看護ケアの価値づけ―コンジョイント分析を用いて

Evaluation of Nursing Care: Using Conjoint Analysis

要旨

　本研究は，看護師が，実施しているケアに対してどのように価値づけを行っているのかを経済的な観点から明らかにする．

　無作為抽出した500床以上の5総合病院に勤務する総数1,000名の看護師を対象に質問紙を配り，郵送による回収を行った．調査は，全身清拭，バイタルサイン測定，点滴管理，給与の4項目について実施回数および支給率を変化させた2つの仮想病院を提示し，二者択一で好ましい職場を回答するものである．それらの回答をコンジョイント分析し，ケアの労働量と同程度の金額がいくらになるのか推定を行った．

　以上の結果から，ケアを金額換算すると，月給が25万円の看護師の場合，全身清拭1回あたり93.38円，バイタルサイン測定は1回あたり35.98円，ルート管理1回あたり42.25円と推定された．

Abstract

　So as to measure the value of hospital care, we conducted a survey using Conjoint Analysis in order to estimate the workload of nursing care. The survey asked questions about individual status and hypothetical situations used for Conjoint Analysis. These questionnaires were distributed by chief nurses to a total of 1,000nurses working in general wards at five hospitals in Osaka which each had more than 500 beds. The hypothetical situation used in this Conjoint Analysis assumes four attributes, i.e. three different types of work: 1) giving complete bed baths, 2)giving intravenous (I.V.s), and 3)measuring vital signs, with payment as the fourth attribute. In the questionnaire, respondents were shown profiles of two hospitals with different hypothetical situations and asked which hospital they would prefer to work at.

　The estimation results show that all attributes were significant. Assuming that a nurse's monthly income is 25thousand yen, the value of one unit of“a complete bed bath”is estimated as 93.38yen, an “I.V.”unit as 42.25yen, and “measuring vital signs”as 35.98yen.