Feminized care work occupations have traditionally paid lower wages compared to non-care work occupations when controlling for human capital. However, when men enter feminized occupations, they often experience a "glass escalator," leading to higher wages and career mobility as compared to their female counterparts. in this study, we examine whether men experience a "wage penalty" for performing care work in today's economy, or whether the glass escalator helps to mitigate the devaluation of care work occupations. Using data from the Survey of income and Program Participation for the years 1996-2011, we examine the career patterns of low-and middle-skill men in health care occupations. We found that men in occupations that provide the most hands-on direct care did experience lower earnings compared to men in other occupations after controlling for demographic characteristics. However, men in more technical allied health occupations did not have significantly lower earnings, suggesting that these occupations may be part of the glass escalator for men in the health care sector. minority men were significantly more likely than white men to be in direct care occupations, but not in frontline allied health occupations. male direct care workers were less likely to transition to unemployment compared to men in other occupations.
Although "off-the-shelf" case-mix measures perform moderately well when applied to another setting, modifications may be required to accurately characterize a population's disease burden with respect to the resource needs of all patients.
Evidence for Christine Williams's 'glass escalator' effect documents how professional men entering female-dominated occupations may advance more quickly toward authority positions and higher salaries. However, studies of men's benefits from occupational segregation have neglected lowwage and diverse groups of workers. Using the representative US National Nursing Assistant Study (NNAS), the article examines organizational measures of inequality and discriminationwages, benefits and working conditions -to understand whether a glass escalator exists among nursing assistants and how it is affected by gender, race, citizenship and facility characteristics. Though gender inequalities were present, citizenship, race, facility type and size emerged as the most important factors in determining advantages for workers, suggesting a revision of the glass escalator metaphor may be in order. NNAS results imply that identity characteristics like nationality and contextual factors like workplace matter and underscore the importance of using an intersectional approach to examine inequality.
An empirically derived risk adjustment model is useful in distinguishing among facilities in their quality of care. We used Veterans Affairs (VA) administrative databases to develop and validate a risk adjustment model to predict decline in functional status, an important outcome measure in long-term care, among patients residing in VA long-term care facilities. This model was used to compare facilities on adjusted and unadjusted rates of decline. Predictors of decline included age, time between assessments, baseline functional status, terminal illness, pressure ulcers, pulmonary disease, cancer, arthritis, congestive heart failure, substance-related disorders, and various neurologic disorders. The model performed well in the development and validation databases (c statistics, 0.70 and 0.68, respectively). Risk-adjusted rates and rankings of facilities differed from unadjusted ratings. We conclude that judgments of facility performance depend on whether risk-adjusted or unadjusted decline rates are used. Valid risk adjustment models are therefore necessary when comparing facilities on outcomes.
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