Impact Of Nurse Unionization On Fiscal Viability And Selected Measures Of Quality In Hospitals

Abstract

<p class="MsoNormal" style="margin: 0in 0.5in 0pt;"><span style="font-size: 10pt;"><span style="font-family: Times New Roman;">Seventy-three New York hospitals were examined to determine if a difference existed between hospitals with nursing unions versus those without as it pertains to fiscal viability and quality of care.<span style="mso-spacerun: yes;">  </span>Several financial variables were used to construct a fiscal viability index; and a quality index was created from selected mortality and procedural measures that may be used to measure specific aspects of institutional care.<span style="mso-spacerun: yes;">  </span>The premise that the union status of a hospital’s nursing staff will influence fiscal viability and quality is based on the impact that unionization may have on staffing and cost per patient.<span style="mso-spacerun: yes;">  </span>The literature is replete with studies that assess the relationship between nurse staffing levels and quality.<span style="mso-spacerun: yes;">  </span>In some cases there is a clear and compelling relationship, but in others, it is indeterminate. <span style="mso-spacerun: yes;"> </span>Utilizing union status, selected employee variables, and financial and quality of care indices, four statistical models were prepared to explain these the interaction of these variables <span style="mso-spacerun: yes;"> </span></span></span></p>

What do Health Care Unions do?

“…15,16 Hospitals have substantial control over the price, quantity, and quality of their inputs and products. 19,20 Manthous worries that higher wages may constrain hospital activity in dimensions that benefit patients, for example, by reducing the number of patients served or the quantity or quality of nursing and other inputs. 17 The classic complaint against unions is that by controlling the labor supply they can demand higher wages than would occur in a competitive labor market.…”