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Reassessing the labor market effects of California's minimum nurse staffing regulations

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  • David W. Harless

Abstract

California implemented hospital‐unit level licensed nurse minimum staffing regulations in 2004, with more stringent regulations applying for certain units in 2005 and 2008. All analyses agree that there were significant increases in Registered Nurse (RN) staffing levels, especially in hospitals with lower preregulation staffing. Analyses of the labor market effects of the regulations, however, come to mixed conclusions. I revisit the labor market effects of the regulations using different data and a different analytical model for RN wages. For the analysis of growth of RN employment, I use information from the National Sample Survey of Registered Nurses, the largest and most complete source of information on nurse employment, and find that RN employment grew significantly faster in California than in other states after the regulations were implemented. For the analysis of changes in RN wages, I apply a panel difference‐in‐difference‐in‐difference model to wage averages in Metropolitan Statistical Areas, controlling for MSA‐, occupation‐, and time‐fixed effects, and all their two‐way interactions. Analysis of changes in the differential between RN wages and wages in four other selected occupations indicates significant growth in RN wages after the regulations were implemented.

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  • David W. Harless, 2019. "Reassessing the labor market effects of California's minimum nurse staffing regulations," Health Economics, John Wiley & Sons, Ltd., vol. 28(10), pages 1226-1231, October.
    • Handle: RePEc:wly:hlthec:v:28:y:2019:i:10:p:1226-1231
    DOI: 10.1002/hec.3924
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    References listed on IDEAS

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    1. Elizabeth L. Munnich, 2014. "The Labor Market Effects Of California'S Minimum Nurse Staffing Law," Health Economics, John Wiley & Sons, Ltd., vol. 23(8), pages 935-950, August.
    2. David H. Autor, 2003. "Outsourcing at Will: The Contribution of Unjust Dismissal Doctrine to the Growth of Employment Outsourcing," Journal of Labor Economics, University of Chicago Press, vol. 21(1), pages 1-42, January.
    3. Min M. Chen & David C. Grabowski, 2015. "Intended and Unintended Consequences of Minimum Staffing Standards for Nursing Homes," Health Economics, John Wiley & Sons, Ltd., vol. 24(7), pages 822-839, July.
    4. Christopher J. Ruhm, 1998. "The Economic Consequences of Parental Leave Mandates: Lessons from Europe," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 113(1), pages 285-317.
    5. Cook, Andrew & Gaynor, Martin & Stephens Jr, Melvin & Taylor, Lowell, 2012. "The effect of a hospital nurse staffing mandate on patient health outcomes: Evidence from California's minimum staffing regulation," Journal of Health Economics, Elsevier, vol. 31(2), pages 340-348.
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    1. Raja, Chandni, 2023. "How do hospitals respond to input regulation? Evidence from the California nurse staffing mandate," Journal of Health Economics, Elsevier, vol. 92(C).

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