IDEAS home Printed from https://ideas.repec.org/a/aea/aejpol/v4y2012i1p127-57.html
   My bibliography  Save this article

Do Strikes Kill? Evidence from New York State

Author

Listed:
  • Jonathan Gruber
  • Samuel A. Kleiner

Abstract

Hospitals now represent one of the largest union sectors of the US economy, and there is particular concern about the impact of strikes on patient welfare. We analyze the effects of nurses' strikes in hospitals on patient outcomes in New York State. Controlling for hospital specific heterogeneity, the results show that nurses' strikes increase in-hospital mortality by 18.3 percent and 30-day readmission by 5.7 percent for patients admitted during a strike, with little change in patient demographics, disease severity or treatment intensity. The results suggest that hospitals functioning during nurses' strikes do so at a lower quality of patient care. (JEL H75, I11, I12, J52)

Suggested Citation

  • Jonathan Gruber & Samuel A. Kleiner, 2012. "Do Strikes Kill? Evidence from New York State," American Economic Journal: Economic Policy, American Economic Association, vol. 4(1), pages 127-157, February.
    • Handle: RePEc:aea:aejpol:v:4:y:2012:i:1:p:127-57
    Note: DOI: 10.1257/pol.4.1.127
    as

    Download full text from publisher

    File URL: http://www.aeaweb.org/articles.php?doi=10.1257/pol.4.1.127
    Download Restriction: no
    File URL: http://www.aeaweb.org/aej/pol/data/2010-0221_data.zip
    Download Restriction: Access to full text is restricted to AEA members and institutional subscribers.
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Gowrisankaran, Gautam & Town, Robert J., 1999. "Estimating the quality of care in hospitals using instrumental variables," Journal of Health Economics, Elsevier, vol. 18(6), pages 747-767, December.
    2. Alan B. Krueger & Alexandre Mas, 2004. "Strikes, Scabs, and Tread Separations: Labor Strife and the Production of Defective Bridgestone/Firestone Tires," Journal of Political Economy, University of Chicago Press, vol. 112(2), pages 253-289, April.
    3. Alexandre Mas, 2008. "Labour Unrest and the Quality of Production: Evidence from the Construction Equipment Resale Market," Review of Economic Studies, Oxford University Press, vol. 75(1), pages 229-258.
    4. Jonathan Gruber & Samuel A. Kleiner, 2012. "Do Strikes Kill? Evidence from New York State," American Economic Journal: Economic Policy, American Economic Association, vol. 4(1), pages 127-157, February.
    5. Richard B. Freeman, 1998. "Spurts in Union Growth: Defining Moments and Social Processes," NBER Chapters, in: The Defining Moment: The Great Depression and the American Economy in the Twentieth Century, pages 265-296, National Bureau of Economic Research, Inc.
    6. Randall D. Cebul & James B. Rebitzer & Lowell J. Taylor & Mark E. Votruba, 2008. "Organizational Fragmentation and Care Quality in the U.S. Healthcare System," Journal of Economic Perspectives, American Economic Association, vol. 22(4), pages 93-113, Fall.
    7. Daniel P. Kessler & Jeffrey J. Geppert, 2005. "The Effects of Competition on Variation in the Quality and Cost of Medical Care," NBER Working Papers 11226, National Bureau of Economic Research, Inc.
    8. Cramton, Peter & Tracy, Joseph, 1998. "The Use of Replacement Workers in Union Contract Negotiations: The U.S. Experience, 1980-1989," Journal of Labor Economics, University of Chicago Press, vol. 16(4), pages 667-701, October.
    9. Mark McClellan & Douglas Staiger, 1999. "The Quality of Health Care Providers," NBER Working Papers 7327, National Bureau of Economic Research, Inc.
    10. Andrew Cook & Martin Gaynor & Melvin Stephens, Jr. & Lowell Taylor, 2010. "The Effect of Hospital Nurse Staffing on Patient Health Outcomes: Evidence from California's Minimum Staffing Regulation," NBER Working Papers 16077, National Bureau of Economic Research, Inc.
    11. John Geweke & Gautam Gowrisankaran & Robert J. Town, 2003. "Bayesian Inference for Hospital Quality in a Selection Model," Econometrica, Econometric Society, vol. 71(4), pages 1215-1238, July.
    12. Thomas J. Holmes, 2006. "Geographic Spillover of Unionism," NBER Working Papers 12025, National Bureau of Economic Research, Inc.
