Compensating Wage Differentials and AIDS Risk

We examine the effect of HIV/AIDS infection risks on the earnings of registered nurses (RNs) and other health care workers by combining data on metropolitan statistical area (MSA) AIDS prevalence rates with annual 1987 --2001 Current Population Survey (CPS) and quadrennial 1988 --2000 National Sample Survey of Registered Nurses (SRN) data. Holding constant wages of control groups that are likely not exposed to AIDS risks and group-specific MSA fixed effects, a 10 percent increase in the AIDS rate raises RN earnings by about 0.8 percent in post-1992 samples, when AIDS rates were falling but a more comprehensive categorization of AIDS was used by the CDC. AIDS wage differentials are much larger for RNs and non-nursing health practitioners than for other nursing and health care workers, suggesting that this differential represents compensation paid for job-related exposure to potentially HIV-infected blood.

Underpaid or Overpaid? Wage Analysis for Nurses Using Job and Worker Attributes

The nursing labor market presents an apparent puzzle. Hospitals report chronic shortages, yet standard wage analysis shows that nursing wages have increased over time and greatly exceed those received by other college-educated women. This paper addresses this puzzle. Data from the Current Population Survey (CPS) are matched with detailed job content descriptors from the Occupational Information Network (O*NET). Nursing jobs require higher levels of skills and more difficult working conditions than do jobs for other college educated workers. A standard CPS-only wage regression shows a registered nurse (RN) wage advantage of .22 log points compared to a pooled male/female group of college-educated workers. Control for O*NET job attributes reduces the RN gap to .08, while an arguably preferable nonparametric estimator produces a wage gap estimate close to zero. We conclude that nurses receive compensation close to long-run opportunity costs, narrowing if not resolving the RN wage-shortage puzzle.nursing, wage differentials, job attributes

Relative Wages and Exit Behavior Among Registered Nurses

I examine the exit decision of registered nurses using the longitudinal data files generated by the March Current Population Surveys (CPS) from 1983 through 1994. By examining the wages of workers outside of nursing, a measure of the reservation wage is constructed and related to the decision to leave nursing, either for an alternative job or to exit employment. My results indicate that nurses respond to outside wage opportunities. A one standard deviation decrease in the difference between the actual and predicted log wage results in an 8 percent increase in the exit of nurses. Secretaries, however, are shown to have a much greater sensitivity to outside wages due to the lower degree of occupation-specific training required for secretarial jobs. A similar increase in the wage gap for secretaries results in an 18 percent increase in turnover. RNs employed in hospitals, covered by a union contract, and employed in the public sector are relatively attached to the nursing profession

What Explains Wage Differences between Union Members and Covered Nonmembers?

An individual covered by a collective bargaining agreement but who is not a union member is estimated to earn about 13% lower wages than a union member. Sectors with relatively few covered nonmembers are associated with a large coverage differential, while sectors with high proportions of covered nonmembers are associated with small differentials. This suggests freeriders either weaken the bargaining position of the union or weak bargaining positions increase the incentive to freeride. Only a modest amount of this differential is accounted for by unmeasured ability, the probationary period associated with newly hired union workers, or union status misclassification

Relative Wages and the Returns to Education in the Labor Market for Registered Nurses

Over the past two decades there have been substantial changes in the health care sector in general and hospitals in particular. These changes in turn have had an impact on the labor market for nurses. Nursing comprises the third largest occupation among women (behind secretaries and teachers) and is the largest occupation in hospitals, accounting for about a quarter of total hospital employment in 1992 (Wootton & Ross, 1995). It is well documented that there were substantial shortages of qualified RNs during the 1980s, reaching a peak in the late 1980s (Aiken & Mullinex, 1987; Buerhaus, 1993; Hassanein, 1991; McKibbon, 1990). Recently, however, new RNs are having a more difficult time finding employment after graduation and shortages are no longer perceived to pose a problem in the nursing labor market (Brider, 1996; Buerhaus, 1995). As the health care industry continues to evolve, an understanding of the labor market for registered nurses is essential to understanding how this market will respond to change. While there has been substantial research on the labor market for RNs, these studies focus primarily on monopsony power (Hirsch & Schumacher, 1995; Sullivan, 1989), labor supply (Phillips, 1996; Link 1992), unionism (Hirsch & Schumacher, in press; Adamache & Sloan, 1982; Feldman & Scheffler, 1982; Cain et al., 1981 ), or schooling (Lehrer et al., 1991; Link, 1988; Booton & Lane, 1985). There has been little research, however, providing wage analysis of RNs over time or relative to wage opportunities outside of nursing

