IDEAS home Printed from https://ideas.repec.org/p/zbw/cexwps/306342.html
   My bibliography  Save this paper

The deadly consequences of labor scarcity: Evidence from hospitals

Author

Listed:
  • Schlenker, Oliver

Abstract

This paper estimates the impact of nursing shortages in hospitals on healthcare provision and patient outcomes by exploiting a strong and stable appreciation of the Swiss franc in 2011. Due to collective bargaining hindering wage adjustments in the German healthcare sector, cross-border wage differentials increased and led to a significant outflow of German registered nurses to Switzerland, causing a 12.5% reduction in nurse staffing rates in German hospitals near the border. Using a matched difference-in-differences approach, I find that hospitals responded by decreasing care intensity, leading to a 12% decrease in surgeries. Although hospitals are increasingly performing triage, also patients with high medical needs - such as elderly and emergency cases - face a reduction in care and, consequently, a stark increase in mortality rates, resulting in a measurable decline in regional life expectancy.

Suggested Citation

  • Schlenker, Oliver, 2024. "The deadly consequences of labor scarcity: Evidence from hospitals," Working Papers 42, University of Konstanz, Cluster of Excellence "The Politics of Inequality. Perceptions, Participation and Policies".
    • Handle: RePEc:zbw:cexwps:306342
    DOI: 10.48787/kops/352-2-1ii51x0tstwlz2
    as

