BACKGROUND: Regional disparities in the working conditions of medical doctors have not been fully assessed in Japan. We aimed to clarify these differences in hospital characteristics: doctors' workload, wages, and popularity among medical students by city population sizes. METHODS: We targeted 423 teaching hospitals certified by the Japanese Society of Internal Medicine and assessed the working conditions of physicians specializing in internal medicine. We calculated their workload (the annual number of discharged patients per physician) and retrieved data on junior residents' monthly wages from the Resinavi Book which is popular among medical students in Japan to know the teaching hospital's information and each hospital's website. Furthermore, we explored the interim matching rate of each hospital as its popularity among medical students. Next, we classified cities in which all hospitals were located into eight groups based on their population size and compared the characteristics of these hospitals using a one-way analysis of variance. RESULTS: The average workload was 110.3, while the average workload in hospitals located in most populated cities (≥ 2,000,000) was 88.4 (p < 0.05). The average monthly wage was 351,199 Japanese yen, while that in most populated cities was 305,635.1 Japanese yen. The average popularity (matching rate) was 101.9%, and the rate in most populated areas was 142.7%, which was significantly higher than in other areas. CONCLUSIONS Hospitals in most populated areas had significantly lower workloads and wages; however, they were more popular among medical students than those in other areas. This study was the first to quantify the regional disparities in physicians' working conditions in Japan, and such disparities need to be corrected.
Cities/statistics & numerical data* ; Geography ; Hospitals, Teaching/statistics & numerical data* ; Japan ; Physicians/statistics & numerical data* ; Population Density ; Salaries and Fringe Benefits/statistics & numerical data* ; Students, Medical/psychology* ; Workload/statistics & numerical data*

BACKGROUND: Chronic kidney disease (CKD) is an independent risk factor for progression to an end-stage renal disease requiring dialysis or kidney transplantation. We investigated the association of lifestyle behaviors with the initiation of renal replacement therapy (RRT) among CKD patients using an employment-based health insurance claims database linked with specific health checkup (SHC) data. METHODS: This retrospective cohort study included 149,620 CKD patients aged 40-74 years who underwent a SHC between April 2008 and March 2016. CKD patients were identified using ICD-10 diagnostic codes and SHC results. We investigated lifestyle behaviors recorded at SHC. Initiation of RRT was defined by medical procedure claims. Lifestyle behaviors related to the initiation of RRT were identified using a Cox proportional hazards regression model with recency-weighted cumulative exposure as a time-dependent covariate. RESULTS: During 384,042 patient-years of follow-up by the end of March 2016, 295 dialysis and no kidney transplantation cases were identified. Current smoking (hazard ratio: 1.87, 95% confidence interval, 1.04─3.36), skipping breakfast (4.80, 1.98─11.62), and taking sufficient rest along with sleep (2.09, 1.14─3.85) were associated with the initiation of RRT. CONCLUSIONS Among CKD patients, the lifestyle behaviors of smoking, skipping breakfast, and sufficient rest along with sleep were independently associated with the initiation of RRT. Our study strengthens the importance of monitoring lifestyle behaviors to delay the progression of mild CKD to RRT in the Japanese working generation. A substantial portion of subjects had missing data for eGFR and drinking frequency, warranting verification of these results in prospective studies.
Aged ; Cohort Studies ; Databases, Factual ; Disease Progression ; Female ; Health Benefit Plans, Employee ; Humans ; Japan/epidemiology* ; Life Style ; Male ; Meals ; Middle Aged ; Proportional Hazards Models ; Renal Insufficiency, Chronic/therapy* ; Renal Replacement Therapy ; Retrospective Studies ; Sleep ; Smoking/epidemiology*

