Socio-Economic Implications of Japanese Hospitals Accepting Foreign Nurses Under Bilateral Agreements: Analysis of the Cognitive Burdens of the Hospitals

Since 2008, Japan has commenced recruiting foreign nurses under bilateral agreements established between Japan and Indonesia, Philippines, and Vietnam. As of March 2015, 481 Indonesian nurses, 337 Filipino nurses, and 21 Vietnamese nurses have entered Japan under the program. These nurses must pass the National Board Examination for Nurses in the Japanese language, within three years of such entry. Previous studies (Hirano et al, 2010) found that hospitals accepting foreign nurses under the program are disappointed with the significant costs involved, including the related economic and social expenses to support these nurses, before these nurses pass the examination. However, Tsubota et al (2015) reported that there were no significant causal links between the economic expenses and the willingness to recruit foreign nurses under the program. Although no correlations were found between the willingness to proceed with future recruitment and economic expenses, accepting foreign nurses is still a ‘burden’ for these hospitals (Nagano, 2015). 

In the present study, correlations between socio-economic factors and cognitive burdens, represented by laborious and emotionally strained work of the hospitals on supporting foreign nurses were tested through bivariate and multivariate analysis. The strongest indicator of the level of cognitive burden was a given hospital’s number of beds (beta=.384, p<0.05), followed by the type of hospital as a private institution (beta=.335, p<0.05), and the tendency of financial evaluation made by hospitals regarding their profitability should foreign nurses continue in employment over the long terms with the same institution that support them (beta=-.271, p<0.05).

The analysis indicate that the size and management system of the hospitals and likelihood of job settlement of foreign nurses after they pass the examination may be a factor correlated with the cognitive burdens of the hospitals accepting foreign nurses under the program.