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Labor Mobility Of The Direct Care Workforce: Implications For The Provision Of Long‐Term Care

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  • Reagan A. Baughman
  • Kristin E. Smith

Abstract

This study provides the first comprehensive analysis of the dynamics of labor supply of direct care workers, the lower‐skill nursing workers who provide the bulk of long‐term care for the elderly in the USA. Our estimates from the 1996 and 2001 panels of the Survey of Income and Program Participation (SIPP) show that the mean (median) duration of employment spells for the same direct care employer is only 9.7 (5.0) months. We find that fewer than one‐third of direct care workers leave a job to take another job in the direct care field. There is also little indication of upward mobility in the health sector; direct care workers are approximately equally likely to transition to working as Registered Nurses as they are to working in household service jobs. Additionally, the rate at which spells end in work‐limiting disability (5.4%) is very high compared with rates in similar occupations. We estimate duration models of direct care job spell length and find that, after correcting for the endogenous relationship between wages and tenure, wages appear to have a modest effect in preventing turnover; this effect is concentrated among the shortest spells. Copyright © 2011 John Wiley & Sons, Ltd.

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  • Reagan A. Baughman & Kristin E. Smith, 2012. "Labor Mobility Of The Direct Care Workforce: Implications For The Provision Of Long‐Term Care," Health Economics, John Wiley & Sons, Ltd., vol. 21(12), pages 1402-1415, December.
    • Handle: RePEc:wly:hlthec:v:21:y:2012:i:12:p:1402-1415
    DOI: 10.1002/hec.1798
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    1. Moffitt, Robert, 1992. "Incentive Effects of the U.S. Welfare System: A Review," Journal of Economic Literature, American Economic Association, vol. 30(1), pages 1-61, March.
    2. Jeffrey E. Zabel, 1998. "An Analysis of Attrition in the Panel Study of Income Dynamics and the Survey of Income and Program Participation with an Application to a Model of Labor Market Behavior," Journal of Human Resources, University of Wisconsin Press, vol. 33(2), pages 479-506.
    3. Jeff Biddle & Karen Roberts, 2003. "Claiming Behavior in Workers' Compensation," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 70(4), pages 759-780, December.
    4. Rickman, Bill D. & Parker, Carl D., 1990. "Alternative wages and teacher mobility: A human capital approach," Economics of Education Review, Elsevier, vol. 9(1), pages 73-79, March.
    5. Mitchell P. LaPlante & H. Stephen Kaye & Taewoon Kang & Charlene Harrington, 2004. "Unmet Need for Personal Assistance Services: Estimating the Shortfall in Hours of Help and Adverse Consequences," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 59(2), pages 98-108.
    6. Terza, Joseph V. & Basu, Anirban & Rathouz, Paul J., 2008. "Two-stage residual inclusion estimation: Addressing endogeneity in health econometric modeling," Journal of Health Economics, Elsevier, vol. 27(3), pages 531-543, May.
    7. Powers Elizabeth T & Powers Nicholas J, 2010. "Causes of Caregiver Turnover and the Potential Effectiveness of Wage Subsidies for Solving the Long-Term Care Workforce 'Crisis'," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 10(1), pages 1-30, January.
    8. Sally C. Stearns & Laura P. D'Arcy, 2008. "Staying the Course: Facility and Profession Retention Among Nursing Assistants in Nursing Homes," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 63(3), pages 113-121.
    9. Krueger, Alan B., 1990. "Incentive effects of workers' compensation insurance," Journal of Public Economics, Elsevier, vol. 41(1), pages 73-99, February.
    10. Brown, James N & Light, Audrey, 1992. "Interpreting Panel Data on Job Tenure," Journal of Labor Economics, University of Chicago Press, vol. 10(3), pages 219-257, July.
    11. David M. Blau, 1992. "The Child Care Labor Market," Journal of Human Resources, University of Wisconsin Press, vol. 27(1), pages 9-39.
    12. Michael P. Murray, 2006. "Avoiding Invalid Instruments and Coping with Weak Instruments," Journal of Economic Perspectives, American Economic Association, vol. 20(4), pages 111-132, Fall.
