Bohyun Park; Sukyung Seo; Taejin Lee

doi:10.4040/jkan.2013.43.1.39

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Original Article
Structure of Nurse Labor Market and Determinants of Hospital Nurse Staffing Levels: Bohyun Park, Sukyung Seo, Taejin Lee; Journal of Korean Academy of Nursing 2013;43(1):39-49.
DOI: https://doi.org/10.4040/jkan.2013.43.1.39
Published online: February 28, 2013

¹Department of Nursing, Kimcheon Science College, Gimcheon, Korea.

²BK21 Center for Elderly Health Policy Research, Seoul National University, Seoul, Korea.

³Graduate School of Public Health, Seoul National University, Seoul, Korea.

Address reprint requests to: Lee, Taejin. Graduate School of Public Health, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 151-742, Korea. Tel: +82-2-880-2726, Fax: +82-2-762-9105, tjlee@snu.ac.kr

• Received: May 30, 2012 • Accepted: September 26, 2012

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Abstract
NOTES
REFERENCES

Abstract

Purpose
To analyze the structure of Korean nurse labor market and examine its effect on hospital nurse staffing.
Methods
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.
Results
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.
Conclusion
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.
Keywords: Nursing staff; Economics; Nursing; Health care sector; Hospitals

This manuscript is based on a part of the first author's doctoral dissertation from Seoul National University.

This study was supported by the research fund of the Korea Health & Medical Worker's Union in 2011.

REFERENCES

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Table 1

Definition of Variables and Data Sources

Note: Capitalize all of the above names.

HIRA=Healthcare insurance review & assessment service; HHI=Herfindahl Hirshman index; KRINP=The Korean research institute for nursing policy; KOSIS=Korean statistical information service; CMI=Case mix index.

Table 2

Demand and Supply for Nurses by Region

HHI=Herfindahl Hirshman index; RN=Registered nurse.

Table 3

Wage of Nurses by Hospital Characteristics

^*10,000 won/year; ^**Duncan grouping: a>b, c>d; ^†General hospital: 1st-2nd grade, Tertiary hospital: 3rd grade or higher; ^‡General hospital: 3rd-5th grade, Tertiary hospital: 4-6th grade.

Table 4

Hospital and Environmental Characteristics by Nurse Staffing Level

^*Fisher's exact test; CMI=Case mix index; HHI=Herfindahl Hirshman index; RN=Registered nurse.

Table 5

Determinants of Hospital Nurse Staffing Levels (Dependent variable: High nurse grade)

OR=Odds ratio; CMI=Case mix index; HHI=Herfindahl Hirshman index; ICC=Intraclass correlation.

^*HHI was calculated on the basis of hospital's nurse share in their labor market(HHI_RN).

Figure & Data

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Structure of Nurse Labor Market and Determinants of Hospital Nurse Staffing Levels

J Korean Acad Nurs. 2013;43(1):39-49. Published online February 28, 2013

DOI: https://doi.org/10.4040/jkan.2013.43.1.39

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Structure of Nurse Labor Market and Determinants of Hospital Nurse Staffing Levels

Table 1

Definition of Variables and Data Sources

Note: Capitalize all of the above names.

Table 2

Demand and Supply for Nurses by Region

HHI=Herfindahl Hirshman index; RN=Registered nurse.

Table 3

Wage of Nurses by Hospital Characteristics

^*10,000 won/year; ^**Duncan grouping: a>b, c>d; ^†General hospital: 1st-2nd grade, Tertiary hospital: 3rd grade or higher; ^‡General hospital: 3rd-5th grade, Tertiary hospital: 4-6th grade.

Table 4

Hospital and Environmental Characteristics by Nurse Staffing Level

^*Fisher's exact test; CMI=Case mix index; HHI=Herfindahl Hirshman index; RN=Registered nurse.

Table 5

Determinants of Hospital Nurse Staffing Levels (Dependent variable: High nurse grade)

OR=Odds ratio; CMI=Case mix index; HHI=Herfindahl Hirshman index; ICC=Intraclass correlation.

^*HHI was calculated on the basis of hospital's nurse share in their labor market(HHI_RN).

Table 1 Definition of Variables and Data Sources

Note: Capitalize all of the above names.

Table 2 Demand and Supply for Nurses by Region

HHI=Herfindahl Hirshman index; RN=Registered nurse.

Table 3 Wage of Nurses by Hospital Characteristics

^*10,000 won/year; ^**Duncan grouping: a>b, c>d; ^†General hospital: 1st-2nd grade, Tertiary hospital: 3rd grade or higher; ^‡General hospital: 3rd-5th grade, Tertiary hospital: 4-6th grade.

Table 4 Hospital and Environmental Characteristics by Nurse Staffing Level

^*Fisher's exact test; CMI=Case mix index; HHI=Herfindahl Hirshman index; RN=Registered nurse.

Table 5 Determinants of Hospital Nurse Staffing Levels (Dependent variable: High nurse grade)

OR=Odds ratio; CMI=Case mix index; HHI=Herfindahl Hirshman index; ICC=Intraclass correlation.

^*HHI was calculated on the basis of hospital's nurse share in their labor market(HHI_RN).