The distribution of hospital nurses and associated factors.
The distribution of hospital nurses and associated factors.
复制标题
医院护士分布及相关因素。
DOI：
--
复制
发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Yasuki Kobayashi
中科院分区：
文献类型：
--
作者：
Y. Sakata;Noriko Morioka;F. Nakamura;S. Toyokawa;Yasuki Kobayashi
目的 随着日本老龄化人口的增加，对医疗和长期护理的需求预计将会增加。因此，确保医疗机构有足够的护理人员是很重要的。仔细监测护士的分配情况对于提供符合人口需求的服务至关重要。然而，很少有研究根据护士工作的设施类型来检查他们的分布情况，或者确定任何相关因素。本研究的目的是调查护士在医院工作的分布趋势，并找出政策变化、当地社会经济特征和护士供求相关因素等相关因素。方法 我们利用2002年至2011年的公共调查数据进行了一项生态研究。我们专注于38个县的274个二级医疗区域(SMA)，从中我们可以获得研究期间的连续数据。我们计算了每100,000人口中的医院护士人数以及基尼系数。被解释的变量是每10万人口中的医院护士数量。我们使用了以下解释变量：SMA人口、老龄化人口比例、人口密度类别、人均收入、地区、护理学校毕业生人数和前一年提供的护士工资。结果 在此期间，每100,000人口中的医院护士人数有所增加。基尼系数总体上呈下降趋势，但在2007年和2008年有所上升。在对SMA人口及其增长进行调整后，根据年份的不同，医院护士人数与人均收入较高、人口老龄化比例较高、关东以外地区、护理学校毕业生人数较多、上一年工资较高呈正相关。结论 虽然各SMA医院护士人数的差异较小，并因此有所改善，但在2006年医疗支付制度修订后的两年内，差异有扩大的趋势。结果表明，医疗支付制度的修订等政策变化的影响是可能的。当地的社会经济特征、护理学校毕业生的数量和护士工资也是影响医院护士分布的因素。
Objectives With the increasing aging population in Japan, the demand for medical and long-term care is expected to grow. Consequently, it is important to secure sufficient nursing personnel for medical care facilities. Careful monitoring of the allocation of nurses is crucial for providing services that match the needs of the population. However, few studies have examined the distribution of nurses by the type of facility in which they work or identified any associated factors. The objectives of this study are to examine trends in the distribution of nurses working in hospitals and to identify any associated factors such as policy changes, local socioeconomic characteristics, and nurse supply-and-demand-related factors.Methods We conducted an ecological study using public survey data from 2002 to 2011. We focused on 274 secondary medical areas (SMAs) in 38 prefectures from which we could obtain continuous data over the study period. We calculated the number of hospital nurses per 100,000 of the population in each SMA as well as the Gini coefficient. The explained variable was the number of hospital nurses per 100,000 of the population. We employed the following explanatory variables: SMA population, aging population ratio, population density category, per capita income, region, number of nursing school graduates, and nurse wages offered during the previous year. We then examined the association by applying multilevel analysis.Results The number of hospital nurses per 100,000 of the population in the SMAs increased during the period. The Gini coefficient decreased as a general trend but increased in 2007 and 2008. After adjusting for the SMA population and its increase, depending on the year, the number of hospital nurses was positively correlated with higher income per capita, higher aging population ratio, regions other than Kanto, higher number of nursing school graduates, and higher previous-year wages.Conclusion Although the differences in the numbers of hospital nurses across SMAs were lower, and thus improved, the differences tended to expand for 2 years after revision of the medical payment system in 2006. The results show the possibility of the influence of policy changes such as the revision of the medical payment system. The local socioeconomic characteristics, the number of nursing school graduates, and nurse wages were also factors affecting the distribution of hospital nurses.