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Foreign Nurses and Hospital Quality: Evidence from Brexit

Author

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  • Castro-Pires, Henrique

    (University of Surrey)

  • Mello, Marco

    (University of Aberdeen)

  • Moscelli, Giuseppe

    (University of Surrey)

Abstract

We exploit the 2016 Brexit referendum as a migration shock to evaluate the impact of reduced labour supply on the provision of hospital care. After the referendum, a sharp drop in the number of early-career new joiners from Europe resulted in a considerable decrease in the share of EU nurses in the English NHS. Using an enclave instrumental variable empirical strategy, we find that emergency readmission rates increased, and more so in hospital organizations more exposed to the missing inflow of new joiners. A theoretical model shows that this is consistent with a decrease in the quality of new hires.

Suggested Citation

  • Castro-Pires, Henrique & Mello, Marco & Moscelli, Giuseppe, 2023. "Foreign Nurses and Hospital Quality: Evidence from Brexit," IZA Discussion Papers 16616, Institute of Labor Economics (IZA).
  • Handle: RePEc:iza:izadps:dp16616
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    1. Rui Costa & Swati Dhingra & Stephen Machin, 2022. "New dawn fades: Trade, labour and the Brexit exchange rate depreciation," CEP Discussion Papers dp1890, Centre for Economic Performance, LSE.
    2. Breinlich, Holger & Leromain, Elsa & Novy, Dennis & Sampson, Thomas, 2020. "Voting with their money: Brexit and outward investment by UK firms," European Economic Review, Elsevier, vol. 124(C).
    3. Ellen R. McGrattan & Andrea Waddle, 2020. "The Impact of Brexit on Foreign Investment and Production," American Economic Journal: Macroeconomics, American Economic Association, vol. 12(1), pages 76-103, January.
    4. Holger Breinlich & Elsa Leromain & Dennis Novy & Thomas Sampson & Ahmed Usman, 2018. "The Economic Effects of Brexit: Evidence from the Stock Market," Fiscal Studies, John Wiley & Sons, vol. 39(4), pages 581-623, December.
    5. Thomas Sampson, 2017. "Brexit: The Economics of International Disintegration," Journal of Economic Perspectives, American Economic Association, vol. 31(4), pages 163-184, Fall.
    6. Jonathan Portes, 2022. "Immigration and the UK economy after Brexit," Oxford Review of Economic Policy, Oxford University Press and Oxford Review of Economic Policy Limited, vol. 38(1), pages 82-96.
    7. Card, David, 2001. "Immigrant Inflows, Native Outflows, and the Local Labor Market Impacts of Higher Immigration," Journal of Labor Economics, University of Chicago Press, vol. 19(1), pages 22-64, January.
    8. Mustapha Douch & Terence Huw Edwards, 2022. "The bilateral trade effects of announcement shocks: Brexit as a natural field experiment," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 37(2), pages 305-329, March.
    9. Christian Dustmann & Tommaso Frattini, 2014. "The Fiscal Effects of Immigration to the UK," Economic Journal, Royal Economic Society, vol. 124(580), pages 593-643, November.
    10. Carol Propper & John Van Reenen, 2010. "Can Pay Regulation Kill? Panel Data Evidence on the Effect of Labor Markets on Hospital Performance," Journal of Political Economy, University of Chicago Press, vol. 118(2), pages 222-273, April.
    11. 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.
    12. Giovanni Peri, 2016. "The Effect Of Immigration On Productivity: Evidence From U.S. States," World Scientific Book Chapters, in: The Economics of International Migration, chapter 8, pages 265-275, World Scientific Publishing Co. Pte. Ltd..
    13. Davies, Ronald B. & Studnicka, Zuzanna, 2018. "The heterogeneous impact of Brexit: Early indications from the FTSE," European Economic Review, Elsevier, vol. 110(C), pages 1-17.
    14. Bartel, Ann P, 1989. "Where Do the New U.S. Immigrants Live?," Journal of Labor Economics, University of Chicago Press, vol. 7(4), pages 371-391, October.
    15. Holger Breinlich & Elsa Leromain & Dennis Novy & Thomas Sampson, 2022. "The Brexit Vote, Inflation And U.K. Living Standards," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 63(1), pages 63-93, February.
    16. Holger Breinlich & Elsa Leromain & Dennis Novy & Thomas Sampson, 2022. "The Brexit Vote, Inflation And U.K. Living Standards," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 63(1), pages 63-93, February.
    17. Mette Foged & Giovanni Peri, 2016. "Immigrants' Effect on Native Workers: New Analysis on Longitudinal Data," American Economic Journal: Applied Economics, American Economic Association, vol. 8(2), pages 1-34, April.
    18. Swati Dhingra & Hanwei Huang & Gianmarco Ottaviano & João Paulo Pessoa & Thomas Sampson & John Van Reenen, 2017. "The costs and benefits of leaving the EU: trade effects," Economic Policy, CEPR, CESifo, Sciences Po;CES;MSH, vol. 32(92), pages 651-705.
