J Korean Acad Nurs.  2017 Dec;47(6):828-841. 10.4040/jkan.2017.47.6.828.

Impact of Increased Supply of Newly Licensed Nurses on Hospital Nurse Staffing and Policy Implications

Affiliations
  • 1College of Nursing, Eulji University, Seongnam, Korea.
  • 2Department of Nursing, Mokpo National University, Mokpo, Korea. sunju@mokpo.ac.kr
  • 3College of Nursing, Seoul National University, Seoul, Korea.

Abstract

PURPOSE
This study aimed to analyze the impact of increasing the supply of newly licensed nurses on improving the hospital nurse staffing grades for the period of 2009~2014.
METHODS
Using public administrative data, we analyzed the effect of newly licensed nurses on staffing in 1,594 hospitals using Generalized Estimating Equation (GEE) ordered logistic regression, and of supply variation on improving staffing grades in 1,042 hospitals using GEE logistic regression.
RESULTS
An increase of one newly licensed nurse per 100 beds in general units had significantly lower odds of improving staffing grades (grades 6~0 vs. 7) (odds ratio=0.95, p=.005). The supply of newly licensed nurses increased by 32% from 2009 to 2014, and proportion of hospitals whose staffing grade had improved, not changed, and worsened was 19.1%, 70.1%, and 10.8% respectively. Compared to 2009, the supply variation of newly licensed nurses in 2014 was not significantly related to the increased odds of improving staffing grades in the region (OR=1.02, p=.870).
CONCLUSION
To achieve a balance in the regional supply and demand for hospital nurses, compliance with nurse staffing legislation and revisions in the nursing fee differentiation policy are needed. Rather than relying on increasing nurse supply, retention policies for new graduate nurses are required to build and sustain competent nurse workforce in the future.

Keyword

Nurses; Nursing student; Staffing; Hospital

MeSH Terms

Compliance
Fees and Charges
Humans
Logistic Models
Nursing
Students, Nursing

Cited by  1 articles

Factors Influencing Nursing Students' Choices of a Place of Employment
Sun Ju You, Jong Kyung Kim, Myun Sook Jung, Se Young Kim, Eun Kyung Kim
Korean J Health Promot. 2018;18(4):184-193.    doi: 10.15384/kjhp.2018.18.4.184.


