Nurses are medical personnel, who play a key role in supporting patient care, so it is important to supply them adequately in balance with ever increasing medical demand. But there appears severe shortage of nurses in some hospitals because of their uneven distribution, especially in small sized-hospitals and rural-hospitals. As nationwide distorted distribution of nurses in Korea is just like what monopsony model(a kind of market structure model) tells us, it is attempted to explain this situation of nurse labor market in Korea on the basis of monopsony model and presented in this paper. Specifically, determinants of nurse wage and the level of their relative employment were examined, and monopsony impact on their wage and the level of relative employment controlling those determinants were studied. Major results of this study arc as follows. The most important determinant of nurse wage level in this study was the wage level of a local community where each hospital located Hospital owner's characteristics an educational function of each hospital were also important factors. With these factor controlled, it was found that monopsony power of each hospital was negativel associated with nurse wage level as expected. 1% increase in monopsony power of hospital(measured by Herfindah-Hirschman Index) reduced nurse wage by $5,674{\sim}19,19$ won(in Korean currency). With regard to the level of relative employment, the most important determinant wa the capacity for supplying nurses of the local community. Again, hospital owner characteristics and educational function of each hospital were also important. With these factors controlled, it was found that monopsony power of each hospital was negative associated with the number of nurses per bed, as expected. 1% increase in monopsony power of each hospital(again measured by Herfindah-Hirschman Index) reduced the number of nurses per 100 bed as much as $0.46{\sim}0.67$. In conclusion. structural factors of nurse labor market influence the instability of nurse labor supply in Korea. Further consideration for these market structural characteristics needed for policy making related to nurse resource allocation.
Purpose: The purpose of this study was to investigate the wage structure of hospital nurses in Korea and to analyze the factors that determine the level of nurses' wages. Methods: First, a mobile survey on nurses' wages was conducted with a total of 3,742 nurses working in hospitals. A literature review was also done. Second, a regression model was applied to analyze the determinants of nurses' wages. Results: The average monthly wage of 3,742 nurses based on the survey was KRW 3,588,000 and the standardized monthly income of 3,742 nurses was estimated to be KRW 3,364,000 as of the end of 2018. The results of regression analysis(R2=61.7%) showed that gender, nursing experience, designated night duty, ownership, and number of beds were statistically significant variables for nurses' wages at 1% significance level. The monthly wage of nurses working in total nursing care wards was not significantly different from those working in other wards at 5% significance level. Conclusion: The substantial difference in nurses' wages according to job career, hospital size, region, etc may result in the low proportion of nurses with more than three to five years of service experience and the high turnover of less-experienced workers. Consideration should be given to adjust the gap in wage level and a standard nurse wage system could be effective measures.
Korean labor market has showed remarkable change of the increase in the amount of unemployment and contingent employment since IMF bailout agreement. There is a theoretical position to explain this increase in contingent employment at hospitals with the notion of flexibility. The high flexibility of employment due to the increase of contingent employees is becoming very important part in new business strategy of hospitals. The types of contingent employment of the nurse are part-time employment temporary employment, fixed-term employment, and internship which was introduced in early 1999. Recently, Korean health care industry managers have paid attention to the customer oriented service, rationalization of business administration, service quality control so that they can adjust their business to outer environment. Especially their efforts concentrate on the wage reduction through efficient and scientific control of man power because wage shares about 40% of total cost. This dissertation aims at verifying the phenomena of the contingent employment of the nurse and analyzing the related factors and problems. To rephrase these aims in ordinal: First, verifying the phenomena of contingent employment of the nurse. Second, verifying the problems of that phenomena. Third, analyzing the related factors of the contingent employment of the nurse. To accomplish these research goals, a statistical survey was executed. in which 384 questionnaires-66 for manager nurses, 318 for contingent nurses - were given to nurses working at 66 hospitals-which have at least 100 beds-in Seoul. Among them, 187 questionnaires-38 from manager nurses, 149 from contingent nurses'- 'were returned. Then, the data coded and submitted to T-test, $X^2$ -test, variance analysis(ANOVA), correlation analysis, multiple regression analysis, Logistic Regression with SAS program. The research results of the contingent nurses are followings: 1. The average career term at the present hospital 8.4 months: duty-on days per month are 24.2 days: working time per day is 7.9 hours. These results showed little difference from regular nurses. 