health, especially sleep quality. This study aims to determine the relationship between DSE and sleep quality.METHODS: This study analyzed data of 50,250 wage workers from the fifth Korean Working Conditions Survey. Workers that did not respond or refused to answer any questions related to variables were excluded, and finally 36,709 participants were included in this study. A total of 2,287 workers (6.2%) were compared with non-DSE (34,422; 93.8%) workers, and multiple logistic regression analyses were applied.RESULTS: DSE status had a significant association with difficulty falling asleep (odds ratio [OR]: 1.331, 95% confidence interval [CI]: 1.178–1.504), difficulty maintaining sleep (OR: 1.279; 95% CI: 1.125–1.455), and extreme fatigue after waking up (OR: 1.331; 95% CI: 1.184–1.496). A multiple logistic regression of the variables for sleep quality in DSE showed a significant association with exposure to physical factors for all types of poor sleep quality as well as shift work for difficulty maintaining sleep with extreme fatigue after waking up. Long working hours and emotional labor were also associated with extreme fatigue after waking up.CONCLUSIONS: This study shows a significant association between DSE and poor sleep quality, especially when workers were exposed to physical risk factors (noise, vibration, abnormal temperature, etc.) and shift work.]]>
Accidental Falls ; Employment ; Fatigue ; Logistic Models ; Risk Factors ; Salaries and Fringe Benefits ; Vibration

PURPOSE: Scholarly works have reported about the nurses' salary and its impact on job satisfaction, nurse turnover, retention, work condition, and provision of nursing care. However, studies are either focused on the nurses in government hospitals or nurses working outside the country. Thus, the study aims to explore and describe the lived experience of nurses employed in private hospitals in Albay province, the Philippines, and explicate the need for better pay. DESIGN: The study used a qualitative design, specifically a descriptive phenomenology approach. METHODS: Purposive sampling and in-depth interviews were conducted among seventeen (17) nurse informants. The audio-recorded interviews were transcribed verbatim and analyzed following the seven-stage process as described by Colaizzi (1978) for data coding and identifying themes. The same process of analysis performed among the responses or data gathered through electronic communication platforms. FINDINGS: Four themes and nine sub-themes were identified. The first theme is 'Over but under,' which includes three sub-themes: (1) Over-worked, underpaid working conditions, (2) Finding an additional source of income as a result of low-wages, (3) More nurses are produced, but less are staying in the country, (4) Required by law in the country but not permitted by low salary. The second theme is 'Same but different,' which includes three sub-themes: (1) The Nursing profession is akin to others, yet uncompensated, (2) Work demands are comparable to government hospitals. The third theme is 'Caring but uncared-for,' which includes two sub-themes: (1) Psychologically upsetting, (2) Stimulates nurses transition. The fourth theme is 'Selfless foresight,' which include only one sub-theme (1) Increasing the salary attracts nurses to stay in the country. CONCLLUSION AND RECOMMENDATIONS: The study results showed that nurses in private hospitals need better remuneration as they experience poor work conditions. Also, it described a low salary that impacts the nurses' workload, their physical and mental health, their socio-economic being, their ability to avail professional development, the retention or turnover, and the provision of nursing care. The study findings suggest data triangulation of the study in some other private hospitals outside the region and explore strategies for increasing nurses' retention and satisfaction. Nonetheless, these efforts will robust the empirical data about the need for better pay among nurses in the private sector.
Job Satisfaction ; Personnel Turnover ; Hospitals, Private ; Salaries and Fringe Benefits

