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Can pay regulation kill? Panel data evidence on the effect of labor markets on hospital performance

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  • Emma Hall
  • Carol Propper
  • John Van Reenen

    ()

Abstract

Labor market regulation can have harmful unintended consequences. In many markets, especially for public sector workers, pay is regulated to be the same for individuals across heterogeneous geographical labor markets. We would predict that this will mean labor supply problems and potential falls in the quality of service provision in areas with stronger labor markets. In this paper we exploit panel data from the population of English acute hospitals where pay for medical staff is almost flat across the country. We predict that areas with higher outside wages should suffer from problems of recruiting, retaining and motivating high quality workers and this should harm hospital performance. We construct hospital-level panel data on both quality - as measured by death rates (within hospital deaths within thirty days of emergency admission for acute myocardial infarction, AMI) - and productivity. We present evidence that stronger local labor markets significantly worsen hospital outcomes in terms of quality and productivity. A 10% increase in the outside wage is associated with a 4% to 8% increase in AMI death rates. We find that an important part of this effect operates through hospitals in high outside wage areas having to rely more on temporary “agency staff” as they are unable to increase (regulated) wages in order to attract permanent employees. By contrast, we find no systematic role for an effect of outside wages of performance when we run placebo experiments in 42 other service sectors (including nursing homes) where pay is unregulated.

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Bibliographic Info

Paper provided by Department of Economics, University of Bristol, UK in its series The Centre for Market and Public Organisation with number 08/184.

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Length: 39 pages
Date of creation: Dec 2007
Date of revision:
Handle: RePEc:bri:cmpowp:08/184

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Keywords: labor market regulation; hospital quality; hospital productivity; skills.;

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References

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  1. A Bad Bargain by Mark Harrison
    by Mark Harrison in Mark Harrison's blog on 2012-09-19 07:40:08
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Cited by:
  1. Nicola Lacetera & Mario Macis & Robert Slonim, 2011. "Rewarding Altruism? A Natural Field Experiment," NBER Working Papers 17636, National Bureau of Economic Research, Inc.
  2. Simon Burgess & Carol Propper & Marisa Ratto & Emma Tominey, 2011. "Incentives in the Public Sector: Evidence from a Government Agency," The Centre for Market and Public Organisation 11/265, Department of Economics, University of Bristol, UK.
  3. Propper, C & Bloom, N & Seiler, S & Van Reenen, J, . "The impact of competition on management quality: evidence from public hospitals," Working Papers 5915, Imperial College, London, Imperial College Business School.
  4. Falch, Torberg & Johansen, Kåre & Strøm, Bjarne, 2009. "Teacher shortages and the business cycle," Labour Economics, Elsevier, vol. 16(6), pages 648-658, December.
  5. Martin Gaynor & Rodrigo Moreno-Serra & Carol Propper, 2010. "Death by Market Power. Reform, Competition and Patient Outcomes in the National Health Service," The Centre for Market and Public Organisation 10/242, Department of Economics, University of Bristol, UK.
  6. Stratford Douglas & Thomas A. Garrett & Russell M. Rhine, 2009. "Disallowances and overcapitalization in the U.S. electric utility industry," Review, Federal Reserve Bank of St. Louis, issue Jan, pages 23-32.
  7. Daniele Nosenzo, 2012. "Pay Secrecy and effort provision," Discussion Papers 2012-13, The Centre for Decision Research and Experimental Economics, School of Economics, University of Nottingham.
  8. MORIKAWA Masayuki, 2010. "Economies of Scale and Hospital Productivity: An empirical analysis of medical area level panel data," Discussion papers 10050, Research Institute of Economy, Trade and Industry (RIETI).
  9. Giulia Faggio & Henry G. Overman, 2012. "The Effect of Public Sector Employment on Local Labour Markets," SERC Discussion Papers 0111, Spatial Economics Research Centre, LSE.
  10. Eric Delattre & Jean-Baptiste Combès & Bob Elliott & Diane Skatun, 2012. "Hospital Staffing and Local Pay: an Investigation into the Impact of Local variations in the Competitiveness of Nurses Pay on the Staffing of Hospitals in France," THEMA Working Papers 2012-35, THEMA (THéorie Economique, Modélisation et Applications), Université de Cergy-Pontoise.
  11. Ann P. Bartel & Ciaran S. Phibbs & Nancy Beaulieu & Patricia Stone, 2011. "Human Capital and Organizational Performance: Evidence from the Healthcare Sector," NBER Working Papers 17474, National Bureau of Economic Research, Inc.
  12. Corry, Dan & Valero, Anna & Van Reenen, John, 2011. "UK economic performance since 1997: growth, productivity and jobs ," Open Access publications from London School of Economics and Political Science CEPSP24, London School of Economics and Political Science.
  13. Eich, Frank, 2009. "Evaluating public and private sector pensions: The importance of sectoral pay differentials," EconStor Preprints 54561, ZBW - German National Library of Economics.
  14. repec:cep:cepsps:24 is not listed on IDEAS

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