health Care Organizations. Aspen, Gaithersburg, MD. 9. Graf C. M., Millar S., Feilteau C., Coakley P.J. and Erickson J. I. (2003) Patients’ Needs for Nursing Care: Beyond Staffing Ratios. Journal of Nursing Administration 33(1): 76–81. 10. Horngren C. T., Foster G. and Datar S. M. (2006) Cost-Accounting – A Managerial Emphasis. Prentice-Hall, Inc., New Jersey. 11. Jenkins P. and Welton J. (2014) Measuring Direct Nursing Cost per Patient in the Acute Care Setting. Journal of Nursing Administration 44(5):257–262. 12. Jenkins P. (2017) Identifying Direct Nursing Cost Per Patient Episode in Acute Care-Merging Data from Multiple Sources. C. W. Delaney, C. A. Weaver, J. J. Warren, T. R. Clancy and R. L. Simpson In, Big Data-Enabled Nursing: Education, Research and Practice (s. 359-363 ). Springer International Publishing, New York. 13. Knauf R. A., Ballard K., Mossman P. N. and Lichtig L. K. (2006) Nursing Cost by DRG: Nursing Intensity Weights. Policy, Politics, & Nursing Practice 7(4): 281–289. 14. Moss J. and Saba V. (2011) Costing Nursing Care Using the Clinical Care Classification System to Value Nursing Intervention in an Acute-Care Setting. Computers, Informatics, Nursing 29(8): 455–460. 15. Needleman J., Buerhaus P. I., Stewart M., Zelevinsky K. and Mattke, S. (2005) Nurse-Staffing in Hospitals: Is There a Business Case for Quality? Health Affairs 25(10): 204–211. 16. Pappas, S. H. (2007) Describing Costs Related to Nursing. The Journal of Nursing Administration 37(1): 32- 40. 17. Pirson M., Delo C., Di Pierdomenico L., Laport N., Biloque V. and Leclercq P. (2013) Variability of Nursing Care by APR-DRG and by Severity of Illness in a Sample of Nine Belgian Hospitals. BMC Nursing 12(26):1-6. 18. Rutherford M. M. (2012) Nursing is the Room Rate. Nursing Economics 30(4):193-206. 19. Spetz J. (2005) Public Policy and Nurse Staffing: What Approach is Best? Journal of Nursing Administration 35(1):14–16. 20. Tan S. S., Chiarello P. and Quentin W. (2013) Knee Replacement and Diagnosis Related Groups (DRGs): Patient Classification and Hospital Reimbursement in 11 European Countries. Knee Surgery, Sports Traumatology, Arthroscopy 21(11): 2548–2556. 21. Twigg D. and Duffield C. (2009) A Review of Workload Measure: A Context for a New Staffing Methodology in Western Australia. International Journal of Nursing Studies 46(1):132-140. 22. Unruh L. Y. and Hassmiller B. S. (2008) Legislative: Economics of Nursing Invitational Conference Addresses Quality and Payment Issues in Nursing Care. The Online Journal of Issues in Nursing 13(1):1-5. 23. Unruh L. Y., Hassmiller S. B. and Reinhard S. C. (2008) The Importance and Challenge of Paying for Quality Nursing Care. Policy, Politics, & Nursing Practice 9(2): 68-72. 24. Welton J. M. and Dismuke C. E. (2008) Testing an Inpatient Nursing Intensity Billing Model. Policy, Politics, and Nursing Practice 9(2):103-111. 25. Welton J. M., Fischer M. H., DeGrace S. and Zone-Smith L. (2006) Hospital Nursing Costs, Billing and Reimbursement. Nursing Economics 24 (5): 239-245. 26. Wilson L., Prescott P. A. and Aleksandrowicz L. (1998) Nursing: A Major Hospital Cost Component. Health Services Research 22(6): 773–796. 27. Witzel P. A., Ingersoll G. L., Schultz A. W. and Ryan S. A. (1996) A Cost Estimation Model for Measuring Professional Practice. Nursing Economics 14(5): 286-291.