OBJECTIVES: The purpose of this study was to investigate the job satisfaction level of the dental staff working at oral health centers for people with disabilities. METHODS: A questionnaire survey was conducted with 73 dentists and dental hygienists working at seven regional oral health centers for people with special needs and dental hospitals for people with disabilities in Seoul. The questionnaire consisted of seven questions across two subscales: general satisfaction (4 questions) and satisfaction with wage and welfare (3 questions). The internal consistency of the questionnaire items was assessed using Cronbach's alpha (0.80). The responses were analyzed using a t-test with SPSS (version 23.0). RESULTS: Of the 73 dental staff members, 50% were dentists, 64% were women, and participants' average age was 30 years. In total, 58% of the participants had up to five years of experience working with people with disabilities, 42% of them worked full-time, and each participant treated an average of 200 patients with disabilities per month. The participants reported that their salary was relatively low. Dental hygienists had higher satisfaction level than dentists in the institution's welfare work. The more full-time workers answered, the more suitable they are for their work. CONCLUSIONS: The job satisfaction level of most professionals working in oral health centers for people with disabilities was not very high but they felt rewarded by their welfare work. It was inferred that it is necessary to examine and improve institutional support aspects such as human resource support. Increasing the number of centers in the central region is also needed.
Dental Hygienists ; Dental Staff ; Dentists ; Disabled Persons ; Female ; Humans ; Job Satisfaction ; Oral Health ; Reward ; Salaries and Fringe Benefits ; Seoul

Currently, the South Korean Government does not provide sickness benefits from the National Health Insurance, which is different from most other Organization for Economic Cooperation and Development countries. The sickness benefit guarantees a part of lost income due to injuries or diseases. The purpose of this study is to propose a sickness benefit scheme for South Korea. To this end, we compare health care systems, sickness benefit schemes, and delivery systems of those in Germany, Japan, and Sweden, focusing on the seven categories: management authority, object, level of payment, duration of payment, qualification requirements, connection with paid sick leave of workplace, and financial resources, and as to delivery system, the six categories: the number of procedures, transferring document between institutions, whether or not utilizing electronic reporting system, applicant, and administrative convenience. Based on the implications derived from the case study, we propose the sickness benefit scheme and its delivery pathway and other details for South Korea. This study is first to propose the sickness benefit for health insurance in Korea with its level of details. More studies should follow with case studies of other countries, as well as productive debates to build a feasible and sustainable sickness benefit system in South Korea.
Delivery of Health Care ; Germany ; Insurance, Health ; Japan ; Korea ; National Health Programs ; Organisation for Economic Co-Operation and Development ; Sick Leave ; Sweden

BACKGROUND: This study aimed to provide basic data to establish a foundation for efficient operation of the organization by assessing the effects of self-efficacy and job stress (measured by self-efficacy, job demand, and job autonomy) on organizational commitment among clinical dental hygienists. METHODS: This was a cross-sectional survey study that used a self-administered questionnaire to collect data. After institutional review board approval, a survey was conducted from January to May 2017, targeting dental hygienists working in dental clinics and hospitals. The final 199 questionnaires were analyzed with PASW 18.0 for Windows (IBM Corp.). The data were analyzed using mean and/or standard deviation t-test, one-way ANOVA, and multiple regression analysis. RESULTS: The means for self-efficacy, job demand, job autonomy, and organizational commitment were 55.94±9.65, 26.55±2.29, 20.24±3.88, and 49.49±8.39, respectively. Along with self-efficacy, the other factors of organizational commitment among dental hygienists that were statistically significant included job autonomy, mean salary (2,500~2,990 thousand Korean won [KRW] and ≥3,000 thousand KRW), and employee welfare (good), which are sub-areas of the surface acting. In other words, it was found that the higher the mean salary, the better the employee welfare, the higher self-efficacy, and the higher the organizational commitment, and the explanatory power of the model was approximately 42.1%. CONCLUSION: These results suggest that the higher the self-efficacy, job autonomy, mean salary, and employee welfare, the higher the organizational commitment. In order to improve job demand among dental hygienists, it is necessary to establish an effective plan to improve job welfare, self-efficacy, and job autonomy.
Cross-Sectional Studies ; Dental Clinics ; Dental Hygienists ; Ethics Committees, Research ; Humans ; Salaries and Fringe Benefits

