Skip to main content
Top
Published in: Environmental Health and Preventive Medicine 2/2011

01-03-2011 | Regular Article

Inpatient satisfaction and job satisfaction/stress of medical workers in a hospital with the 7:1 nursing care system (in which 1 nurse cares for 7 patients at a time)

Authors: Yuko Fujimura, Hideji Tanii, Kiyofumi Saijoh

Published in: Environmental Health and Preventive Medicine | Issue 2/2011

Login to get access

Abstract

Objectives

Inpatient satisfaction, job satisfaction/stress of medical workers, and hospital profitability under the 7:1 nursing care system (in which 1 nurse cares for 7 patients at a time) were compared with those under the 10:1 system at a hospital with the diagnosis procedure combination (DPC) payment system.

Methods

A total of 202 inpatients discharged from the Departments of Cardiology and Metabolism completed an inpatient satisfaction questionnaire. A total of 108 medical workers were recruited to survey their job satisfaction/stress and to estimate the effects of the DPC. The profits for 10 cardiac and metabolic diseases in 2008 were compared with those in 2007.

Results

Mean inpatient satisfaction scores were around 4 (“somewhat satisfied”) under both the 10:1 and 7:1 systems, and increased significantly to 4.14–4.38 under the 7:1 system. Excluding workload of physicians, the other stresses of physicians/nurses remained unaltered, as did their low job satisfaction. They estimated their understanding of the DPC as insufficient but felt that introducing the DPC neither shortened length of stay nor improved “the quality of medical/nursing care,” regardless of the system. Total percentage profit increased to 1.17% in 2008 from 0.73% in 2007, whereas 7 of 10 diseases showed deficits in 2008.

