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http://dx.doi.org/10.4040/jkan.2013.43.1.39

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

Park, Bohyun (Department of Nursing, Kimcheon Science College)
Seo, Sukyung (BK21 Center for Elderly Health Policy Research, Seoul National University)
Lee, Taejin (Graduate School of Public Health, Seoul National University)
Publication Information
Journal of Korean Academy of Nursing / v.43, no.1, 2013 , pp. 39-49 More about this Journal
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;
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1 Adamache, K. W., & Sloan, F. A. (1982). Unions and hospitals: Some unresolved issues. Journal of Health Economics, 1(1), 81-108.   DOI   ScienceOn
2 Bhaskar, V., Manning, A., & To, T. (2002). Oligopsony and monopsonistic competition in labor markets. Journal of Economic Perspectives, 16(2), 155-174. http://dx.doi.org/10.1257/0895330027300   DOI
3 Blegen, M. A., Goode, C. J., & Reed, L. (1998). Nurse staffing and patient outcomes. Nursing Research, 47(1), 43-50. http://dx.doi.org/10.1097/0000 6199-199801000-00008   DOI   ScienceOn
4 Blegen, M. A., Vaughn, T., & Vojir, C. P. (2008). Nurse staffing levels: Impact of organizational characteristics and registered nurse supply. Health Services Research, 43(1), 154-173. http://dx.doi.org/10.1111/j.1475-677 3.2007.00749.x
5 Bloom, J. R., Alexander, J. A., & Nuchols, B. A. (1997). Nurse staffing patterns and hospital efficiency in the United States. Social Science and Medicine, 44(2), 147-155. http://dx.doi.org/10.1016/S0277-9536(96)00063-9   DOI   ScienceOn
6 Brewer, C. S., & Frazier, P. (1998). The influence of structure, staff type, and managed-care indicators on registered nurse staffing. Journal of Nursing Administration, 28(9), 28-36. http://dx.doi.org/10.1097/00005110-199809000-00007
7 Cho, S. H., June, K. J., Kim, Y. M., & Park, B. H. (2008). Changes in hospital nurse staffing after implementing differentiated inpatient nursing fees by staffing grades. The Journal of Korean Nursing Administration Academic Society, 14(2), 167-175.   DOI
8 Cho, W. H. (1999). Labor economics: Theory and reform policy. Paju: Bobmunsa.
9 Dickens, W. T., & Lang, K. (1987). Neoclassical and sociological perspectives on segmented labor markets. Cambridge: National Bureau of Economic Research.
10 Feldman, R., & Scheffler, R. (1982). The union impact on hospital wages and fringe benefits. Industrial and Labor Relations Review, 35(2), 196-206. http://dx.doi.org/10.2307/2522318   DOI   ScienceOn
11 Greene, J., & Nordhaus-Bike, A. M. (1998). Nurse shortage. Where have all the RNs gone? Hospitals and Health Networks, 72(15-16), 78-80.
12 Grumbach, K., Ash, M., Seago, J. A., Spetz, J.,& Coffman, J. (2001). Measuring shortages of hospital nurses: How do you know a hospital with a nursing shortage when you see one? Medical Care Research and Review, 58(4), 387-403. http://dx.doi.org/10.1177/107755870105800401   DOI
13 Hirsch, B. T., & Schumacher, E. J. (2005). Classic or new monopsony? Searching for evidence in nursing labor markets. Journal of Health Economics, 24(5), 969-989. http://dx.doi.org/10.1016/j.jhealeco.2005. 03.006   DOI   ScienceOn
14 Hodge, M. B., Romano, P. S., Harvey, D., Samuels, S. J., Olson, V. A., Sauvé, M. J., et al. (2004). Licensed caregiver characteristics and staffing in California acute care hospital units. Journal of Nursing Administration, 34(3), 125-133. http://dx.doi.org/10.1097/00005110-200403000-00005   DOI   ScienceOn
15 Mark, B. A., Jones, C. B., Lindley, L., & Ozcan, Y. A. (2009). An examination of technical efficiency, quality, and patient safety in acute care nursing units. Policy, Politics & Nursing Practice, 10(3), 180-186. http://dx.doi. org/10.1177/1527154409346322   DOI
16 Jeong, H. J., & Yang, B. M. (2000). Monopsony power of general hospitals in nurse labor market. Korean Journal of Hospital Management, 5(2), 40-58.
17 Kim, Y. M., Cho, S. H., Jun, K. J., & Go, S. H. (2007). The effects of institutional and market factors on nurse staffing in acute care hospitals. Korean Journal of Health Policy and Administration, 17(2), 68-90.
18 Kim, Y. M., June, K. J., & Cho, S. H. (2005). Factors related to nurse staffing levels in tertiary and general hospitals. Journal of Korean Academy of Nursing, 35(8), 1493-1499.   DOI
19 Miller, R. A. (1982). The herfindahl-hirschman index as a market structure variable: An exposition for antitrust practitioners. The Antitrust Bulletin, 27(3), 593-618.
20 Ministry of Health & Welfare. (2008). OECD health data.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. (1983). Community hospital characteristics associated with RN and LPN vacancy rates. Social Science and Medicine, 17(15), 1055-1059. http://dx.doi.org/10.1016/027 7-9536(83)90411-2   DOI   ScienceOn
22 Oh, Y. H. (2008). Distributional change in major health manpower in Korea, 2000-2006. Health and Welfare Policy Forum, 139, 98-110.
23 Peterson, C. A. (2001). Nursing shortage: Not a simple problem-no easy answers. Online Journal of Issues in Nursing, 6(1), 1.
24 Sullivan, D. (1989). Monopsony power in the market for nurses. Journal of Law and Economics, 32(2), S135-S179. http://dx.doi.org/10.1086/467192   DOI   ScienceOn
25 Robinson, J. C. (1988). Market structure, employment, and skill mix in the hospital industry. Southern Economic Journal, 55(2), 315-325. http://dx.doi.org/10.2307/1059105   DOI   ScienceOn
26 Seago, J. A., Ash, M., Spetz, J., Coffman, J., & Grumbach, K. (2001). Hospital registered nurse shortages: Environmental, patient, and institutional predictors. Health Services Research, 36(5), 831-852.
27 Staiger, D. O., Spetz, J., & Phibbs, C. S. (2010). Is there monopsony in the labor market? Evidence form a natural experiment. Journal of Labor Economics, 28(2), 211-236.   DOI
28 Yett, D. E. (1966). An analysis of the causes and consequences of salary differentials in nursing. Economic Inquiry, 5(1), 103. http://dx.doi.org/ 10.11 11/j.1465-7295.1966.tb01990.x   DOI