OBJECTIVES: The authors evaluated the environment and conditions of Korean psychiatric residents to identify important factors for them in determining their satisfaction with training programs. METHODS: Questionnaires on the residency training program were administered to 513 Korean psychiatric residents from 2016 to 2017. The questionnaire was composed of sociodemographic background, work environment and status of the training program. The authors analyzed questionnaire according to the residents' grade and hospital type and identified the significant factors for satisfaction with their training. RESULTS: Compared to the 1st grade, the 4th grade psychiatric residents have significantly less working time, duty days, and more sleep time, mealtime, and annual salary. In the hospital type, the residents of general hospitals and university hospitals have more working time, annual salary, and accessibility to educational material than mental hospitals. The satisfaction with their training is higher in the 1st grade than in the 4th grade, in those with more than six hours of sleep time, and in residents who are satisfied with the accessibility of educational materials. CONCLUSION: Compared to the 1st grade, the working intensity of 4th grade psychiatric residents is lower and their welfare is better. To improve the satisfaction with the training program, it is necessary to make efforts to increase the sleep time of residents, improve the accessibility of educational material, identify the problem of the training program, particularly in the 4th grade, and make institutional improvements.
Education ; Hospitals, General ; Hospitals, Psychiatric ; Hospitals, University ; Internship and Residency ; Meals ; Salaries and Fringe Benefits

OBJECTIVES: Presenteeism is currently recognized as a significant global health issue that can potentially cause productivity losses. Hence, many studies have analyzed the relationships between workplace factors and presenteeism. However, few studies have considered non-occupational factors. This study examined the associations between presenteeism and activities outside work, including volunteering, self-development, leisure/sports, and gardening and house repair activities, in Korean wage workers. METHODS: This study analyzed the fourth Korean Working Conditions Survey, in which a total of 19 294 wage workers participated. To identify relationships between presenteeism and activities outside work, multivariate logistic regression analysis was used after adjusting for general and occupational characteristics. RESULTS: Self-development and leisure/sports activities significantly increased the odds ratio (OR) of presenteeism (OR, 1.166; 95% confidence interval [CI], 1.061 to 1.282 and OR, 1.276; 95% CI, 1.181 to 1.379, respectively). CONCLUSIONS: Certain activities outside work, such as self-development or leisure/sports, were related to presenteeism among Korean wage workers. Although many previous studies have emphasized the positive effects of those activities on health, this study documented negative effects of these activities outside work on health.
Agriculture ; Efficiency ; Gardening ; Global Health ; Korea ; Logistic Models ; Odds Ratio ; Presenteeism ; Salaries and Fringe Benefits

BACKGROUND AND OBJECTIVES: Most thyroid cancers progress slowly, have high survival rates, and have good prognosis. Therefore, the management of patients with thyroid cancer should be viewed from a long-term perspective, taking into account a return to normal social life. Cancer patients have a higher risk of unemployment than the general population, and so unemployment can be an economic problem for thyroid cancer patients. However, there have been few studies on factors affecting return to work in thyroid cancer patients. The purpose of this study is to investigate occupational changes and the period of leave of absence for patients with thyroid cancer and to identify factors that affect the return to work after surgery.MATERIALS AND METHODS: A total of 427 questionnaires of thyroid cancer patients were used for the analysis. The occupational changes and sick leave periods were analyzed according to general characteristics, disease-related characteristics, and side effects.RESULTS: The factors related to occupational change and leave of absence in thyroid cancer patients were sex and type of occupation. Women had more occupational changes and longer leave of absence than men, office workers had the least change in occupation, and professional workers had a longer period of sick leave. Fatigue was the primary side effect that affected the leave of absence.CONCLUSION: Occupation is very important in the life of a thyroid cancer patient. Informing the patient of possible complications and planning proper leave of absence will help the patient return to work and improve the quality of life.
Fatigue ; Female ; Humans ; Male ; Occupations ; Prognosis ; Quality of Life ; Return to Work ; Sick Leave ; Survival Rate ; Thyroid Gland ; Thyroid Neoplasms ; Unemployment