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The Effect of Registered Nurses' Unions on Heart-Attack Mortality

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  • Michael Ash
  • Jean Ann Seago

Abstract

Although hospital work organization affects patient outcomes and in some states registered nurses (R.N.'s) are increasingly forming unions, the relationship between R.N. unions and patient outcomes has received little attention. This study examines the relationship between R.N. unionization and the mortality rate for acute myocardial infarction (AMI), or heart attack, in acute-care hospitals in California. After controlling for patient and hospital characteristics, the authors find that hospitals with unionized R.N.'s have 5.5% lower heart-attack mortality than do non-union hospitals. This result remains substantively unchanged when the analysis accounts for possible selection bias—specifically, the possibility that unionized hospitals have certain important but unobservable characteristics, independent of unionization, that affect patient care.

Suggested Citation

  • 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.
    • Handle: RePEc:sae:ilrrev:v:57:y:2004:i:3:p:422-442
    DOI: 10.1177/001979390405700306
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    References listed on IDEAS

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    1. Barry T. Hirsch & David A. MacPherson, 2003. "Union Membership and Coverage Database from the Current Population Survey: Note," ILR Review, Cornell University, ILR School, vol. 56(2), pages 349-354, January.
    2. Hirsch, Barry T. & Schumacher, Edward J., 1995. "Monopsony power and relative wages in the labor market for nurses," Journal of Health Economics, Elsevier, vol. 14(4), pages 443-476, October.
    3. Addison, John T & Hirsch, Barry T, 1989. "Union Effects on Productivity, Profits, and Growth: Has the Long Run Arrived?," Journal of Labor Economics, University of Chicago Press, vol. 7(1), pages 72-105, January.
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    1. 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.
    2. Richard N. Block & Sheldon Friedman & Michelle Kaminski & Andy Levin (ed.), 2006. "Justice on the Job: Perspectives on the Erosion of Collective Bargaining in the United States," Books from Upjohn Press, W.E. Upjohn Institute for Employment Research, number joj, August.

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