Purpose: Workers in special employment relationship (WSERs) are workers in nonstandard employment arrangements who lack worker protection accorded in standard employment arrangements. This study aimed to describe self-rated health (SRH) and depressive symptoms (DS) among Korean WSERs in comparison to regular wage workers (RWW) and identify associations between working conditions and those outcomes. Methods: In this study, secondary data analysis using the 5th Korean Working Conditions Survey was used. The sample totaled 29,120, including 1,538 WSERs and 27,564 RWWs. Sociodemographic and work-related characteristics were employed as explanatory variables and SRH and DS as dependent variables. Using multiple logistic regression, the determinants of fair/poor SRH and DS were identified. Results: The prevalence rates for fair/poor SRH and DS in WSERs were 25.2% and 28.3%, respectively, and 20.7% and 25.0% in RWWs, respectively. Compared to RWWs, WSERs had 31% (aOR=1.31, 95% CI=1.14~1.49) and 20% (aOR=1.20, 95% CI=1.06~1.36) higher odds of SRH and DS, respectively.Some factors, such as a lack of rest guarantee and sickness presenteeism, had a larger influence in the WSER than in the RWW group. Conclusion Compared to RWWs, WSERs reported having poorer working conditions and were more likely to report poor general and mental health. Therefore, in Korea, public health policymakers should consider measures to protect the working conditions and health of WSERs, a growing segment of the working population. The study produced new epidemiological evidence regarding the relationships between employment arrangements and health.

PURPOSE: This study was to identify health-related quality of life of Korean young adults and elderly with multimorbidity and to examine factors influencing their health-related quality of life. METHODS: Health-related quality of life was measured by the Korean version of the EQ-5D. Using a descriptive study, the study incorporated a secondary analysis of the Korean version of the EQ-5D data from the 8th wave of the Korea Health Panel Survey in 2013. Selected demographic data and the Korean version of the EQ-5D were analyzed using χ²-test, t-test, ANOVA and multiple regression analysis. RESULTS: Education, drinking, type of health insurance, and number of chronic disease significantly affected the health-related quality of life in the young adults with multimorbidity. Educational level, occupational type, drinking, physical activity, number of chronic disease, unmet healthcare need and the type of multimorbidity significantly affected the health-related quality of life in the elderly with multimorbidity. CONCLUSION: The factors influencing health-related quality of life were different for young adults versus elderly with multimorbidity. Therefore, there is a need for age-specific health care programs that may improve health-related quality of life of adults with multimorbidity.
Adult ; Aged* ; Chronic Disease ; Comorbidity ; Delivery of Health Care ; Drinking ; Education ; Humans ; Insurance, Health ; Korea* ; Motor Activity ; Quality of Life* ; Young Adult*

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.
Hospitals ; Humans ; Logistic Models ; Nursing Staff, Hospital/economics/*supply & distribution ; Workplace

PURPOSE: The purpose of this study was to identify the effects of nursing work environment and job stress on health problems of hospital nurses. METHODS: The subjects were 200 nurses working in S general hospital in Gyeongnam, and the data were collected using organized questionnaire from Jan 10 to 25, 2015. The Korean version of the practice environment scale of nursing work index, the instrument for job stress, and the Korean version of Todie Health Index for health problem were used for measurement. The collected data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation, and multiple regression. RESULTS: The nursing work environment was found to be slightly negative, and the job stress was found to be high. There were significant correlation among nursing work environment, job stress, and health problems. In addition, it showed that the nursing work environment and job stress of nurses were factors affecting their health problems. CONCLUSION: The nursing work environment and job stress are influencing factors on the health problems of hospital nurses. Multi-faceted efforts to create a positive nursing work environment are required. Further researches related to association between the nursing work environment and health problem of nurses are needed.
Hospitals, General ; Nursing*

PURPOSE: This study aims to investigate the cross-sectional association of company size and self-rated health using representative data on Korean workers. METHODS: We used the data from 2,884 wage workers collected by Korean Labor and Income Panel Study (17th). The association between company size and self-rated health was analyzed using logistic regression with covariates including demographic characteristics, work environment, job satisfaction, and health-related behaviors. RESULTS: Odds ratio (OR) for better health status among workers in large-sized company was 1.351 (CI. 1.054~1.731), compared to workers in small-sized company. We performed three separate models stratified by firm size (small, medium, and large companies). Occupation variables showed different effect on health depending on firm sizes. OR for better health of white-color job (referred to blue-color job) was 1.693 in medium-sized company model but it was 0.615 in large company model. OR for better health of the workers working shift work showed 0.606 in large company model but it was not significant in small and medium company models. CONCLUSION: We found that small-sized company workers have significantly poor self-rated health compared to large-sized firm workers. This study revealed that there exist differences among health related factors depending on firm sizes.
Health Promotion ; Job Satisfaction ; Logistic Models ; Occupational Health Nursing ; Occupations ; Odds Ratio ; Salaries and Fringe Benefits

PURPOSE: The purpose of this study was to analyze the migration patterns of new nurses and experienced nurses and to identify the factors influencing inter-regional migration for solving regional imbalances of clinical nurses in South Korea. METHODS: This study involved a secondary analysis of data from the Health Insurance Review and Assessment Service (HIRA). Data were analyzed using descriptive statistics and multiple logistic regression analysis. RESULTS: New nurses tended to migrate from Kyunggi to Seoul. However, experienced nurses tended to migrate from Seoul and Chungchung to Kyunggi. Significant predictors of inter-regional migration among new nurses were location and nurse staffing grade of hospitals. Significant predictors of inter-regional migration among experienced nurses were location, hospital type, nurse staffing grade, ownership of hospitals and age of nurses. CONCLUSION: Inter-regional migration occupied a small portion of total hospital movement among clinical nurses. The regional imbalances of nurses were not caused by the migration from non-metropolitan areas to Seoul. Nurse shortage problems in the small and medium hospitals of the non-metropolitan area can be solved only through improvement of work environment.
Geography ; Gyeonggi-do ; Health Care Rationing ; Human Migration ; Insurance, Health ; Korea ; Logistic Models ; Ownership ; Personnel Turnover ; Seoul