2. Their wage level is about 70% of regular nurses except for internship nurses whose wage level is 41% of regular nurses. To break down the wage composition, part-time nurses and internship nurses get few allowance and bonus. And contingent nurses get very low level of additional pay except for fixed-term nurses who are under similar condition of employment to regular nurses. These results show that hospital managers are trying to reduce the labor cost not only through the direct way of wage reduction but through differential treatment of bonus, retirement allowance, and other additional pay. 3. The problem of contingent employment: low level of pay; high level of turn-over rate: weakening of union; low level of working condition: heavy burden of work; inhuman treatment. The contingent nurses consider these problems more seriously than manager nurses do. What manager nurses regard problematic is the absence of feeling-belonged and responsibility of the contingent nurses. 4. The factors strongly related with the rate of the number of contingent nurses for the number of regular nurses; gross turn-over nurses; average in-patients per day; staring wage of graduate from professional college: the type of hospital ownership; the number of beds; the gap between gross newcomer nurses and gross turn-over nurses. The factors related with their gross wage per month; the number of beds; applying of health insurance; applying of industrial casualty insurance; applying of yearly-paid leave; the type of hospital ownership; average out-patients per day; gross turn-over nurses. The meaningful factors which make difference by employment type: monthly-paid leave; physiological leave. The logistic regression analysis using these two factors shows that monthly-paid leave is related with the type of hospital ownership; the number of beds; average out-patient per day, and physiological leave is related with the gross newcomer nurses; gross turn-over nurses; the number of beds.
It is generally believed that the medical profession in Korea is an well-paid field along with legal profession. In this vein, the nursing is regarded one of well-paid profession. The actual data, however, reveals that nurses belong to low income bracket. We carefully compare the nurse's earnings with those of other professions. We selected 58 professions, which are similar in vocational characteristics and education background to nurses and conduct a regression analysis to estimate earning functions. Using the estimated coefficients, we project an optimum salary level for nurse, and compare it with the actual salary level. The estimated results show that the nurses are underpaid : their actual salary is less than the optimum level. We provide several explanations for this phenomenon : a tradition based on Confucian value, wage discrimination for women, and wage inequality among hospitals. Undercompensation will result either ratard professional development, or block the motivation for high quality of nursing care. If the current underpaying situation is not improved, a shortage of nurses along with an noticeable decline in the quality of medical services are expected. Therefore an adequate compensation for nurses must be properly assessed and addresed not only be health care authorities but also by legislators. Further research is needed to explain why there is such as wide salary inequality among nurses, and to find what cause it.
compensation is a major function of human resources management. The hospital industry is characterized by its remarkable labor intensity and human resource input by unit. That is why the hospital industry has a higher level of wage/cost ration. The issues of how much the hospital personnel's direct financial compensation amounts to and how the organizational and other factors generate compensation differentiation, are central problems for research in hospitals. But there have been few approaches to study staff compensation in hospitals, its magnitude and inter-hospital relative compensation amounts for the same personnel. A worker who moves from low-wage to a high-wage employer can usually increase his or her pay without change in job description. This means in the cases of same jobs, relative importance is different for each hospitals. The purpse of this study were to find the compensation levels of hospital personnel and to determine the factors affecting compensation levels of hospital personnel. The unit of analysis is the hospital and 145 hospitals were studied for nurse(RN), medical technoloist(MT), managerial personnel(MP) and 100 hospitals for medical doctor(MD). In this study the definitions of direct financial compensation are before tax, excluding employer's contriution and total annual remuneration received by the employee. Main findings of the research can be summarized as follows. 1. Direct financial compensation of hospital personnel are MD 45,056,000 won, RN 9,222,000 won, MT 9,513,000 won and MP 9,185,000 won in the starting year's employment in hospital. 2. According to determinants of hospital personnel compensations, there are no statistical significant variables to determine the level of MD's compensation. Wlith RN and MT's compensation level, the greater the patient revenue per 100 hospital beds, the higher the RN compensation and the tertiary hospital's compensation is much more than other types of hospitals. The location of hospital is another determinant factor for the MT's compensation level. Hospitals that are in the uban area have lower compensation level than rural area. There are the same results in MP with MT. Conclusions can be drawn from the results of the study. First, the wage differentiation of MD and other health personnel still remains and the differentiation existed in inter and intra job personnel of hospitals. Second, determinants of hospital personnel personnel compensation level are patient revenue, location, and type of hospital level.
