BLOOMINGTON, Ind. - A team of health economists, including Distinguished Professor Kosali Simon from the Paul H. O’Neill School of Public and Environmental Affairs, have evaluated pre- and post-pandemic healthcare employment levels to identify healthcare subsectors hardest hit by job losses and recovery.
Their study, “Changes in Employment in the U.S. Health Care Workforce, 2016-22,” published in today's Journal of the American Medical Association, found that nursing homes have been the most adversely affected by declines in employment growth with a rate that is twice that of hospitals and physician offices—10.5 percent below pre-pandemic levels for nursing homes, also known as skilled nursing facilities, compared to 3.3 percent for hospitals and 1.6 percent for physician offices.
“The shortage of nursing home workers—and healthcare workers in general—isn't new, but the study can help inform policy change, including a federal proposal targeting staffing levels at skilled nursing facilities, or SNFs,” said Thuy Nguyen, assistant professor and health economist at the University of Michigan. Nguyen is the lead author of the study.
“The Biden administration’s new nursing home staffing standards aim to boost staffing in nursing homes by setting national mandatory minimum nurse staffing levels, which has the potential to positively impact declining SNF employment levels and eventually to improve quality outcomes for nursing home residents,” Nguyen said. “The findings of our research can help to define the scale of the challenge faced by policymakers. These declines in SNF employment levels are likely multifaceted, and the Biden administration’s proposal alone is unlikely to fully address the myriad of reasons for declining employment in this healthcare subsector.”
The data used in the study came via a census of employment and wages that covers 95 percent of the jobs in the United States.
“As the post-pandemic recovery continues, these same government databases will be important to watch for future changes in healthcare sector employment,” Simon said.
Nguyen and co-authors, including health economists from Brown University and the RAND Corporation, used U.S. Census Bureau national labor statistics to assess employment recovery since an initial decrease in employment after the March 2020 public health emergency through the end of 2022. The study contributes to existing research by providing more up-to-date data for evaluating the healthcare workforce on a broader scale.
“The current staffing shortage at nursing homes is likely to continue to exacerbate staff burnout and high turnover,” Nguyen said. “Higher levels of nurse staffing and a higher skill mix appear to be associated with better quality outcomes in nursing home residents. This raises concerns about the quality of care at nursing homes among patients, healthcare workers, as well as healthcare organization leaders.”
Ken Bikoff, Faculty Liaison and Public Relations Officer
Paul H. O’Neill School of Public and Environmental Affairs | Indiana University
About the O’Neill School of Public and Environmental Affairs
The O’Neill School is a world leader in public and environmental affairs and is the largest school of public administration and public policy in the United States. In the 2023 "Best Graduate Public Affairs Programs" by U.S. News & World Report, the O'Neill School is the top-ranked program in the country. Five of its specialty programs are ranked in the top-five listings, including top-ranked concentrations in environmental policy and management; nonprofit management; and public finance.