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Cut to the Bone? Hospital Takeovers and Nurse Employment Contracts

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  • Janet Currie
  • Mehdi Farsi
  • W. Bentley MacLeod

Abstract

This paper uses data from the 1990s to examine changes in the wages, employment, and effort of nurses in California hospitals following takeovers by large chains. The market for nurses has been described as a classic monopsony, so that one might expect increases in firm market power to be associated with declines in wages. However, we show that if one extends the monopsony model to consider effort, or if we apply a basic contracting model to the data, then we would expect to see effects on effort rather than on wages. This prediction is bourne out by the data nurses see few declines in wages following takeovers, but see increases in the number of patients per nurse, our measure of effort. We also find that these changes are similar in the largest for-profit and non-profit chains, suggesting that market forces are more more important than institutional form.

Suggested Citation

  • Janet Currie & Mehdi Farsi & W. Bentley MacLeod, 2003. "Cut to the Bone? Hospital Takeovers and Nurse Employment Contracts," NBER Working Papers 9428, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:9428
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    References listed on IDEAS

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    Citations

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    Cited by:

    1. Hirsch, Barry T. & Schumacher, Edward J., 2005. "Classic or new monopsony? Searching for evidence in nursing labor markets," Journal of Health Economics, Elsevier, vol. 24(5), pages 969-989, September.
    2. Foster, Andrew D. & Lee, Yong Suk, 2015. "Staffing subsidies and the quality of care in nursing homes," Journal of Health Economics, Elsevier, vol. 41(C), pages 133-147.
    3. 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.
    4. Hirsch, Barry & Schumacher, Edward J., 2004. "Classic Monopsony or New Monopsony? Searching for Evidence in Nursing Labor Markets," IZA Discussion Papers 1154, Institute for the Study of Labor (IZA).
    5. John P. Burkett, 2005. "The Labor Supply of Nurses and Nursing Assistants in the United States," Eastern Economic Journal, Eastern Economic Association, vol. 31(4), pages 585-599, Fall.
    6. Mehdi Farsi & Geert Ridder, 2006. "Estimating the out-of-hospital mortality rate using patient discharge data," Health Economics, John Wiley & Sons, Ltd., vol. 15(9), pages 983-995.
    7. João Ejarque, 2004. "Neoclassical Investment with Moral Hazard," Working Papers w200417, Banco de Portugal, Economics and Research Department.
    8. 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.
    9. Avdic, Daniel & Lundborg, Petter & Vikström, Johan, 2014. "Learning-by-Doing in a High-Skill Profession when Stakes are High: Evidence from Advanced Cancer Surgery," Annual Conference 2014 (Hamburg): Evidence-based Economic Policy 100278, Verein für Socialpolitik / German Economic Association.
    10. Cortés, Patricia & Pan, Jessica, 2014. "Foreign nurse importation and the supply of native nurses," Journal of Health Economics, Elsevier, vol. 37(C), pages 164-180.
    11. Jordan D. Matsudaira, 2014. "Government Regulation and the Quality of Healthcare: Evidence from Minimum Staffing Legislation for Nursing Homes," Journal of Human Resources, University of Wisconsin Press, vol. 49(1), pages 32-72.

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    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets

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