Impact evaluation of nurse staffing policy reform in Korea: A quasi-experimental study

Abstract

Aim: This study aims to evaluate the new nursing policy's effect on improving overall nurse staffing levels in Korean acute care hospitals. Background: The Korean government introduced the Integrated Nursing and Care Service policy, which adopted advanced staffing standards. Under the new scheme, reimbursement of nursing fees was differentiated by the patient-to-nurse ratios, and financial incentives were provided to policy participating hospitals to promote additional employment in overall hospitals. Methods: We analysed 1362 acute care hospitals. The probability and degree of improving nurse staffing levels for each hospital were examined using a two-part model. Whether policy participation had affected to improve nurse staffing levels was evaluated by the difference-in-difference approach. Results: Policy participating hospitals were 3.89 times more likely to enhance nurse staffing levels compared to non-participating hospitals. The policy participation effect was found to improve average nurse staffing levels by 1.12 grades. Conclusion: Korean nurse staffing policy reform was successful to encourage hospitals to improve their overall nurse staffing levels. Implication for Nursing Management: Nursing leaders and policymakers should understand that providing incentives could affect hospitals' employment behaviour change under the market-oriented healthcare system. For developing future nursing policies, these strategies should be considered appropriately.