Remuneration of nurses

The remuneration level of nurses is one of the factors affecting their job satisfaction and the attractiveness of the profession. It also has a sizeable impact on costs, since wages of nurses represent one of the largest spending items in health systems.

The data presented in this section generally focus on the remuneration of nurses working in hospitals, although the data coverage differs for some countries (see the box below on “Definition and comparability”).

The data are presented in two ways. First, it is compared with the average wage of all workers in each country, providing some indication of the relative financial attractiveness of nursing compared to other occupations. Second, the remuneration level in each country is converted into a common currency, the US dollar, and adjusted for purchasing power parity, to provide an indication of the relative economic well-being of nurses compared with their counterparts in other countries.

In most OECD countries, the remuneration of hospital nurses was at or slightly above the average wage of all workers in 2015 (Figure 8.16). In Mexico and Chile, the hospital nurses earned almost twice the average wage, while in Israel, Luxembourg and Spain, the wages of nurses were respectively 49%, 38% and 28% greater than the average wage. In New Zealand, the United States, Greece and Australia, it was about 20% greater than the average wage. In most of the other countries, the wage of hospital nurses was roughly equal to the average wage in the economy, while in Hungary it was about 10% and in Latvia about 20% lower.

8.16. Remuneration of hospital nurses, ratio to average wage, 2015 (or nearest year)
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1. Data refer to registered (“professional”) nurses in Chile, the United States and Ireland (resulting in an over-estimation).

2. Data refer to registered (“professional”) nurses and unregistered nursing graduates.

Source: OECD Health Statistics 2017.

 http://dx.doi.org/10.1787/888933604818

When converted to a common currency (and adjusted for purchasing power parity), the remuneration of nurses was about five times higher in Luxembourg than in Hungary and Latvia (Figure 8.17). Nurses in the United States also had relatively high earnings compared with their counterparts in other countries, which explains, at least partly, the ability of the United States to attract many nurses from other countries.

8.17. Remuneration of hospital nurses, USD PPP, 2015 (or nearest year)
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1. Data refer to registered (“professional”) nurses in the United States, Ireland and Chile (resulting in an over-estimation).

2. Data refer to registered (“professional”) nurses and unregistered nursing graduates.

Source: OECD Health Statistics 2017.

 http://dx.doi.org/10.1787/888933604837

The economic crisis in 2008 has had a varying impact on the remuneration of nurses (Figure 8.18). The Netherlands, for example, has seen a steady growth in remuneration for nurses. Some Central and Eastern European countries have introduced a series of measures in recent years to increase the retention of nurses and other health workers, including pay raises despite tight budget constraints. In Hungary, a staged increase of 20% in the salaries of nurses and doctors was introduced in 2012, phased over a three-year period. In the Czech Republic, nurses also benefitted from a pay increase following protests of hospital workers in 2011 (although their pay raise was lower than that for doctors), accompanied by some improvement in other aspects of their working conditions (OECD, 2016).

8.18. Trend in the remuneration of hospital nurses in real terms, selected OECD countries, 2005-15
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1. Index for France and the Netherlands, 2006 = 100.

2. Index for Greece, 2009 = 100.

Source: OECD Health Statistics 2017.

 http://dx.doi.org/10.1787/888933604856

Following the recession, the remuneration of nurses was cut down in some countries such as in Italy, which has frozen wage increase over the past few years. In Greece, the remuneration of nurses has been reduced significantly, by as much as 25% in real terms between 2009 and 2015.

Definition and comparability

The remuneration of nurses refers to average gross annual income, including social security contributions and income taxes payable by the employee. It should normally include all extra formal payments, such as bonuses and payments for night shifts and overtime. In most countries, the data relate specifically to nurses working in hospitals, although in Canada the data also cover nurses working in other settings. In some federal states, such as Australia, Canada and the United States, the level and structure of nurse remuneration is determined at the sub-national level, which may contribute to variations across jurisdictions.

Data refer only to registered (“professional”) nurses in Chile, Ireland and the United States, resulting in an over-estimation compared to other countries where lower-level nurses (“associate professional”) are also included. Data for Canada include registered (“professional”) nurses and unregistered nursing graduates. Data for New Zealand include all nurses employed by publically funded district health boards, registered and otherwise, and includes health assistants who have a different and significantly lower salary structure than registered nurses.

The data relate to nurses working full time, with the exception of Belgium where part-time nurses are also included (resulting in an under-estimation). The data for some countries do not include additional income such as overtime payments and bonuses (e.g. Italy and Slovenia). Informal payments, which in some countries represent a significant part of total income, are not reported.

The income of nurses is compared to the average wage of full-time employees in all sectors in the country. The source for the average wage of workers in the economy is the OECD Employment Database. For the calculation of remuneration trends in real terms, economy-wide GDP deflators are used.

References

OECD (2016), Health Workforce Policies in OECD Countries: Right Jobs, Right Skills, Right Places, OECD Publishing, Paris, http://dx.doi.org/10.1787/9789264239517-en.

OECD (2015), Fiscal Sustainability of Health Systems: Bridging Health and Finance Perspectives, OECD Publishing, Paris, http://dx.doi.org/10.1787/9789264233386-en.