    Download full text from publisher

    File URL: https://www.econstor.eu/bitstream/10419/306342/1/1907579613.pdf
    Download Restriction: no
    File URL: https://libkey.io/10.48787/kops/352-2-1ii51x0tstwlz2?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Andreas Beerli & Jan Ruffner & Michael Siegenthaler & Giovanni Peri, 2021. "The Abolition of Immigration Restrictions and the Performance of Firms and Workers: Evidence from Switzerland," American Economic Review, American Economic Association, vol. 111(3), pages 976-1012, March.
    2. Olivier Blanchard & Jordi Galí, 2010. "Labor Markets and Monetary Policy: A New Keynesian Model with Unemployment," American Economic Journal: Macroeconomics, American Economic Association, vol. 2(2), pages 1-30, April.
    3. Ann H. Stevens & Douglas L. Miller & Marianne E. Page & Mateusz Filipski, 2015. "The Best of Times, the Worst of Times: Understanding Pro-cyclical Mortality," American Economic Journal: Economic Policy, American Economic Association, vol. 7(4), pages 279-311, November.
    4. Christian Dustmann & Uta Schönberg & Jan Stuhler, 2017. "Labor Supply Shocks, Native Wages, and the Adjustment of Local Employment," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 132(1), pages 435-483.
    5. Carol Propper & John Van Reenen, 2010. "Can Pay Regulation Kill? Panel Data Evidence on the Effect of Labor Markets on Hospital Performance," Journal of Political Economy, University of Chicago Press, vol. 118(2), pages 222-273, April.
    6. Christian Dustmann & Tommaso Frattini & Ian P. Preston, 2013. "The Effect of Immigration along the Distribution of Wages," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 80(1), pages 145-173.
    7. Nicolas Berman & Philippe Martin & Thierry Mayer, 2012. "How do Different Exporters React to Exchange Rate Changes?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 127(1), pages 437-492.
    8. Amy Finkelstein & Matthew Gentzkow & Heidi Williams, 2016. "Sources of Geographic Variation in Health Care: Evidence From PatientMigration," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 131(4), pages 1681-1726.
    9. Pascal Michaillat & Emmanuel Saez, 2015. "Aggregate Demand, Idle Time, and Unemployment," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 130(2), pages 507-569.
    10. Jäger, Simon & Heining, Jörg, 2019. "How Substitutable Are Workers? Evidence from Worker Deaths," MPRA Paper 109757, University Library of Munich, Germany, revised 01 Jan 2019.
    11. Card, David, 2001. "Immigrant Inflows, Native Outflows, and the Local Labor Market Impacts of Higher Immigration," Journal of Labor Economics, University of Chicago Press, vol. 19(1), pages 22-64, January.
    12. Mario Bossler & Martin Popp, 2022. "Labor Demand on a Tight Leash," Papers 2203.05593, arXiv.org, revised Feb 2024.
    13. Daron Acemoglu, 2010. "When Does Labor Scarcity Encourage Innovation?," Journal of Political Economy, University of Chicago Press, vol. 118(6), pages 1037-1078.
    14. Marianne Bertrand & Esther Duflo & Sendhil Mullainathan, 2004. "How Much Should We Trust Differences-In-Differences Estimates?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 119(1), pages 249-275.
    15. Charles I. Jones, 2022. "The End of Economic Growth? Unintended Consequences of a Declining Population," American Economic Review, American Economic Association, vol. 112(11), pages 3489-3527, November.
    16. Sellars, Emily A. & Alix-Garcia, Jennifer, 2018. "Labor scarcity, land tenure, and historical legacy: Evidence from Mexico," Journal of Development Economics, Elsevier, vol. 135(C), pages 504-516.
    17. Mette Foged & Giovanni Peri, 2016. "Immigrants' Effect on Native Workers: New Analysis on Longitudinal Data," American Economic Journal: Applied Economics, American Economic Association, vol. 8(2), pages 1-34, April.
    18. Goodman-Bacon, Andrew, 2021. "Difference-in-differences with variation in treatment timing," Journal of Econometrics, Elsevier, vol. 225(2), pages 254-277.
    19. Matthias Flückiger & Christian Rutzer & Rolf Weder, 2016. "Die Schweizer Wirtschaft zwischen Hammer und Amboss: Eine Analyse der "Franken-Schocks" 2010/11 und 2015," Aussenwirtschaft, University of St. Gallen, School of Economics and Political Science, Swiss Institute for International Economics and Applied Economics Research, vol. 67(03), pages 95-133, December.
    20. Mr. Romain A Duval & Yi Ji & Longji Li & Myrto Oikonomou & Carlo Pizzinelli & Mr. Ippei Shibata & Alessandra Sozzi & Kirsi Silvennoinen & Ms. Marina Mendes Tavares, 2022. "Labor Market Tightness in Advanced Economies," IMF Staff Discussion Notes 2022/001, International Monetary Fund.
    21. Helmut Herwartz & Christoph Strumann, 2014. "Hospital efficiency under prospective reimbursement schemes: an empirical assessment for the case of Germany," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(2), pages 175-186, March.
    22. Kyle Butts, 2021. "Difference-in-Differences Estimation with Spatial Spillovers," Papers 2105.03737, arXiv.org, revised Jun 2023.
    23. Robert Messerle & Jonas Schreyögg, 2024. "Country-level effects of diagnosis-related groups: evidence from Germany’s comprehensive reform of hospital payments," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 25(6), pages 1013-1030, August.
    24. Bossler, Mario & Popp, Martin, 2024. "Labor Demand on a Tight Leash," IZA Discussion Papers 16837, Institute of Labor Economics (IZA).
    25. Jonas Krämer & Jonas Schreyögg & Reinhard Busse, 2019. "Classification of hospital admissions into emergency and elective care: a machine learning approach," Health Care Management Science, Springer, vol. 22(1), pages 85-105, March.