Foreign-Born Nurses in the US Labor Market

This paper examines immigration and the wages of foreign and native nurses in the US labor market. Data from the Current Population Survey identifies a worker’s country of birth and the National Survey of Registered Nurses (NSRN) identifies nurses who received their basic training outside the US. In 2004 about 3.1% of the registered nurse (RN) workforce is foreign-born non-US citizens, and 3.3% received their basic education elsewhere. The principal countries of origin are the Philippines, Canada, India, and England. Regression results show a 4.5% lower wage for non-citizen nurses born outside of the US (Canadian nurses are an exception). The wage disadvantage is concentrated on foreign-born nurses new to the US; once a nurse has been in the US for 6 years there is no longer a significant penalty. Results from the NSRN show relatively little overall wage differences between RNs who received their basic training outside versus inside the US, but there is a significant wage disadvantage for those new to the US market. The presence of foreign-trained nurses appears to decrease earnings for native RNs, but the effects are small

Does Public or Not-for-Profit Status Affect the Earnings of Hospital Workers?

This paper examines the earnings differentials among hospital workers in the public, private nonprofit, and private for-profit sectors. Utilizing data from the 1995 through 2007 Current Population Surveys, unadjusted earnings are highest in the private nonprofit sector and lowest in private for-profit firms. Once measurable characteristics are accounted for, health practitioners in for-profit and nonprofit hospitals earn similar wages while public sector workers earn small but significant wage penalties. Nonprofit hospitals tend to attract workers with higher levels of skill as measured by schooling and potential experience. This could be explained in part by worker sorting and lower cost containment incentives in nonprofit hospitals. Wage change analysis using pooled 2-year panels constructed from the CPS indicate no significant differences in earnings between the three sectors of employment. Whatever the role of the sector of employment on the overall earnings of hospital workers, there is sufficient worker mobility within the industry to largely eliminate systematic wage differences across type of hospital

Technology, Skills, and Health Care Labor Markets

I. Introduction Over the past twenty years dramatic changes have occurred in the health care industry. Between 1980 and 1993 expenditures increased from about 9 to almost 14 percent of GDP. Since 1993 spending has remained at about 14 percent of GDP, and health care spending in the U.S. has grown at an average rate of 5 percent, substantially below the 12 percent annual growth experienced in earlier years (Health Care Financing Administration, 2000). The emerging consensus is that the rapidly rising costs of the 1980s and early 1990s was driven primarily by technological change (Newhouse, 1992; Fuchs, 1996), and the slowdown in the mid-1990s was a one-time reduction in spending driven primarily by the emergence of managed-care health insurance. Recent reports suggest that health care expenditures are on the rise as technology continues to evolve (Health Insurance Association of America, 2001 ), and nursing shortages are again a concern (Freudenheim and Villarosa, 2001 )

Compensating Differentials and Unmeasured Ability in the Labor Market for Nurses: Why Do Hospitals Pay More?

Registered nurses (RNs) employed in hospitals realize a large wage advantage relative to RNs employed elsewhere. Cross-sectional estimates indicate a hospital RN wage advantage of roughly 20%. This paper examines possible sources of the hospital premium, a topic of some interest given the current shifting of medical care out of hospitals. Longitudinal analysis of Current Population Survey data for 1979-94 suggests that a third to a half of the advantage is due to unmeasured worker ability, and the authors conclude that the remainder of the advantage probably reflects compensating differentials for hospital disamenities. Supporting these conclusions is evidence that hospital RNs have higher cognitive ability and higher-quality job experience than non-hospital RNs, and indications that shift work accounts for roughly 10% of the hospital premium

Union Wages, Rents, and Skills in Health Care Labor Markets

We examine the effect of unions on the earnings of health care workers, with emphasis on the measurement and sources of union wage premiums. Using data constructed from the 1973 though 1994 Current Population Surveys, standard union premium estimates are found to be substantially lower among workers in health care than in other sectors of the economy, and to be smaller among higher skill than among lower skill occupational groups. Longitudinal analysis of workers switching union status, which controls for worker-specific skills, indicates a small impact of unions on earnings within both high and low skilled health care occupations. Evidence is found for small, but significant, union threat effects in health care labor markets. It has been argued that recent legal changes in bargaining unit determination should enhance union organizing and bargaining power. Although we cannot rule this out, such effects are not readily apparent in our data