    19. Lee, Jongkwan & Peri, Giovanni & Yasenov, Vasil, 2022. "The labor market effects of Mexican repatriations: Longitudinal evidence from the 1930s," Journal of Public Economics, Elsevier, vol. 205(C).
    20. Kleibergen, Frank & Paap, Richard, 2006. "Generalized reduced rank tests using the singular value decomposition," Journal of Econometrics, Elsevier, vol. 133(1), pages 97-126, July.
    21. Di Iasio, Valentina & Wahba, Jackline, 2023. "Expecting Brexit and UK migration: Should I go?," European Economic Review, Elsevier, vol. 157(C).
    22. Susana Alvarez-Diez & J. Samuel Baixauli-Soler & Maria Belda-Ruiz, 2019. "Co-movements between the British pound, the euro and the Japanese yen: the Brexit impact," Journal of Economic Studies, Emerald Group Publishing Limited, vol. 46(2), pages 467-481, March.
    23. Valentina Bosetti & Cristina Cattaneo & Elena Verdolini, 2012. "Migration, Cultural Diversity and Innovation: A European Perspective," Working Papers 2012.69, Fondazione Eni Enrico Mattei.
    24. Bosetti, Valentina & Cattaneo, Cristina & Verdolini, Elena, 2015. "Migration of skilled workers and innovation: A European Perspective," Journal of International Economics, Elsevier, vol. 96(2), pages 311-322.
    25. Haizhen Lin, 2014. "Revisiting the relationship between nurse staffing and quality of care in nursing homes: An instrumental variables approach," Working Papers 2014-01, Indiana University, Kelley School of Business, Department of Business Economics and Public Policy.
    26. Patricia Cortés & José Tessada, 2011. "Low-Skilled Immigration and the Labor Supply of Highly Skilled Women," American Economic Journal: Applied Economics, American Economic Association, vol. 3(3), pages 88-123, July.
    27. Stock, James H & Wright, Jonathan H & Yogo, Motohiro, 2002. "A Survey of Weak Instruments and Weak Identification in Generalized Method of Moments," Journal of Business & Economic Statistics, American Statistical Association, vol. 20(4), pages 518-529, October.
    28. David C. Grabowski & Jonathan Gruber & Brian McGarry, 2023. "Immigration, The Long-Term Care Workforce, and Elder Outcomes in the U.S," NBER Working Papers 30960, National Bureau of Economic Research, Inc.
    29. Alejandro G Graziano & Kyle Handley & Nuno Limão, 2021. "Brexit Uncertainty and Trade Disintegration," The Economic Journal, Royal Economic Society, vol. 131(635), pages 1150-1185.
    30. Jonathan Wadsworth, 2018. "Off EU Go? Brexit, the UK Labour Market and Immigration," Fiscal Studies, John Wiley & Sons, vol. 39(4), pages 625-649, December.
    31. Mathias Czaika & Christopher R. Parsons, 2017. "The Gravity of High-Skilled Migration Policies," Demography, Springer;Population Association of America (PAA), vol. 54(2), pages 603-630, April.
    32. Keane, Michael & Neal, Timothy, 2023. "Instrument strength in IV estimation and inference: A guide to theory and practice," Journal of Econometrics, Elsevier, vol. 235(2), pages 1625-1653.
    33. Jinyong Hahn & Jerry Hausman, 2003. "Weak Instruments: Diagnosis and Cures in Empirical Econometrics," American Economic Review, American Economic Association, vol. 93(2), pages 118-125, May.
    34. Benjamin U Friedrich & Martin B Hackmann, 2021. "The Returns to Nursing: Evidence from a Parental-Leave Program [Access to Cardiac Rehabilitation and the Role of Language Barriers in the Provision of Cardiac Rehabilitation to Migrants]," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 88(5), pages 2308-2343.
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    Cited by:

    1. Peter Haan & Izabela Wnuk, 2024. "The Effect of Migration on Careers of Natives: Evidence from Long-term Care," Discussion Papers of DIW Berlin 2070, DIW Berlin, German Institute for Economic Research.
    2. Haan, Peter & Wnuk, Izabela, 2024. "The Effect of Migration on Careers of Natives: Evidence from Long-Term Care," IZA Discussion Papers 16749, Institute of Labor Economics (IZA).

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    More about this item

    Keywords

    labour supply; workers' mobility; immigration; patient care; hospital quality; Brexit;
    All these keywords.

    JEL classification:

    • J45 - Labor and Demographic Economics - - Particular Labor Markets - - - Public Sector Labor Markets
    • J61 - Labor and Demographic Economics - - Mobility, Unemployment, Vacancies, and Immigrant Workers - - - Geographic Labor Mobility; Immigrant Workers
    • J68 - Labor and Demographic Economics - - Mobility, Unemployment, Vacancies, and Immigrant Workers - - - Public Policy
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • C26 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Instrumental Variables (IV) Estimation

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