Mi Won Kim | 2 Articles |
PURPOSE
The purpose of this study was to perform an economic analysis and estimate the fee for the practices that carried out by Emergency Nurse Practitioner (ENP) using relative value scale (RVS) and its conversion factor. METHODS First, we developed ENP's RVS for 25 advanced nursing services based on ENP's workload and its time spent by survey. A cost analysis was performed to evaluate the conversion factor of ENP's RVS. The share of ENP's contribution to fee-for-service in emergency setting was also analyzed. RESULTS Calculation of the RVS of 25 advanced nursing practices showed a range of points from 73.4 to 296.3 and an average of 145.1 points. The relevant conversion factor for advanced nursing practices among ENP was estimated at 12.2~15.9 won. The contribution rate of ENP's advanced nursing practices in the relative value scale of the national health insurance was estimated at 13.1~17.0%. CONCLUSION The practices of ENP are not compensated separately and its reimbursement is usually included in physician fee. An estimation of nursing fee and an independent fee related to ENP's services shows the contribution rate to total revenue. It suggests that emergency nurse practitioners be considered as a revenue source the in emergency room.
Nausea, vomiting and retching are universal symptoms that affect individuals' state of health and self-care activities of individuals. Accurate measurements of individual symptoms are required to gather more definitive data, and enhance understanding, planning, and implementation of self-care actions. Recently the Rhodes Index of Nausea, Vomiting, and Retching(INVR), a new format of the INV-2(the Rhodes Index of Nausea and Vomiting), was developed to measure the symptoms of nausea, vomiting and retching in an English speaking population. To determine the reliability and validity of the INVR, and the possibility of using the instrument in Korea, the Korean translation of the INVR and the INV-2 were administered to a convenient sample of 105 patients at two University Hospitals in Kwangju, Korea. The Cronbach's alpha to estimate the internal consistency of reliability for INVR was 0.844. Equivalent measures of reliability were conducted to determine the percentage of agreement and the Spearman rank correlation coefficients for responses on the two instruments. The percent agreement was 83% and the correlation coefficient was 0.906 over all. A significant differences between the INVR scores of the patients with and without nausea, vomiting, or retching were seen, which indicated a construct validity. The INVR was found to be more user friendly for the patient and the healthcare providers. As a result, it is suggested that the INVR can provide a scientific base for measuring the symptoms of nausea, vomiting, and retching for nurses to improve patients' care and quality of life.
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