Recently, Korean health care industry managers are paying more attention to customer oriented service, the rationalization of business administration, and quality control of service to adjust their business to outer environment since IMF bailout program. They are focusing on the cost reduction through remodeling the size and structure of man power, viz. labor flexibility. Nurses are not free from this juncture and contingent nurses are increasing fast. This article intends to verify the actual condition of two types of contingent nurses -part-time nurses and internship nurses-and to compare their job satisfaction to provide basic resource for efficient management of nurse man power. The concrete goals of this article are; Firstly, to verify the actual condition of their employment. Secondly, to compare their job satisfaction. And Thirdly, to the relation between employment condition and job satisfaction. To accomplish these research goals, a statistical survey was executed, in which 384 questionnaires - 66 for manager nurses, 318 for contingent nurses-were given to nurses working at 66 general hospitals-which have at least 100 beds-in Seoul. Among them, 121 questionnaires-of 28 general hospitals-were returned. Then, the data coded and submitted to mean, standard deviation, T-test, variance analysis (ANOVA), correlation analysis, multiple regression analysis with SAS program. The research results of the contingent nurses are followings: 1. Two types of contingent nurses shows similar age spans: they are mostly 21 - 30 years old and unmarried. But internship nurses have high level of educational career. Part - time nurses spread at general beds, out -patient part, intensive care part, operation part, etc, but internship nurses work mostly at general beds. 2. Two groups shows difference in actual employment condition: average employment career of part -time nurses is 7.0 months but internship nurses' is 2.0 months: average duty-on days per month of part - time nurses are 23.7 days but internship nurses' are 24.8 days. But there are little difference in average working time per day: 7.7 hours for part -time nurses and 0 hours for internship nurses. 3. The average wage per month for part -time nurses is 836,026 won but for internship nurses is 557,428 won-66.7% of part-time nurses'. Both groups are enjoying little additional pay. 4. Both groups are getting job not so much through advertisement of newspaper or hospitals as through acquainted person or college. 5. Both groups show very high level of job satisfaction: 3.2195 for part -time nurses and 3.2881 for internship nurses. But they show very low satisfaction on payment level compared with other categories and two groups show meaningful difference(P<.0001). 6. The multiple regression test reveals the factors related with job satisfaction: wage level, working part(OR or ICU), age, job career, and motive of contingent job-taking('because I can take care of family duties at the same time') influence positively: motive of contingent job-taking('because I can work regularly without alternation') influences negatively.
Recently, small and medium-sized hospitals which are located in rural areas have many difficulties in securing high quality nurses. That is because working environments for nurses in small and medium-sized hospitals in rural areas are poor compared with those of big hospitals in urban. As a result, the migration of nurses from small and medium-sized hospitals in rural areas to big hospitals in urban is continuously happening. In general, big hospitals provide nurses with high level of salary and fringe benefits. To prevent the migration of nurses, chief executive officers of small & medium hospitals in rural areas have been interested in improving nurses' working conditions including wages. Also, they have raised nurses' salary and improved working conditions. But, basically these individualized efforts have some limit. In connection with this, medical interest groups have produced various voices in terms of interpretation and solutions for these issues. However, from the future perspectives, it seems evident that two approaches for both manpower supply and demand plans of nurses are necessary. They should contain not only accurate estimation of the supply-demand of nursing manpower but also the improvement of working conditions and wages of nurses. Estimation of nursing manpower supply-demand depends on the standards and criteria being used. Supply and demand may be met or not in accordance with the points emphasized on the decision. In the articles, issues regarding nursing manpower, levels of salary, other working conditions and social support system for child care are discussed. According to Joe's report (2005), most health institutions did not meet the guidelines of nurse staffing in Medical Law. The wages of nurse vary on every hospital and there is a big difference in wages' range. The average starting salary for a nurse is 22 million won a year. In case of tertiary hospitals, it reaches up to 30 million won a year. Nurse as a profession should have a strong responsibility and should take care of the patients for 24 hours with three working shifts. Also, most of them are female who have the burden of child rearing. Therefore, it is suggested to increase the salary, to provide comfortable working conditions, and to have social support system for nurses with household affairs.
