연령에 따른 근무환경 및 의료기관 특성이 간호사 이직에 미치는 영향

Abstract

Background: Demand for nurses is increasing in various fields of health care services. Despite the increase in the number of nurses, the shortage of nurses has not been solved. The leading cause of the lack of nursing staff is the high turnover rate. This study aims to examine the characteristics of the hospitals and working environment related to nurse turnover and identify the differences by age group. Methods: In this study, the data reported to the Health Insurance Review and Assessment Service were used. The subjects were nurses who worked in hospitals from 2017 to 2019. Nurse turnover, a dependent variable determined by a continuous work episode, was constructed in consideration of the date of employment and resignation. A total of 194,343 nurse staff in 1,316 hospitals and 245,004 work episodes were examined. Results: Among the work episodes analyzed, the turnover rate was 40.3%. The turnover of nurses was higher at a younger age, with lower clinical experience, and lower length of stay (odds ratio [OR], 1.56; 95% confidence interval [CI], 1.51–1.63; OR, 2.11; 95% CI, 2.02–2.21; OR, 1.38; 95% CI, 1.33–1.44). Irregular work nurses had a very significant risk of turnover compared to regular work (OR, 3.15; 95% CI, 2.99–3.33). After stratification by age, irregular work nurses in the working environment and nurse rate grade of the hospital were the main factors affecting a turnover in all age groups. Conclusion: Nurse turnover was significantly differed according to the hospital characteristics and working environment. In the future, system design or health policy development to reduce the nurse turnover requires a customized design considering age, not introducing a comprehensive system for managing nurses.