    13. Ho, Vivian & Hamilton, Barton H., 2000. "Hospital mergers and acquisitions: does market consolidation harm patients?," Journal of Health Economics, Elsevier, vol. 19(5), pages 767-791, September.
    14. Martin B. Schmidt & David J. Berri, 2004. "The Impact of Labor Strikes on Consumer Demand: An Application to Professional Sports," American Economic Review, American Economic Association, vol. 94(1), pages 344-357, March.
    15. Jonathan K. Kramer & Geraldo M. Vasconcellos, 1996. "The Economic Effect of Strikes on the Shareholders of Nonstruck Competitors," ILR Review, Cornell University, ILR School, vol. 49(2), pages 213-222, January.
    16. James, J.J., 1979. "Impacts of the medical malpractice slowdown in Los Angeles County: January 1976," American Journal of Public Health, American Public Health Association, vol. 69(5), pages 437-443.
    17. Richard A. De Fusco & Scott M. Fuess Jr., 1991. "The Effects of Airline Strikes on Struck and Nonstruck Carriers," ILR Review, Cornell University, ILR School, vol. 44(2), pages 324-333, January.
    18. Daniel P. Kessler & Jeffrey J. Geppert, 2005. "The Effects of Competition on Variation in the Quality and Cost of Medical Care," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 14(3), pages 575-589, September.
    19. Michael D. Bordo & Claudia Goldin & Eugene N. White, 1998. "The Defining Moment: The Great Depression and the American Economy in the Twentieth Century," NBER Books, National Bureau of Economic Research, Inc, number bord98-1, August.
    20. Morris M. Kleiner & Jonathan S. Leonard & Adam M. Pilarski, 2002. "How Industrial Relations Affects Plant Performance: The Case of Commercial Aircraft Manufacturing," ILR Review, Cornell University, ILR School, vol. 55(2), pages 195-218, January.
    21. Richard McHugh, 1991. "Productivity Effects of Strikes in Struck and Nonstruck Industries," ILR Review, Cornell University, ILR School, vol. 44(4), pages 722-732, July.
    22. Cutler, David M, 1995. "The Incidence of Adverse Medical Outcomes under Prospective Payment," Econometrica, Econometric Society, vol. 63(1), pages 29-50, January.
    23. George R. Neumann, 1980. "The Predicability of Strikes: Evidence from the Stock Market," ILR Review, Cornell University, ILR School, vol. 33(4), pages 525-535, July.
    24. Michael Ash & Jean Ann Seago, 2004. "The Effect of Registered Nurses' Unions on Heart-Attack Mortality," ILR Review, Cornell University, ILR School, vol. 57(3), pages 422-442, April.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Benjamin U. Friedrich & Martin B. Hackmann, 2017. "The Returns to Nursing: Evidence from a Parental Leave Program," NBER Working Papers 23174, National Bureau of Economic Research, Inc.
    2. Jonathan Gruber & Samuel A. Kleiner, 2012. "Do Strikes Kill? Evidence from New York State," American Economic Journal: Economic Policy, American Economic Association, vol. 4(1), pages 127-157, February.
    3. Brenøe, Anne Ardila & Canaan, Serena & Harmon, Nikolaj & Royer, Heather, 2019. "Is Parental Leave Costly for Firms and Coworkers?," IZA Discussion Papers 12870, Institute of Labor Economics (IZA).
    4. Moscelli, G.; & Sayli, M.; & Blanden, J.; & Mello, M.; & Castro-Pires, H.; & Bojke, C.;, 2023. "Non-monetary interventions, workforce retention and hospital quality: evidence from the English NHS," Health, Econometrics and Data Group (HEDG) Working Papers 23/13, HEDG, c/o Department of Economics, University of York.
    5. Kolstad, Jonathan T. & Kowalski, Amanda E., 2012. "The impact of health care reform on hospital and preventive care: Evidence from Massachusetts," Journal of Public Economics, Elsevier, vol. 96(11), pages 909-929.
    6. Carol Propper & George Stoye & Ben Zaranko, 2020. "The Wider Impacts of the Coronavirus Pandemic on the NHS," Fiscal Studies, John Wiley & Sons, vol. 41(2), pages 345-356, June.
    7. Piérard, Emmanuelle, 2014. "The effect of physician supply on health status: Canadian evidence," Health Policy, Elsevier, vol. 118(1), pages 56-65.
    8. Kelly, E.; & Propper, C.; & Zaranko, B.;, 2022. "Team composition and productivity: evidence from nursing teams in the English National Health Service," Health, Econometrics and Data Group (HEDG) Working Papers 22/19, HEDG, c/o Department of Economics, University of York.
    9. Barrero, Jose Maria, 2022. "The micro and macro of managerial beliefs," Journal of Financial Economics, Elsevier, vol. 143(2), pages 640-667.
