Monday, April 05, 2010

The effects on mortality of nurses striking

The health sector in Ireland has experienced a fair amount of industrial strife in recent years with nurses in particular taking industrial action over pay and other issues. Understandably this generates a lot of anxiety amongst the public or at least those directly or indirectly affected by this. So it is interesting to know whether such industrial action has any consequences for the health of patients. The paper below finds that it does have negative effects & fairly sizable ones at that. This underlines the importance of avoiding these break-downs in normal industrial relations.
Do strikes kill? evidence from New York state
J Gruber, S A Kleiner

Concerns over the impacts of hospital strikes on patient welfare led to substantial delay in the ability of hospitals to unionize. Once allowed, hospitals unionized rapidly and now represent one of the largest union sectors of the U.S. economy. Were the original fears of harmful hospital strikes realized as a result? In this paper we analyze the effects of nurses’ strikes in hospitals on patient outcomes. We utilize a unique dataset collected on nurses’ strikes over the 1984 to 2004 period in New York State, and match these strikes to a restricted use hospital discharge database which provides information on treatment intensity, patient mortality and hospital readmission. Controlling for hospital specific heterogeneity, patient demographics and disease severity, the results show that nurses’ strikes increase in-hospital mortality by 19.4% and 30-day readmission by 6.5% for patients admitted during a strike, with little change in patient demographics, disease severity or treatment intensity. This study provides some of the first analytical evidence on the effects of health care strikes on patients, and suggests that hospitals functioning during nurses’ strikes are doing so at a lower quality of patient care.
NBER Working Paper No. 15855 (March 2010)

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