ArticleJournal of nursing management2026
Effect of Nurses' Working Conditions Improvement Policy on Patient Outcomes in General Hospitals: A Quasiexperimental Study Using National Health Insurance Claims Data From Korea.
Article in Journal of nursing management, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Abstract
backgroundA good nursing work environment is a key determinant of patient safety. In 2018, the Korean government introduced the Nurse Working Conditions Improvement Policy (NWCIP), accompanied by a revision of the nurse staffing grade calculation method. Under this policy, hospitals with revenue growth due to upward adjustments in nurse staffing grade were recommended to allocate revenue growth for improving nurses' working conditions.
objectiveTo evaluate whether funding under the NWCIP, aimed at improving nurses' working conditions, is associated with changes in patient outcomes.
methodsA quasiexperimental study was conducted using National Health Insurance claims data from 198,318 adult inpatients across 99 general hospitals. After confirming the parallel trends assumption, a difference-in-differences approach was used to evaluate the policy's effect. Patient outcomes were compared between the first quarters of 2018 (baseline) and 2019 (postimplementation). Hospitals were categorized into an intervention group (those that received nurses' working conditions improvement fund) and a comparison group (those that did not). Outcomes included in-hospital mortality, 7-day readmission, and length of stay. Among the 99 hospitals, 60 were assigned to the intervention group and 39 to the comparison group.
resultsAccording to difference-in-differences analysis, the intervention group showed a 19% increase in 7-day readmission (adjusted odds ratio = 1.19; 95% confidence interval: 1.09-1.29; p < 0.001) and a 5% decrease in length of stay (adjusted incidence rate ratio = 0.95; 95% confidence interval: 0.92-0.97; p < 0.001), with no significant change in in-hospital mortality.
conclusionsGeneral hospitals subject to the NWCIP did not show improved patient outcomes: They had a higher risk of readmission despite a shorter length of stay. IMPLICATIONS FOR NURSING MANAGEMENT: The use of revenue growth to improve nurses' working conditions should be mandated rather than recommended, prioritizing high-impact staffing investments, such as hiring additional nurses, most directly linked to patient outcomes.
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