    10. Pham, Tho & Talavera, Oleksandr & Tsapin, Andriy, 2018. "Shock contagion, asset quality and lending behavior," BOFIT Discussion Papers 21/2018, Bank of Finland Institute for Emerging Economies (BOFIT).
    11. Stefan Bauernschuster & Timo Hener & Helmut Rainer, 2017. "When Labor Disputes Bring Cities to a Standstill: The Impact of Public Transit Strikes on Traffic, Accidents, Air Pollution, and Health," American Economic Journal: Economic Policy, American Economic Association, vol. 9(1), pages 1-37, February.
    12. Knutsson, Daniel & Tyrefors, Björn, 2020. "The Quality and Efficiency Between Public and Private Firms: Evidence from Ambulance Services," Working Paper Series 1365, Research Institute of Industrial Economics, revised 01 Jul 2021.
    13. Friedman, Willa & Keats, Anthony & Mutua, Martin Kavao, 2022. "Disruptions to healthcare quality and early child health outcomes: Evidence from health-worker strikes in Kenya," Journal of Health Economics, Elsevier, vol. 86(C).
    14. repec:zbw:bofitp:2018_021 is not listed on IDEAS
    15. Furtado, Delia & Ortega, Francesc, 2020. "Does Immigration Improve Quality of Care in Nursing Homes?," IZA Discussion Papers 13552, Institute of Labor Economics (IZA).
    16. Engy Ziedan & Kosali I. Simon & Coady Wing, 2022. "Mortality Effects of Healthcare Supply Shocks: Evidence Using Linked Deaths and Electronic Health Records," NBER Working Papers 30553, National Bureau of Economic Research, Inc.
    17. Peter McHenry & Jennifer Mellor, 2018. "Medicare hospital payment adjustments and nursing wages," International Journal of Health Economics and Management, Springer, vol. 18(2), pages 169-196, June.
    18. Moscelli, Giuseppe & Sayli, Melisa & Blanden, Jo & Mello, Marco & Castro-Pires, Henrique & Bojke, Chris, 2023. "Non-monetary Interventions, Workforce Retention and Hospital Quality: Evidence from the English NHS," IZA Discussion Papers 16379, Institute of Labor Economics (IZA).
    19. Eduardo Costa, 2022. "The unintended consequences of hospital strikes on patient outcomes evidence from multiple strikes in the Portuguese National Health Service," Health Economics, John Wiley & Sons, Ltd., vol. 31(11), pages 2499-2511, November.
    20. Kai Fischer, 2023. "Skilled Labour Migration and Firm Performance: Evidence from English Hospitals and Brexit," CESifo Working Paper Series 10747, CESifo.
    21. Topi Miettinen & Olli Ropponen & Pekka Sääskilahti, 2020. "Prospect Theory, Fairness, and the Escalation of Conflict at a Negotiation Impasse," Scandinavian Journal of Economics, Wiley Blackwell, vol. 122(4), pages 1535-1574, October.
    22. Nassim Nicholas Taleb & Jeffrey West, 2022. "Working With Convex Responses: Antifragility From Finance to Oncology," Papers 2209.14631, arXiv.org, revised Jan 2023.
    23. Stoye, George & Warner, Max, 2023. "The effects of doctor strikes on patient outcomes: Evidence from the English NHS," Journal of Economic Behavior & Organization, Elsevier, vol. 212(C), pages 689-707.
    24. Michael DiNardi, 2017. "Affordable Care Act Medicaid Expansions and the Impact on Nurses," 2017 Papers pdi509, Job Market Papers.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Gaynor, Martin & Town, Robert J., 2011. "Competition in Health Care Markets," Handbook of Health Economics, in: Mark V. Pauly & Thomas G. Mcguire & Pedro P. Barros (ed.), Handbook of Health Economics, volume 2, chapter 0, pages 499-637, Elsevier.
    2. Martin Gaynor, "undated". "What Do We Know About Competition and Quality in Health Care Markets?," GSIA Working Papers 2006-E62, Carnegie Mellon University, Tepper School of Business.
    3. Mehdi Farsi & Geert Ridder, 2006. "Estimating the out‐of‐hospital mortality rate using patient discharge data," Health Economics, John Wiley & Sons, Ltd., vol. 15(9), pages 983-995, September.
    4. Zack Cooper & Stephen Gibbons & Simon Jones & Alistair McGuire, 2011. "Does Hospital Competition Save Lives? Evidence From The English NHS Patient Choice Reforms," Economic Journal, Royal Economic Society, vol. 121(554), pages 228-260, August.
    5. Giuseppe Moscelli & Hugh Gravelle & Luigi Siciliani, 2018. "Effects of Market Structure and Patient Choice on Hospital Quality for Planned Patients," School of Economics Discussion Papers 1118, School of Economics, University of Surrey.