    26. Efraim Benmelech & Michal Zator, 2022. "Robots and Firm Investment," NBER Working Papers 29676, National Bureau of Economic Research, Inc.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Kai Fischer, 2023. "Skilled Labour Migration and Firm Performance: Evidence from English Hospitals and Brexit," CESifo Working Paper Series 10747, CESifo.
    2. Edo, Anthony & Özgüzel, Cem, 2023. "The impact of immigration on the employment dynamics of European regions," Labour Economics, Elsevier, vol. 85(C).
    3. Committee, Nobel Prize, 2021. "Answering causal questions using observational data," Nobel Prize in Economics documents 2021-2, Nobel Prize Committee.
    4. Naguib, Costanza, 2019. "Estimating the Heterogeneous Impact of the Free Movement of Persons on Relative Wage Mobility," Economics Working Paper Series 1903, University of St. Gallen, School of Economics and Political Science.
    5. Berbée, Paul & Brücker, Herbert & Garloff, Alfred & Sommerfeld, Katrin, 2022. "The labor demand effects of refugee immigration: Evidence from a natural experiment," ZEW Discussion Papers 22-069, ZEW - Leibniz Centre for European Economic Research.
    6. Nicolò Gatti & Fabrizio Mazzonna & Raphaël Parchet & Giovanni Pica, "undated". "Opening the labor market to qualified immigrants in absence of linguistic barriers," Development Working Papers 483, Centro Studi Luca d'Agliano, University of Milano.
    7. Nicolò Gatti & Fabrizio Mazzonna & Raphaël Parchet & Giovanni Pica, 2023. "Opening the labor market to qualified immigrants: a double-edged sword for native employees," IdEP Economic Papers 2201, USI Università della Svizzera italiana.
    8. Peter Haan & Izabela Wnuk, 2024. "The Effect of Migration on Careers of Natives: Evidence from Long-term Care," Discussion Papers of DIW Berlin 2070, DIW Berlin, German Institute for Economic Research.
    9. Edo, Anthony & Rapoport, Hillel, 2019. "Minimum wages and the labor market effects of immigration," Labour Economics, Elsevier, vol. 61(C).
    10. Borjas, George J. & Edo, Anthony, 2021. "Gender, Selection into Employment, and the Wage Impact of Immigration," IZA Discussion Papers 14261, Institute of Labor Economics (IZA).
    11. Markus Gehrsitz & Martin Ungerer, 2022. "Jobs, Crime and Votes: A Short‐run Evaluation of the Refugee Crisis in Germany," Economica, London School of Economics and Political Science, vol. 89(355), pages 592-626, July.
    12. Aksu, Ege & Erzan, Refik & Kırdar, Murat Güray, 2022. "The impact of mass migration of Syrians on the Turkish labor market," Labour Economics, Elsevier, vol. 76(C).
    13. Sara Signorelli, 2020. "Do Skilled Migrants Compete with Native Workers? Analysis of a Selective Immigration Policy," Working Papers halshs-01983071, HAL.
    14. Brunello, Giorgio & Lodigiani, Elisabetta & Rocco, Lorenzo, 2020. "Does low-skilled immigration increase profits? Evidence from Italian local labour markets," Regional Science and Urban Economics, Elsevier, vol. 85(C).
    15. Michal Burzynski & Giovanni Peri, 2024. "Natives Sorting and the Impact of Immigration on European Labor Markets," LISER Working Paper Series 2024-09, Luxembourg Institute of Socio-Economic Research (LISER).
    16. Parisa Ghasemi & Paulino Teixeira & Carlos Carreira, 2024. "Immigrants and the Portuguese labor market: Threat or Advantage?," CeBER Working Papers 2024-02, Centre for Business and Economics Research (CeBER), University of Coimbra.
    17. Lebow Jeremy, 2022. "The labor market effects of Venezuelan migration to Colombia: reconciling conflicting results†," IZA Journal of Development and Migration, Sciendo & Forschungsinstitut zur Zukunft der Arbeit GmbH (IZA), vol. 13(1), pages 1-49, January.
    18. Akira Yakita, 2021. "Is tightening immigration policy good for workers in the receiving economy?," Asia-Pacific Journal of Regional Science, Springer, vol. 5(3), pages 975-991, October.
    19. Lebow, Jeremy, 2024. "Immigration and occupational downgrading in Colombia," Journal of Development Economics, Elsevier, vol. 166(C).
    20. Joan Monras, 2020. "Immigration and Wage Dynamics: Evidence from the Mexican Peso Crisis," Journal of Political Economy, University of Chicago Press, vol. 128(8), pages 3017-3089.

    More about this item

    Keywords

    Labor scarcity; cross-border commuting; wage differentials; nurse shortages; healthcare provision; triage; patient outcomes;
    All these keywords.

    JEL classification:

    • F22 - International Economics - - International Factor Movements and International Business - - - International Migration
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J22 - Labor and Demographic Economics - - Demand and Supply of Labor - - - Time Allocation and Labor Supply
    • J31 - Labor and Demographic Economics - - Wages, Compensation, and Labor Costs - - - Wage Level and Structure; Wage Differentials
    • J61 - Labor and Demographic Economics - - Mobility, Unemployment, Vacancies, and Immigrant Workers - - - Geographic Labor Mobility; Immigrant Workers
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • R23 - Urban, Rural, Regional, Real Estate, and Transportation Economics - - Household Analysis - - - Regional Migration; Regional Labor Markets; Population

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:zbw:cexwps:306342. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: ZBW - Leibniz Information Centre for Economics (email available below). General contact details of provider: https://www.exc.uni-konstanz.de/en/inequality/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.