A structural pathway from wage discrepancy to turnover intention among hospital nurses: the mediating roles of effort–reward imbalance, organizational justice, burnout, and organizational commitment
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background Perceived wage inadequacy is an important concern for nurse retention, but the mechanisms through which perceived wage discrepancy is associated with turnover intention remain unclear. Thus, this study aimed to examine the structural pathways linking wage discrepancy to turnover intention among hospital nurses, focusing on the roles of effort–reward imbalance, organizational justice, burnout, and organizational commitment. Methods This cross-sectional study was conducted with 792 nurses employed in tertiary hospitals, general hospitals, and hospitals across South Korea. Wage discrepancy was calculated as the ratio of perceived appropriate annual wage to current annual wage. Structural equation modeling was used to examine the hypothesized relationships and direct, indirect, and total effects among the study variables. Results The mean wage discrepancy ratio was 1.14, indicating that nurses perceived an appropriate wage to be approximately 14% higher than their current wage. Greater wage discrepancy was positively associated with effort–reward imbalance ( β = 0.303, p < 0.001) and negatively associated with organizational justice ( β = −0.281, p < 0.001). Effort–reward imbalance was positively associated with burnout, whereas organizational justice was negatively associated with burnout and positively associated with organizational commitment. Burnout showed the strongest direct association with turnover intention ( β = 0.667, p < 0.001), whereas organizational commitment was negatively associated with turnover intention ( β = −0.245, p < 0.001). Wage discrepancy showed no significant direct association with turnover intention but had a significant indirect association through the proposed pathways ( β = 0.226, p = 0.001). The model accounted for 76.2% of the variance in turnover intention in the present sample. Conclusion Wage discrepancy is associated with nurses’ turnover intention primarily through organizational and psychological pathways rather than through a direct effect. These findings suggest that the association between compensation and turnover intention may depend not only on wage level but also on how nurses perceive the adequacy and fairness of rewards relative to their contributions. Therefore, nurse retention strategies should address compensation adequacy and fairness while reducing burnout and strengthening organizational commitment.
Source: Frontiers in Public Health
Author: Mi Yu
Institution: Gyeongsang National University
Language: English
Subfield: Leadership and Management
Field: Nursing
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7223030253