ArticleBMC health services research2026
Staffing, nursing home, and market characteristics associated with caregiver turnover in Japan: a national cross-sectional study.
Article in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundCaregiver turnover in nursing homes remains a critical issue in long-term care. However, few nationwide studies have distinguished between full-time and part-time caregivers, despite their differing work expectations. This study examined national turnover rates in Japan and identified staffing, facility, and market factors associated with turnover by employment type.
methodsWe conducted a cross-sectional analysis of 4,042 nursing homes operating in 2022, using data from the National Long-Term Care Service Information Disclosure System. Annual caregiver turnover was defined as the number of caregivers who left during the year divided by the average number of caregivers. Geographic variations were assessed by mapping turnover rates across prefectures and municipalities. Logistic regression models were applied to identify staffing, facility, and market factors associated with high turnover rate, with stratification by full-time and part-time employment status.
resultsThe mean annual turnover rate was 12.6% overall, 11.5% for full-time, and 25.0% for part-time caregivers. Considerable geographic variation was observed (4.9%–15.0%). Lower full-time turnover was associated with higher caregiver-to-bed ratios, greater proportions of certified caregivers, and staff with ≥ 3 years’ experience. Increased night-shift staffing was linked to higher turnover for both groups. Larger facilities, shorter years in operation, and provision of sputum suction or end-of-life care were related to lower turnover. At the market level, higher unemployment and higher income were associated with higher turnover.
conclusionsNationwide evidence demonstrates that caregiver turnover is shaped by staffing, facility, and market factors, with distinct patterns between full-time and part-time staff. Recognizing these differences may help nursing homes and policymakers consider more tailored approaches to workforce retention and create supportive environments that reduce turnover.
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