Reference

References

1. Kane RL, Shamliyan T, Mueller C, Duval S, Wilt TJ. Nurse staffing and quality of patient care. Evidence Report Technology Assessment. 2007; (151). 1–115.
2. Buchan J, Black S. The impact of pay increases on nurses’ labour market: A review of evidence from four OECD countries. Paris: OECD Publishing;2011. Aug. Report No.: OECD Health Working Papers No. 57.
3. Lee YG. Status and countermeasures on nurses supply and demand. Korean Hospital Association Newsletter. 2008; 15:46–50.
4. Zurn P, Dolea C, Stilwell B. Nurse retention and recruitment: Developing a motivated workforce. Issue paper 4. Geneva: International Council of Nurses, World Health Organization;2005. Jan. Paper No.: 4.
5. Korean Educational Development Institute. University educational statistics [Internet]. Seoul: Author;c2004. 2015 [cited 2017 Oct 1]. Available from:. http://kess.kedi.re.kr/index.
6. National Law Information Center. Enforcement decree of the higher education act [Internet]. Seoul: Author;c2017. [cited 2017 Oct 1]. Available from:. http://www.law.go.kr/lsInfoP.do?lsiSeq=197216&efYd=20170905#0000.
7. Kim JH. Nursing workforce and policy directions for nurses. Issue paper. Seoul: Korea Institute for Health and Welfare Policy;2014. Jul. Paper No.: 10.
8. Oh YH. The 2011 survey on national health conditions-health care resources survey. Policy paper. Seoul: Korea Institute for Health and Social Affairs;2011. Nov. Report No.: 2011-56-1.
9. Ministry of Health and Welfare. 158,000 nurses, 7,600 doctors, shortage forecast by the year 2030 [Internet]. Sejong: Author;c2017. [cited 2017 May 3]. Available from:. http://www.mohw.go.kr/front_new/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&SEARCHKEY=TITLE&SEARCHVALUE=%B0%A3%C8%A3%BB%E7&DATA_GUBUN=&page=1&CONT_SEQ=339529.
10. Cho SH, Lee JY, Mark BA, Lee HY. Geographical imbalances: Migration patterns of new graduate nurses and factors related to working in non-metropolitan hospitals. Journal of Korean Academy of Nursing. 2012; 42(7):1019–1026. https://doi.org/10.4040/jkan.2012.42.7.1019.
Article
11. Harrington C, Swan JH, Carrillo H. Nurse staffing levels and Medicaid reimbursement rates in nursing facilities. Health Services Research. 2007; 42(3 Pt 1):1105–1129. https://doi.org/10.1111/j.1475-6773.2006.00641.x.
Article
12. Yeager VA, Menachemi N, Savage GT, Ginter PM, Sen BP, Beitsch LM. Using resource dependency theory to measure the environment in health care organizational studies: A systematic review of the literature. Health Care Management Review. 2014; 39(1):50–65. https://doi.org/10.1097/HMR.0b013e3182826624.
13. Kim YM, Cho SH, Jun KJ, Go SK. The effects of institutional and market factors on nurse staffing in acute care hospitals. Health Policy and Management. 2007; 17(2):68–90. https://doi.org/10.4332/KJHPA.2007.17.2.068.
14. Health Insurance Review and Assessment Service. Find a hospital, pharmacy [Internet]. Sejong: Author;c2010. 2015 [cited 2010, 2015 Jun 1]. Available from:. http://www.hira.or.kr/rd/hosp/getHospList.do?pgmid=HIRAA030002000000.
15. Choi HM, Han NK, Lee SK, Kim HS, Choi S, Chung W. Study on factors associated with the rise in grade of nursing management fee among Korean hospitals. Health Policy and Management. 2015; 25(1):40–52. https://doi.org/10.4332/KJHPA.2015.25.1.40.
Article
16. Takaku R, Ando M. Testing for monopsony in the labor market of nurses: Evidence from the 2006 fee schedule revision in Japan. First draft report. Tokyo: Ministry of Health, Labour and Welfare;Japan; c2017 [cited 2017 Oct 1]. Available from. http://www.jeameetings.org/2017s/Gabstract/K-005abstract_ReoTakaku.pdf.
17. Yang BM. Health economics. Seoul: Nanam Press;1999. p. 247–276.
Article
18. Blegen MA, Vaughn T, Vojir CP. Nurse staffing levels: Impact of organizational characteristics and registered nurse supply. Health Services Research. 2008; 43(1p1):154–173. https://doi.org/10.1111/j.1475-6773.2007.00749.x.
Article
19. Ministry of Health & Welfare. Notification no. 2014-189: Revision of medical care benefits and relative value scale [Internet]. Wonju: Author;c2014. [cited 2017 Jun 20]. Available from:. http://www.hira.or.kr/dummy.do?pgmid=HIRAA020002000000&cmsurl=/cms/inform/01/1331741_27106.html&su.
20. Katz MH. Multivariable analysis: A practical guide for clinicians. Cambridge: Cambridge University Press;2006. p. 164–180.
21. Buchan J, Aiken L. Solving nursing shortages: A common priority. Journal of Clinical Nursing. 2008; 17(24):3262–3268. https://doi.org/10.1111/j.1365-2702.2008.02636.x.
Article
22. Hirsch BT, Schumacher EJ. Classic or new monopsony? Searching for evidence in nursing labor markets. Journal of Health Economics. 2005; 24(5):969–989. https://doi.org/10.1016/j.jhealeco.2005.03.006.
Article
23. Health Workforce Australia. Nursing workforce sustainability: Improving nurse retention report [Internet]. Adelaide: Author;c2014. [cited 2017 Jan 5]. Available from:. https://www.health.gov.au/internet/main/publishing.nsf/Content/29418BA17E67.
24. Kim DJ, Hwang NM, Shin JW, Kim SY, Shim BR, Jun JW. Study for the evaluation of comprehensive nursing service fee schedule validity and development 2nd year fee schedule. Seoul: National Health Insurance Service and Korea Institute for Health and Social Affairs;2015. Dec. Policy report No.: 2015-32.
25. Cho SH, Lee JY, June KJ, Hong KJ, Kim YM. Nurse staffing levels and proportion of hospitals and clinics meeting the legal standard for nurse staffing for 1996-2013. Journal of Korean Academy of Nursing Administration. 2011; 22(3):209–219. https://doi.org/10.11111/jkana.2016.22.3.209.
Article
26. American Nurses Association. Staffing plans and ratios [Internet]. Georgia: Author;c2006. [cited 2017 Jan 5]. Available from:. http://www.nursingworld.org/MainMenuCategories/Policy-Advocacy/ExpiredContent-GOVA/2006/staffing12765.html.
27. McHugh MD, Brooks Carthon M, Sloane DM, Wu E, Kelly L, Aiken LH. Impact of nurse staffing mandates on safety-net hospitals: Lessons from California. Milbank Quarterly. 2012; 90(1):160–186. https://doi.org/10.1111/j.1468-0009.2011.00658.x.
Article
28. Royal College of Nursing. Mandatory nurse staffing levels [Internet]. London: Author;c2012. [cited 2016 Jan 20]. Available from:. https://my.rcn.org.uk/__data/assets/pdf_file/0009/439578/03.12_Mandatory_nurse_staffing_levels_v2_FINAL.pdf.
29. Ministry of Health, Labour and welfare: Medical fee and calculation method [Internet]. Tokyo: Author;c2016. [cited 2016 Dec 30]. Available from. http://www.mhlw.go.jp/stf/sei-sakunitsuite/bunya/0000106421.html.
30. Shin YS, Hwang DK, Kim SY, Park KR. Study for improvement policy of differentiated inpatient nursing fee schedule. Wonju, Sejong: Health Insurance Review and Assessment Service and Korea Institute for Health and Social Affairs;2015. Dec. Policy report No.: 2015-59.
Full Text Links
  • JKAN
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr