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Do Strikes Kill? Evidence from New York State

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  • Jonathan Gruber
  • Samuel A. Kleiner

Abstract

Concerns over the impacts of hospital strikes on patient welfare led to substantial delay in the ability of hospitals to unionize. Once allowed, hospitals unionized rapidly and now represent one of the largest union sectors of the U.S. economy. Were the original fears of harmful hospital strikes realized as a result? In this paper we analyze the effects of nurses' strikes in hospitals on patient outcomes. We utilize a unique dataset collected on nurses' strikes over the 1984 to 2004 period in New York State, and match these strikes to a restricted use hospital discharge database which provides information on treatment intensity, patient mortality and hospital readmission. Controlling for hospital specific heterogeneity, patient demographics and disease severity, the results show that nurses' strikes increase in-hospital mortality by 19.4% and 30-day readmission by 6.5% for patients admitted during a strike, with little change in patient demographics, disease severity or treatment intensity. This study provides some of the first analytical evidence on the effects of health care strikes on patients, and suggests that hospitals functioning during nurses' strikes are doing so at a lower quality of patient care.

Suggested Citation

  • Jonathan Gruber & Samuel A. Kleiner, 2010. "Do Strikes Kill? Evidence from New York State," NBER Working Papers 15855, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:15855
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    References listed on IDEAS

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    1. 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.
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    Citations

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    Cited by:

    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. 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.
    3. 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.
    4. 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.
    5. Michael DiNardi, 2017. "Affordable Care Act Medicaid Expansions and the Impact on Nurses," 2017 Papers pdi509, Job Market Papers.
    6. Piérard, Emmanuelle, 2014. "The effect of physician supply on health status: Canadian evidence," Health Policy, Elsevier, vol. 118(1), pages 56-65.

    More about this item

    JEL classification:

    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I23 - Health, Education, and Welfare - - Education - - - Higher Education; Research Institutions
    • J52 - Labor and Demographic Economics - - Labor-Management Relations, Trade Unions, and Collective Bargaining - - - Dispute Resolution: Strikes, Arbitration, and Mediation
    • J62 - Labor and Demographic Economics - - Mobility, Unemployment, Vacancies, and Immigrant Workers - - - Job, Occupational and Intergenerational Mobility; Promotion

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