To analyze the structure of Korean nurse labor market and examine its effect on hospital nurse staffing.

Secondary data were obtained from Statistics Korea, Education Statistics, and Health Insurance Review & Assessment Service and Patient Survey. Intensity of monopsony in the nurse labor market was measured by Herfindahl Hirshman Index (HHI). Hospital nurse staffing level was divided into high and low. While controlling for confounding factors such as inpatient days and severity mix of patients, effects of characteristics of nurse labor markets on nurse staffing levels were examined using multi-level logistic regressions.

For characteristics of nurse labor markets, metropolitan areas had high intensity of monopsony, while the capital area had competitive labor market and the unemployed nurse rate was higher than other areas. Among hospital characteristics, bed occupancy rate was significantly associated with nurse staffing levels. Among characteristics of nurse labor markets, the effect of HHI was indeterminable.

The Korean nurse labor market has different structure between the capital and other metropolitan areas. But the effect of the structure of nurse labor market on nurse staffing levels is indeterminable. Characteristics such as occupancy rate and number of beds are significantly associated with nurse staffing levels. Further study in support of the effect of nurse labor market is needed.

The purpose of this study was to propose optimal hospitalization fees for nurse staffing levels and to improve the current nursing fee policy.

A break-even analysis was used to evaluate the impact of a nursing fee policy on hospital's financial performance. Variables considered included the number of beds, bed occupancy rate, annual total patient days, hospitalization fees for nurse staffing levels, the initial annual nurses' salary, and the ratio of overhead costs to nursing labor costs. Data were collected as secondary data from annual reports of the Hospital Nursing Association and national health insurance.

The hospitalization fees according to nurse staffing levels in general hospitals are required to sustain or decrease in grades 1, 2, 3, 4, and 7, and increase in grades 5 and 6. It is suggested that the range between grade 2 and 3 be sustained at the current level, the range between grade 4 and 5 be widen or merged into one, and the range between grade 6 and 7 be divided into several grades.

Readjusting hospitalization fees for nurse staffing level will improve nurse-patient ratio and enhance the quality of nursing care in hospitals. Follow-up studies including tertiary hospitals and small hospitals are recommended.

This study was conducted to examine activities of daily living (ADL) of older adults admitted to Korean long-term care hospitals (LTCHs), and to explore the patient and organizational factors that have an impact on the ADL of this population.

A secondary analysis of the Korean minimum data set (K-MDS) of patients (N=14,369) and of the profiles of LTCHs (N=358) from the Health Insurance Review and Assessment Service was done between January and July 2008. The outcome variable was ADL score 6 months after baseline assessment. Multi-level linear regression was employed to explore the patient and organizational factors that affected ADL scores.

Of the patients, 45.4% had a baseline ADL score of between 31 and 40, with a score of 40 indicating that the patient was entirely dependent for all items. None of the organizational characteristics were significantly associated with effects on the ADLs of older adults who had been in a LTHC for at least 6 months. However, patient characteristics, such as age, baseline ADL, frequency of physical therapy, urinary incontinence, fecal incontinence, pressure ulcers, and having a tube or catheter, were significantly associated with ADL 6 months after baseline.

In order to maintain and improve the ADL of older adults in LTCHs, we should develop strategies to prevent urinary and fecal incontinence, pressure ulcers, unnecessary tubes or catheters, providing adequate physical therapy. Additional studies should include more detailed information regarding nursing staff, including RN hours for direct care, education level and turnover.

The purpose of this study was to identify and describe nurses' experience of a career ladder program (CLP) in a general hospital in Korea.

The data were collected from 15 nurses who participated in the CLP. Each nurse completed individual in-depth interviews, for which the main interview question was "How do you describe your experience of CLP?". All interview data were transcribed and were analyzed using the grounded theory method.

The core category of the experience of CLP was identified as "challenging to rebirth as an expert". The participants used five action/interaction strategies such as "taking some time for introspection", "appreciating the essence of nursing", "making use of feedback positively", "throwing away doubts about their own capabilities", "exerting themselves with confidence". The consequence of the process of adjusting to CLP was "positioning a differentiated expert."

The results of this study show that participants recognized CLP as a powerful resource which leads them to professional growth and development. Thus, CLP could be utilized as a clinical career-promoting program and ultimately as a program for providing high-quality nursing services.