Conclusions

The 7:1 system was somewhat beneficial for inpatients but not always for medical worker quality of life (QOL) or for hospital income, which are important to maintain high quality of medical/nursing care. It is important to further explore factors increasing QOL of medical workers and hospital income.
Literature
2.
go back to reference Miller RH, Luft HS. Managed care plans: characteristics, growth, and premium performance. Annu Rev Public Health. 1994;15:437–59.PubMedCrossRef Miller RH, Luft HS. Managed care plans: characteristics, growth, and premium performance. Annu Rev Public Health. 1994;15:437–59.PubMedCrossRef
3.
go back to reference Stoddard JJ, Hargraves JL, Reed M, Vratil A. Managed care, professional autonomy, and income. J Gen Intern Med. 2001;16(10):675–84.PubMedCrossRef Stoddard JJ, Hargraves JL, Reed M, Vratil A. Managed care, professional autonomy, and income. J Gen Intern Med. 2001;16(10):675–84.PubMedCrossRef
4.
go back to reference Idezuki Y. Introduction of new payment system (DRG/PPS) to university hospitals. Nippon Geka Gakkai Zasshi. 2003;104:312–9.PubMed Idezuki Y. Introduction of new payment system (DRG/PPS) to university hospitals. Nippon Geka Gakkai Zasshi. 2003;104:312–9.PubMed
5.
go back to reference Yagihara Y. Influence of DPC on cardiovascular surgery. Nippon Geka Gakkai Zasshi 2005;106:641–4 (in Japanese). Yagihara Y. Influence of DPC on cardiovascular surgery. Nippon Geka Gakkai Zasshi 2005;106:641–4 (in Japanese).
6.
go back to reference Hamada Y. Effects and measures of the flat payment system based on the diagnosis procedure combination system in pediatric surgery. Nippon Geka Gakkai Zasshi 2005;106:654–8 (in Japanese). Hamada Y. Effects and measures of the flat payment system based on the diagnosis procedure combination system in pediatric surgery. Nippon Geka Gakkai Zasshi 2005;106:654–8 (in Japanese).
7.
go back to reference Yasunaga H, Ide H, Imamura T, Ohe K. Impact of the Japanese Diagnosis Procedure Combination-based Payment System on cardiovascular medicine-related costs. Int Heart J. 2005;46(5):855–66.PubMedCrossRef Yasunaga H, Ide H, Imamura T, Ohe K. Impact of the Japanese Diagnosis Procedure Combination-based Payment System on cardiovascular medicine-related costs. Int Heart J. 2005;46(5):855–66.PubMedCrossRef
8.
go back to reference Yoshida K. Joy of work. Tokyo (Japan): Nikkei BP; 2005. p. 39–43 (in Japanese). Yoshida K. Joy of work. Tokyo (Japan): Nikkei BP; 2005. p. 39–43 (in Japanese).
9.
go back to reference Fukuhara S, Suzukamo Y. Manual of SF-36v2 Japanese version. Kyoto: Institute for Health Outcomes & Process Evaluation Research; 2004. Fukuhara S, Suzukamo Y. Manual of SF-36v2 Japanese version. Kyoto: Institute for Health Outcomes & Process Evaluation Research; 2004.
15.
go back to reference Walton M. The deming management method. New York (NY): A Perigee Book; 1986. p. 86–8. Walton M. The deming management method. New York (NY): A Perigee Book; 1986. p. 86–8.
16.
go back to reference Speroff T, James BC, Nelson EC, Headrick LA, Brommels M. Guidelines for appraisal and publication of PDSA quality improvement. Qual Manag Health Care. 2004;13:33–9.PubMedCrossRef Speroff T, James BC, Nelson EC, Headrick LA, Brommels M. Guidelines for appraisal and publication of PDSA quality improvement. Qual Manag Health Care. 2004;13:33–9.PubMedCrossRef
17.
go back to reference Speroff T, O’Connor GT. Study designs for PDSA quality improvement research. Qual Manag Health Care. 2004;13:17–32.PubMed Speroff T, O’Connor GT. Study designs for PDSA quality improvement research. Qual Manag Health Care. 2004;13:17–32.PubMed
18.
go back to reference Mori K, Takebayashi T. The introduction of an occupational health management system for solving issues in occupational health activities in Japan. Ind Health. 2002;40:167–74.PubMedCrossRef Mori K, Takebayashi T. The introduction of an occupational health management system for solving issues in occupational health activities in Japan. Ind Health. 2002;40:167–74.PubMedCrossRef
19.
go back to reference Lambert VA, Lambert CE, Ito M. Workplace stressors, ways of coping and demographic characteristics as predictors of physical and mental health of Japanese hospital nurses. Int Nurs Stud. 2004;41:85–97.CrossRef Lambert VA, Lambert CE, Ito M. Workplace stressors, ways of coping and demographic characteristics as predictors of physical and mental health of Japanese hospital nurses. Int Nurs Stud. 2004;41:85–97.CrossRef
20.
go back to reference Bovier AP, Perneger VT. Predictors of work satisfaction among physicians. Euro J Public Health 2003;13(4):299–305. Bovier AP, Perneger VT. Predictors of work satisfaction among physicians. Euro J Public Health 2003;13(4):299–305.
21.
go back to reference Laubach W, Fischbeck S. Job satisfaction and the work situation of physicians: a survey at a German university hospital. Int Public Health. 2007;52:54–9.CrossRef Laubach W, Fischbeck S. Job satisfaction and the work situation of physicians: a survey at a German university hospital. Int Public Health. 2007;52:54–9.CrossRef
22.
go back to reference OECD. OECD Health Data 2009-Version: November 09. OECD. OECD Health Data 2009-Version: November 09.
Metadata
Title
Inpatient satisfaction and job satisfaction/stress of medical workers in a hospital with the 7:1 nursing care system (in which 1 nurse cares for 7 patients at a time)
Authors
Yuko Fujimura
Hideji Tanii
Kiyofumi Saijoh
Publication date
01-03-2011
Publisher
Springer Japan
Published in
Environmental Health and Preventive Medicine / Issue 2/2011
Print ISSN: 1342-078X
Electronic ISSN: 1347-4715
DOI
https://doi.org/10.1007/s12199-010-0174-x

Other articles of this Issue 2/2011

Environmental Health and Preventive Medicine 2/2011 Go to the issue