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

1. Adamache KW, Sloan FA. Unions and hospitals: Some unresolved issues. J Health Econ. 1982;1(1):81–108.PubMed
2. Bhaskar V, Manning A, To T. Oligopsony and monopsonistic competition in labor markets. J Econo Perspect. 2002;16(2):155–174. http://dx.doi.org/10.1257/0895330027300.Article
3. Blegen MA, Goode CJ, Reed L. Nurse staffing and patient outcomes. Nurs Res. 1998;47(1):43–50. http://dx.doi.org/10.1097/00006199-199801000-00008.Article PubMed
4. Blegen MA, Vaughn T, Vojir CP. Nurse staffing levels: Impact of organizational characteristics and registered nurse supply. Health Serv Res. 2008;43(1):154–173. http://dx.doi.org/10.1111/j.1475-6773.2007.00749.x.Article PubMed PMC
5. Bloom JR, Alexander JA, Nuchols BA. Nurse staffing patterns and hospital efficiency in the United States. Soc Sci Med. 1997;44(2):147–155. http://dx.doi.org/10.1016/S0277-9536(96)00063-9.Article PubMed
6. Brewer CS, Frazier P. The influence of structure, staff type, and managed-care indicators on registered nurse staffing. J Nurs Adm. 1998;28(9):28–36. http://dx.doi.org/10.1097/00005110-199809000-00007.Article
7. Cho SH, June KJ, Kim YM, Park BH. Changes in hospital nurse staffing after implementing differentiated inpatient nursing fees by staffing grades. J Korean Acad Nurs Adm. 2008;14(2):167–175.
8. Cho WH. Labor economics: Theory and reform policy. 1999;Paju, Bobmunsa.
9. Dickens WT, Lang K. Neoclassical and sociological perspectives on segmented labor markets. 1987;Cambridge, National Bureau of Economic Research.
10. Feldman R, Scheffler R. The union impact on hospital wages and fringe benefits. Ind Labor Relat Rev. 1982;35(2):196–206. http://dx.doi.org/10.2307/2522318.Article PubMed
11. Greene J, Nordhaus-Bike AM. Nurse shortage. Where have all the RNs gone? Hosp Health Netw. 1998;72(15-16):7880.
12. Grumbach K, Ash M, Seago JA, Spetz J, Coffman J. Measuring shortages of hospital nurses: How do you know a hospital with a nursing shortage when you see one? Med Care Res Rev. 2001;58(4):387–403. http://dx.doi.org/10.1177/107755870105800401.Article PubMed PDF
13. Hirsch BT, Schumacher EJ. Classic or new monopsony? Searching for evidence in nursing labor markets. J Health Econ. 2005;24(5):969–989. http://dx.doi.org/10.1016/j.jhealeco.2005.03.006.Article PubMed
14. Hodge MB, Romano PS, Harvey D, Samuels SJ, Olson VA, Sauvé MJ, et al. Licensed caregiver characteristics and staffing in California acute care hospital units. J Nurs Adm. 2004;34(3):125–133. http://dx.doi.org/10.1097/00005110-200403000-00005.Article
15. Jeong HJ, Yang BM. Monopsony power of general hospitals in nurse labor market. Korean J Hosp Manage. 2000;5(2):40–58.
16. Kim YM, Cho SH, Jun KJ, Go SH. The effects of institutional and market factors on nurse staffing in acute care hospitals. Korean J Health Policy Adm. 2007;17(2):68–90.Article
17. Kim YM, June KJ, Cho SH. Factors related to nurse staffing levels in tertiary and general hospitals. J Korean Acad Nurs. 2005;35(8):1493–1499.Article PDF
18. Mark BA, Jones CB, Lindley L, Ozcan YA. An examination of technical efficiency, quality, and patient safety in acute care nursing units. Policy Polit Nurs Pract. 2009;10(3):180–186. http://dx.doi.org/10.1177/1527154409346322.Article PubMed PMC PDF
19. Miller RA. The herfindahl-hirschman index as a market structure variable: An exposition for antitrust practitioners. Antitrust Bull. 1982;27(3):593–618.Article PDF
20. Ministry of Health & Welfare. OECD health data. 2008;Retrieved May 2, 2008. from http://stat.mw.go.kr/front/statData/publicationView.jsp?menuId=43&bbsSeq=9&nttSeq=13157&searchKey=&searchWord=&nPage=2.
21. Mullner R, Beyers M, Levy P, Byre C, Mallin K. Community hospital characteristics associated with RN and LPN vacancy rates. Soc Sci Med. 1983;17(15):1055–1059. http://dx.doi.org/10.1016/027 7-9536(83)90411-2.Article PubMed
22. Oh YH. Distributional change in major health manpower in Korea, 2000-2006. Health Welf Policy Forum. 2008;139:98–110.
23. Peterson CA. Nursing shortage: Not a simple problem-no easy answers. Online J Issues Nurs. 2001;6(1):1.
24. Robinson JC. Market structure, employment, and skill mix in the hospital industry. South Econ J. 1988;55(2):315–325. http://dx.doi.org/10.2307/1059105.Article
25. Seago JA, Ash M, Spetz J, Coffman J, Grumbach K. Hospital registered nurse shortages: Environmental, patient, and institutional predictors. Health Serv Res. 2001;36(5):831–852.PubMed PMC
26. Staiger DO, Spetz J, Phibbs CS. Is there monopsony in the labor market? Evidence form a natural experiment. J Labor Econ. 2010;28(2):211–236.
27. Sullivan D. Monopsony power in the market for nurses. J Law Econ. 1989;32(2):S135–S179. http://dx.doi.org/10.1086/467192.Article
28. Yett DE. An analysis of the causes and consequences of salary differentials in nursing. Econ Inq. 1966;5(1):103. http://dx.doi.org/10.1111/j.1465-7295.1966.tb01990.x.Article

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

REFERENCES

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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).