PURPOSE: This study aimed to determine health problems experienced by workers in special employment relationships (WSER) and identify coping strategies used when such problems occur.METHODS: This qualitative study used the focus group interview method. Thirteen study participants included five home-visit tutors, five insurance salespersons, and three credit card recruiters. The interviews were conducted from November 2018 through January 2019, with each occupational group interview lasting about 2 hours. Analysis based on phenomenological research was independently performed by two researchers.RESULTS: Most participants had common health problems involving vocal cord symptoms, and stress related to emotional labor and traffic accidents. The unique health problems included cystitis, musculoskeletal, and digestive symptoms in home-visit tutors; reduced vision and hearing in insurance salespersons; and mental distress in credit card recruiters. There was no protection system for their health coverage, and the company emphasized their self-employed status to avoid taking responsibility for them. Twelve participants did not purchase occupational accident insurance owing to both not having adequate information and economic burden concerning premium status.CONCLUSION: WSER experienced both physical and mental health problems. These problems were caused by their unstable employment status, and the social security system for their coverage being non-functioning.
Accidents, Occupational ; Accidents, Traffic ; Cystitis ; Employment ; Focus Groups ; Hearing ; Humans ; Insurance ; Mental Health ; Methods ; Occupational Groups ; Occupational Health ; Qualitative Research ; Social Security ; Vision, Low ; Vocal Cords

Purpose: This study aimed to explore turnover rates for Korean acute care hospital nurses and identify factors influencing their turnover. Methods: The study was retrospective in nature. Nurse cohort data were obtained from hospital status data from Korea's Health Insurance Review Assessment Service. The observation period was from January 1, 2012 to December 31, 2016, and data for 96,158 nurses were analyzed. Independent variables included nurses' age and sex and hospital setting, type, ownership, and nurse staffing level. KaplaneMeier analysis was performed to estimate survival curves, and factors influencing turnover were analyzed using Cox's proportional hazard regression. Results: The cumulative turnover probability for all nurses was .17, .29, .38, .45, and .50 for the first, second, third, fourth, and fifth years, respectively. The results showed that the longer the career duration, the lower the turnover rates. According to the factors influencing nurse turnover, both nurses' (i.e., sex and career duration) and hospitals' (i.e., hospital setting, type, ownership, and nurse staffing level) characteristics were statistically significant. Conclusion It should be noted that the turnover rate of nurses with less than three year of career duration and of those with less than one year has been shown to be quite high. Therefore, target populations for acute care hospital nurse turnover should be expanded from new graduate nurses to experienced nurses with less than 3 years of career. Further studies are required to examine the causes of high turnover rates in hospitals that are small and/or have low nurse staffing levels.

Purpose: This study aimed to explore turnover rates for Korean acute care hospital nurses and identify factors influencing their turnover. Methods: The study was retrospective in nature. Nurse cohort data were obtained from hospital status data from Korea's Health Insurance Review Assessment Service. The observation period was from January 1, 2012 to December 31, 2016, and data for 96,158 nurses were analyzed. Independent variables included nurses' age and sex and hospital setting, type, ownership, and nurse staffing level. KaplaneMeier analysis was performed to estimate survival curves, and factors influencing turnover were analyzed using Cox's proportional hazard regression. Results: The cumulative turnover probability for all nurses was .17, .29, .38, .45, and .50 for the first, second, third, fourth, and fifth years, respectively. The results showed that the longer the career duration, the lower the turnover rates. According to the factors influencing nurse turnover, both nurses' (i.e., sex and career duration) and hospitals' (i.e., hospital setting, type, ownership, and nurse staffing level) characteristics were statistically significant. Conclusion It should be noted that the turnover rate of nurses with less than three year of career duration and of those with less than one year has been shown to be quite high. Therefore, target populations for acute care hospital nurse turnover should be expanded from new graduate nurses to experienced nurses with less than 3 years of career. Further studies are required to examine the causes of high turnover rates in hospitals that are small and/or have low nurse staffing levels.

PURPOSE: This study aimed to determine health problems experienced by workers in special employment relationships (WSER) and identify coping strategies used when such problems occur. METHODS: This qualitative study used the focus group interview method. Thirteen study participants included five home-visit tutors, five insurance salespersons, and three credit card recruiters. The interviews were conducted from November 2018 through January 2019, with each occupational group interview lasting about 2 hours. Analysis based on phenomenological research was independently performed by two researchers. RESULTS: Most participants had common health problems involving vocal cord symptoms, and stress related to emotional labor and traffic accidents. The unique health problems included cystitis, musculoskeletal, and digestive symptoms in home-visit tutors; reduced vision and hearing in insurance salespersons; and mental distress in credit card recruiters. There was no protection system for their health coverage, and the company emphasized their self-employed status to avoid taking responsibility for them. Twelve participants did not purchase occupational accident insurance owing to both not having adequate information and economic burden concerning premium status. CONCLUSION WSER experienced both physical and mental health problems. These problems were caused by their unstable employment status, and the social security system for their coverage being non-functioning.