    6. Giuseppe Moscelli & Hugh Gravelle & Luigi Siciliani, 2016. "Market structure, patient choice and hospital quality for elective patients," Working Papers 139cherp, Centre for Health Economics, University of York.
    7. Laurent Gobillon & Carine Milcent, 2013. "Spatial disparities in hospital performance," Journal of Economic Geography, Oxford University Press, vol. 13(6), pages 1013-1040, November.
    8. Carine Milcent, 2005. "Hospital ownership, reimbursement systems and mortality rates," Health Economics, John Wiley & Sons, Ltd., vol. 14(11), pages 1151-1168, November.
    9. Giuseppe Moscelli & Hugh Gravelle & Luigi Siciliani, 2021. "Hospital competition and quality for non‐emergency patients in the English NHS," RAND Journal of Economics, RAND Corporation, vol. 52(2), pages 382-414, June.
    10. John Geweke & Gautam Gowrisankaran & Robert J. Town, 2003. "Bayesian Inference for Hospital Quality in a Selection Model," Econometrica, Econometric Society, vol. 71(4), pages 1215-1238, July.
    11. Paolo Berta & Gianmaria Martini & Francesco Moscone & Giorgio Vittadini, 2016. "The association between asymmetric information, hospital competition and quality of healthcare: evidence from Italy," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 179(4), pages 907-926, October.
    12. Barry T. Hirsch, 2008. "Sluggish Institutions in a Dynamic World: Can Unions and Industrial Competition Coexist?," Journal of Economic Perspectives, American Economic Association, vol. 22(1), pages 153-176, Winter.
    13. Carine Milcent, 2021. "Competition in French hospital: Does it impact the patient management in healthcare?," Working Papers halshs-03152752, HAL.
    14. Matilde P. Machado & Ricardo Mora & Antonio Romero-Medina, 2012. "Can We Infer Hospital Quality From Medical Graduates’ Residency Choices?," Journal of the European Economic Association, European Economic Association, vol. 10(6), pages 1400-1424, December.
    15. Bär, Marlies & Bakx, Pieter & Wouterse, Bram & van Doorslaer, Eddy, 2022. "Estimating the health value added by nursing homes," Journal of Economic Behavior & Organization, Elsevier, vol. 203(C), pages 1-23.
    16. Akerlof, Robert & Ashraf, Anik & Macchiavello, Rocco & Rabbani, Atonu, 2020. "Layoffs and productivity at a Bangladeshi sweater factor," The Warwick Economics Research Paper Series (TWERPS) 1293, University of Warwick, Department of Economics.
    17. Abe Dunn & Adam Hale Shapiro, 2018. "Physician Competition and the Provision of Care: Evidence from Heart Attacks," American Journal of Health Economics, University of Chicago Press, vol. 4(2), pages 226-261, Spring.
    18. Stefan Bauernschuster & Timo Hener & Helmut Rainer, 2017. "When Labor Disputes Bring Cities to a Standstill: The Impact of Public Transit Strikes on Traffic, Accidents, Air Pollution, and Health," American Economic Journal: Economic Policy, American Economic Association, vol. 9(1), pages 1-37, February.
    19. Panos, Georgios & Theodossiou, Ioannis, 2009. "Union Mediation and Adaptation to Reciprocal Loyalty Arrangements," MPRA Paper 15471, University Library of Munich, Germany.
    20. Carine Milcent, 2014. "Coût des soins hospitaliers : effet de la concurrence par la qualité," PSE Working Papers halshs-01010327, HAL.

    More about this item

    JEL classification:

    • H75 - Public Economics - - State and Local Government; Intergovernmental Relations - - - State and Local Government: Health, Education, and Welfare
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • J52 - Labor and Demographic Economics - - Labor-Management Relations, Trade Unions, and Collective Bargaining - - - Dispute Resolution: Strikes, Arbitration, and Mediation

    Lists

    This item is featured on the following reading lists, Wikipedia, or ReplicationWiki pages:
    1. Do Strikes Kill? Evidence from New York State (American Economic Journal: Economic Policy 2012) in ReplicationWiki

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:aea:aejpol:v:4:y:2012:i:1:p:127-57. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Michael P. Albert (email available below). General contact details of provider: https://edirc.repec.org/data/aeaaaea.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.