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Do Strikes Kill? Evidence from New York State

  • Jonathan Gruber
  • Samuel A. Kleiner

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.

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File URL: http://www.nber.org/papers/w15855.pdf
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Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 15855.

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Date of creation: Mar 2010
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Publication status: published as 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 127-57, February.
Handle: RePEc:nbr:nberwo:15855
Note: AG HC HE LS PE
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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.
  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. Peter Cramton & Joseph S. Tracy, 1998. "The Use of Replacement Workers in Union Contract Negotiations: The U.S. Experience, 1980-1989," Papers of Peter Cramton 98jole, University of Maryland, Department of Economics - Peter Cramton, revised 09 Jun 1998.
  4. Richard A. DeFusco & Scott M. Fuess & Jr, 1991. "The effects of airline strikes on struck and nonstruck carriers," Industrial and Labor Relations Review, ILR Review, Cornell University, ILR School, vol. 44(2), pages 324-333, January.
  5. George R. Neumann, 1980. "The predictability of strikes: Evidence from the stock market," Industrial and Labor Relations Review, ILR Review, Cornell University, ILR School, vol. 33(4), pages 525-535, July.
  6. 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.
  7. John Geweke & Gautam Gowrisankaran & Robert J. Town, 2001. "Bayesian Inference for Hospital Quality in a Selection Model," NBER Working Papers 8497, National Bureau of Economic Research, Inc.
  8. 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 127-57, February.
  9. 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.
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