特別養護老人ホームにおける組織構造と介護職員の離職に関する一考察

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  • Study on Organizational Structure and Nursing Care Staff Turnover at Special Nursing Homes for the Elderly
  • トクベツ ヨウゴ ロウジンホーム ニ オケル ソシキ コウゾウ ト カイゴショクイン ノ リショク ニ カンスル イチ コウサツ

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This paper seeks to clarify the systematic factors that exert influence over nursing care staff turnover rates at special nursing homes for the elderly. The data analyzed is publically-available data from 198 special nursing home facilities located in Aichi Prefecture. 　The items analyzed with regard to organizational structure are: number of equivalent full-time nursing care staff,minimum hours on night shift, years worked by nursing care staff, ratio of accredited nursing care staffers, and number of years the facility has been in operation. To obtain outcomes, data from 2010, 2012, and 2014 on nursing care staff turnover rates calculated on a per-facility basis were utilized. The analysis method classifies facilities into four types through cluster analysis based on factors extracted by factor analysis. Using analysis of variance (ANOVA), the study compared nursing care staff turnover rates between these four facility groups and clarified the presence or lack of influence from systematic factors. 　The analysis resulted in utilizing the two extracted factors of employee scale and experience accumulated to classify　each facility into the four groups: a high-staff-allocation facility, highly-experienced facility, poorly-experienced facility, and low-staff-allocation facility. When nursing care staff turnover rates were compared for each of the four groups, it became clear that the highly-experienced facility was the only group that would continuously maintain significantly low nursing care staff turnover versus the other three groups between 2010 and 2014. 　As opposed to the findings by other research pieces that wages and training connect to suppressed　turnover levels, this study suggests that cumulative experience of nursing care workers is in actuality a systematic factor that suppresses turnover. Yet, this study has certain limitations in that only use of publically-available data limits analysis criteria and does not help reflect structural changes over time. One issue left unresolved, which needs to be explored in the future study, is the clarification of factors that could exert influence on individual nursing care workers' turnover behavior, not just overall nursing care worker turnover rates alone.

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