Examining wage drivers for nurses and physicians in Swiss hospitals: a retrospective observational study with repeated measurements

Patient safety and quality of care depend on well-trained, motivated staff. Competitive wages are critical for staff satisfaction and retention. Understanding the factors that affect nurses’ and physicians’ wages is the first step to tackling these factors and improving retention and recruitment while reducing shortages. The aim of this study was i) to describe the distribution of nurses’ and physicians’ wages and potential drivers; and ii) to investigate which drivers are most strongly associated with nurses’ and physicians’ wages in Swiss acute care hospitals. We used de-identified routine data from the Federal Statistical Office, covering Swiss acute care and specialized hospitals from 2014 to 2020. We conducted descriptive analysis and examined potential wage drivers, including gender and nationality, among nurses and physicians using mixed-effects models. We included an average of 164 (161–173) hospitals annually and a total of 524,263 nurses and 176,896 physicians over seven years. Descriptive findings revealed variations in wages, workforce demographics, and hospital characteristics. Nurses’ mean monthly wages ranged from 5,920 CHF − 7,720 CHF per FTE, and their mean ages varied from 38.6–42.3 years depending on hospital type. Registered nurses (RNs) were the largest nursing group, with university hospitals employing the highest proportion (75.7%) and the smallest hospitals the lowest (64.6%). For physicians, mean monthly wages ranged from 13,900 CHF − 17,300 CHF, and their mean ages varied from 37.7–44.3 years depending on hospital type. For role distributions university hospitals had more residents and medical students (52.6%), while the smallest hospitals had more senior physicians (32.9%). Inferential analysis showed that nurses’ age, RNs’ proportion, and the physicians’ wages were associated with nurses’ wages. Resident physicians’ and medical students’ proportion, as well as nurses’ wages, were associated with physicians’ wages. Findings on age as a nurses’ wages driver suggest that careful allocation of resources and implementing remuneration policies, such as merit-based systems that reward factors beyond years of experience, may help in retaining and recruiting staff. Further research using individual wage information is essential to gain deeper insights into the health workforce wage landscape and its drivers in Swiss hospitals.