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Relative Quality of Foreign Nurses in the United States


  • Patricia Cortés

    () (School of Management, Boston University)

  • Jessica Pan

    () (National University of Singapore)


In recent years, the US has become increasingly reliant on foreign registered nurses to satisfy health care demands. The Philippines has emerged as the single largest source of nurses educated abroad, representing more than half of foreign nurses entering the US in the last decade. One of the main concerns raised by the importation of nurses is the quality of care that they provide. This paper addresses this question by analyzing the relative quality of foreign educated nurses and its evolution over time using Census data from 1980 to 2010 and wages as a measure of skill. We find a positive wage premium for nurses educated in the Philippines, but not for foreign nurses educated elsewhere. This premium cannot be explained by differences in demographics, education, work experience, location, or detailed job characteristics. The assimilation profile of Filipino nurses and the types of hospitals that hire them strongly suggest that the premium reflects quality differences and not just unobserved characteristics of the job that carry a higher wage but are unrelated to skill. We provide evidence that the wage premium is likely to be driven by strong positive selection into nursing among Filipinos resulting from the high and heterogeneous returns to the occupation generated by active government support for the migration of nurses in the Philippines.

Suggested Citation

  • Patricia Cortés & Jessica Pan, 2012. "Relative Quality of Foreign Nurses in the United States," CReAM Discussion Paper Series 1231, Centre for Research and Analysis of Migration (CReAM), Department of Economics, University College London.
  • Handle: RePEc:crm:wpaper:1231

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    References listed on IDEAS

    1. Barry T. Hirsch & Edward J. Schumacher, 2012. "Underpaid or Overpaid? Wage Analysis for Nurses Using Job and Worker Attributes," Southern Economic Journal, Southern Economic Association, vol. 78(4), pages 1096-1119, April.
    2. Janet Currie & Enrico Moretti, 2003. "Mother's Education and the Intergenerational Transmission of Human Capital: Evidence from College Openings," The Quarterly Journal of Economics, Oxford University Press, vol. 118(4), pages 1495-1532.
    3. Janet Currie & Mehdi Farsi & W. Bentley Macleod, 2005. "Cut to the Bone? Hospital Takeovers and Nurse Employment Contracts," ILR Review, Cornell University, ILR School, vol. 58(3), pages 471-493, April.
    4. A. D. Roy, 1951. "Some Thoughts On The Distribution Of Earnings," Oxford Economic Papers, Oxford University Press, vol. 3(2), pages 135-146.
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    Blog mentions

    As found by, the blog aggregator for Economics research:
    1. Are immigrant nurses better than domestic ones in the US?
      by Economic Logician in Economic Logic on 2012-12-11 21:05:00


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    Cited by:

    1. Naiditch, Claire & Vranceanu, Radu, 2013. "A two-country model of high skill migration with public education," ESSEC Working Papers WP1301, ESSEC Research Center, ESSEC Business School.
    2. repec:hal:journl:hal-00779716 is not listed on IDEAS
    3. Cortes, Patricia & Pan, Jessica, 2014. "Foreign nurse importation to the United States and the supply of native registered nurses," Working Papers 14-7, Federal Reserve Bank of Boston.

    More about this item


    Nurses; Migration; Selection; Skills.;

    JEL classification:

    • J61 - Labor and Demographic Economics - - Mobility, Unemployment, Vacancies, and Immigrant Workers - - - Geographic Labor Mobility; Immigrant Workers
    • J24 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Human Capital; Skills; Occupational Choice; Labor Productivity
    • J44 - Labor and Demographic Economics - - Particular Labor Markets - - - Professional Labor Markets and Occupations

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