PURPOSE: To analyze the proportion of medical institutions meeting the legal standard for
nurse staffing .
METHODS: Data collected from 29,282 institutions between 1996 and 2013 were analyzed.
Nurse staffing was measured as daily
patient census per
registered nurse (RN). The standard for
general hospitals ,
hospitals , and clinics is 2.5 or less, and that for
long-term care hospitals is 6.0 or less of the daily
patient census per RN. Clinics may substitute
nursing assistants for RNs by 50% or 100% depending on their daily
inpatient census ;
long-term care hospitals may substitute
nursing assistants for RNs by two thirds of the required number of RNs.
RESULTS: The proportion of
general hospitals ,
hospitals , clinics, and
long-term care hospitals meeting the
standards was 63%, 19%, 63%, and 94%, respectively, in 2013. While
general hospitals had an increase in the proportion during the 1996-2013 period, small changes were found in
hospitals and clinics. In 2013,
nurses were estimated to care for 16 (interquartile range 12~24)
patients per shift in
general hospitals . Three quarters of clinics had no RNs in 2013.
CONCLUSION: Many medical institutions did not meet the legally mandated minimum
staffing level. The
government must implement
policy actions for all medical institutions to meet the
legal standards .