본 연구의 목적은 간호사들의 병원 근무 경험과 경력단절 영향요인을 심층적으로 분석하기 위해 시도되었다. 이를 위해 26-55세 경력단절 간호사 20명을 대상으로 간호사로서의 경험, 간호 일의 특성과 퇴직사유의 내용을 인터뷰하였으며 현상학적 방법 중 꼴라쥐(Colaizzi)의 분석방법을 적용하였다. 분석결과 104개의 주요 진술과 17개의 구성된 의미, 6개의 공통 주제군, 2개의 범주가 도출되었다. 2개의 범주는 간호 업무 특성과 근무 환경 특성이며 간호 업무 특성에서는 '시간 압박', '자율성 부재', '신체 감정 노동', '낮은 임금 상승률'의 4가지 공통 주제군이, 근무 환경 특성에서는 '물리적 환경', '인적 환경'의 2가지 공통 주제군이 각각 도출되었다. 따라서 간호사의 경력단절 현상을 개선하기 위해서는 과도한 업무강도를 완화하고 적정수준의 임금인상과 안전한 근무환경을 제공하려는 노력이 필요하다.
Purpose: This study aims to provide primary data for policy alternatives by identifying the problem of the nursing workforce shortage. Methods: For quantitative data, 446 questionnaires were analyzed. The mean and standard deviation were used for content description. ANOVA analysis and Scheffe? test were used to compare the differences according to the hospital level. For qualitative data, 1:1 in-depth and group interviews were conducted for six participants. Results: The factors nurses prioritized when choosing a workplace were salary, commuting distance, and work-life balance. Clinical nurses cited low wages, heavy workloads, and burnout as the most considerable difficulties in performing their duties. Factors influencing nurse's turnover intention were low wages, unmanageable workload, and rotation to unwanted departments in that order. New nurses tend not to apply to small-medium-sized hospitals, experienced nurses in their 30s-40s leave hospitals due to childcare and shift work difficulties, and nurses in their 50s and older tend to move to nursing homes rather than acute hospital settings. Conclusion: In this study, wage and workload were mentioned as the most critical factors in nurses' workplace selection, job performance difficulties, and turnover intention, so it is necessary to pay attention to this aspect when improving treatment for nurses.
Purpose: This study aimed to develop and test a reward scale for hospital nurses. Methods: The initial items were identified through a literature review and focus group interviews with ten hospital nurses. The content validity of the items was evaluated by ten experts. Fifty-one items were derived from the pilot survey. Four hundred eighty-eight nurses participated in the study: 248 for exploratory factor analysis (EFA) and 240 confirmatory factor analysis (CFA). Data were analyzed using item analysis, EFA, CFA, convergent validity, known-group validity, and internal consistency using IBM SPSS Statistics 29.0 and IBM SPSS AMOS 29.0. Results: The final scale consisted of 31 items and eight factors (decent wage, opportunity to grow and develop, support for special situations, various benefits, flexibility of work, job-related achievement, reflecting career and performance, and recognition), which explained 67.3% of the total variance. The eight-subscale model was validated by CFA. Convergent validity was evaluated by analyzing correlation with intention to leave (r = - .63, p < .001) and job satisfaction (r = .54, p < .001). The known-group validity was evaluated by comparing the reward scales according to age, clinical career, income level and hospital type. The scale was found to be reliable with a Cronbach's α of .89. Conclusion: Both the validity and reliability of the reward scale for hospital nurses are verified, which can enhance the understanding of the range of rewards and may assist nurse managers in establishing an effective reward system.
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