    13. Scafidi Benjamin & Sjoquist David L. & Stinebrickner Todd R., 2006. "Do Teachers Really Leave for Higher Paying Jobs in Alternative Occupations?," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 6(1), pages 1-44, December.
    14. Blau, David M, 1993. "The Supply of Child Care Labor," Journal of Labor Economics, University of Chicago Press, vol. 11(2), pages 324-347, April.
    15. John C. Ham & Xianghong Li & Lara Shore-Sheppard, 2009. "Seam Bias, Multiple-State, Multiple-Spell Duration Models and the Employment Dynamics of Disadvantaged Women," NBER Working Papers 15151, National Bureau of Economic Research, Inc.
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    2. Baughman Reagan, 2018. "Employment in Long-Term Care: The Role of Macroeconomic Conditions," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 18(4), pages 1-12, October.
    3. Vadean, Florin & Saloniki, Eirini, 2021. "Job separation and sick leave in the long-term care sector in England," GLO Discussion Paper Series 994, Global Labor Organization (GLO).
    4. Thomas Rapp & Jérôme Ronchetti & Jonathan Sicsic, 2021. "Are long-term care jobs harmful? Evidence from Germany," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(5), pages 749-771, July.
    5. Shinya Sugawara, 2013. "An Interval Regression Analysis for Tenures of Japanese Elder Care Workers Using Matched Employer-Employee Data," CIRJE F-Series CIRJE-F-887, CIRJE, Faculty of Economics, University of Tokyo.
    6. R. Tamara Konetzka & Karen B. Lasater & Edward C. Norton & Rachel M. Werner, 2018. "Are Recessions Good for Staffing in Nursing Homes?," American Journal of Health Economics, University of Chicago Press, vol. 4(4), pages 411-432, Fall.
    7. Monica Puoma LAMBON-QUAYEFIO & Nkechi S. OWOO, 2021. "Investigating the Long-Term Effects of Child Labor on Household Poverty and Food Insecurity in Ghana," JODE - Journal of Demographic Economics, Cambridge University Press, vol. 87(4), pages 561-587, December.
    8. Yaa Akosa Antwi & John R. Bowblis, 2018. "The Impact of Nurse Turnover on Quality of Care and Mortality in Nursing Homes: Evidence from the Great Recession," American Journal of Health Economics, University of Chicago Press, vol. 4(2), pages 131-163, Spring.
    9. Kondo, Ayako, 2019. "Impact of increased long-term care insurance payments on employment and wages in formal long-term care," Journal of the Japanese and International Economies, Elsevier, vol. 53(C), pages 1-1.
    10. Andrew Lan & Xu Liu & Xiantong Zhao & Zhen Liang, 2024. "Visible and invisible factors affecting the job satisfaction of agency home caregivers in the UK," Palgrave Communications, Palgrave Macmillan, vol. 11(1), pages 1-10, December.
    11. Okechukwu, Cassandra A. & Kelly, Erin L. & Bacic, Janine & DePasquale, Nicole & Hurtado, David & Kossek, Ellen & Sembajwe, Grace, 2016. "Supporting employees' work-family needs improves health care quality: Longitudinal evidence from long-term care," Social Science & Medicine, Elsevier, vol. 157(C), pages 111-119.
    12. Cécile Martin & Mélina Ramos-Gorand, 2017. "High turnover among nursing staff in private nursing homes for dependent elderly people in France: impact of the local environment and the wage," Economie et Statistique / Economics and Statistics, Institut National de la Statistique et des Etudes Economiques (INSEE), issue 493, pages 49-66.
    13. Johannes Geyer & Peter Haan & Mia Teschner, 2024. "The Impact of Macroeconomic Conditions on Long-Term Care: Evidence on Prices," Discussion Papers of DIW Berlin 2096, DIW Berlin, German Institute for Economic Research.
    14. Rapp, Thomas & Sicsic, Jonathan, 2020. "The contribution of the immigrant population to the U.S. long-term care workforce," Social Science & Medicine, Elsevier, vol. 263(C).
    15. Martin, Cécile, 2014. "Concurrence, prix et qualité de la prise en charge en EHPAD en France : Analyses micro-économétriques," Economics Thesis from University Paris Dauphine, Paris Dauphine University, number 123456789/13712 edited by Dormont, Brigitte.
    16. Andrew Foote & Michel Grosz, 2020. "The Effect of Local Labor Market Downturns on Postsecondary Enrollment and Program Choice," Education Finance and Policy, MIT Press, vol. 15(4), pages 593-622, Fall.

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