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The Returns to Nursing: Evidence from a Parental Leave Program


  • Benjamin U. Friedrich
  • Martin B. Hackmann


Nurses comprise the largest health profession. In this paper, we measure the effect of nurses on health care delivery and patient health outcomes across sectors. Our empirical strategy takes advantage of a parental leave program, which led to a sudden, unintended, and persistent 12% reduction in nurse employment. Our findings indicate detrimental effects on hospital care delivery as indicated by an increase in 30-day readmission rates and a distortion of technology utilization. The effects for nursing home care are more drastic. We estimate a persistent 13% increase in nursing home mortality among the elderly aged 85 and older. Our results also highlight an unintended negative consequence of parental leave programs borne by providers and patients.

Suggested Citation

  • 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.
  • Handle: RePEc:nbr:nberwo:23174
    Note: AG HC HE LS PE

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    References listed on IDEAS

    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. Pedro Carneiro & Katrine V. Løken & Kjell G. Salvanes, 2015. "A Flying Start? Maternity Leave Benefits and Long-Run Outcomes of Children," Journal of Political Economy, University of Chicago Press, vol. 123(2), pages 365-412.
    3. Christopher J. Ruhm, 1998. "The Economic Consequences of Parental Leave Mandates: Lessons from Europe," The Quarterly Journal of Economics, Oxford University Press, vol. 113(1), pages 285-317.
    4. Haizhen Lin, 2014. "Revisiting the relationship between nurse staffing and quality of care in nursing homes: An instrumental variables approach," Working Papers 2014-01, Indiana University, Kelley School of Business, Department of Business Economics and Public Policy.
    5. Kjeld Møller Pedersen & Terkel Christiansen & Mickael Bech, 2005. "The Danish health care system: evolution - not revolution - in a decentralized system," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages 41-57.
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    Cited by:

    1. Martin B. Hackmann, 2017. "Incentivizing Better Quality of Care: The Role of Medicaid and Competition in the Nursing Home Industry," NBER Working Papers 24133, National Bureau of Economic Research, Inc.

    More about this item

    JEL classification:

    • D22 - Microeconomics - - Production and Organizations - - - Firm Behavior: Empirical Analysis
    • H75 - Public Economics - - State and Local Government; Intergovernmental Relations - - - State and Local Government: Health, Education, and Welfare
    • I10 - Health, Education, and Welfare - - Health - - - General
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • J13 - Labor and Demographic Economics - - Demographic Economics - - - Fertility; Family Planning; Child Care; Children; Youth

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