Resident Mortality And Worker Infection Rates From COVID-19 Lower In Union Than Nonunion US Nursing Homes, 2020–21

Dean, Adam; McCallum, Jamie K.; Kimmel, Simeon D; Venkataramani, Atheendar S.

doi:10.1377/hlthaff.2021.01687

Cited by 16 publications

(17 citation statements)

References 23 publications

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“…found robust evidence that higher average resident age, lower percentage of Medicare residents, small size, for-profit ownership, and chain organization affiliation were associated with a higher resident COVID-19 mortality percentage, consistent with prior literature on risk factors affecting nursing home COVID-19 mortality [15,16]. Compared to the prior research that examined nursing home unionization and resident COVID-19 mortality [4,5], our measurement of unionization has two main strengths [6,7]. First, our definition of unionization is not based on the presence of employees who are members of a union, but based on the existence of a union contract.…”

Section: Plos Onesupporting

confidence: 81%

“…Using the merged dataset that contained 7,509 nursing homes, consistent with prior literature [4,5], we compared county-level population and COVID-19 infection percentage, average age of residents, percent of residents enrolled in the Medicare program, percent of residents enrolled in the Medicaid program, percent white residents, RN hours per patient, LPN hours per patient, CNA hours per patient, five-star quality rating, percent obese residents, resident Notes: Before names were used to merge Union F-7 Filings, names were changed to all lower-case and non-alphanumeric characters were removed. Stata's reclink command was used to obtain potential name matches.…”

Section: Discussionmentioning

confidence: 54%

“…Moreover, we calculated county-level COVID-19 infection percentages by using information downloaded from USAFacts on May 12, 2022 [12], and merged them with the nursing home dataset based on Federal Information Processing Standards (FIPS) county codes. All variables obtained were consistent with those examined in prior research [4,5]. The merged dataset included 7,509 nursing homes with non-missing values on all variables.…”

Section: Data and Samplementioning

confidence: 61%

“…Numerous research has established the association between key nursing home characteristics-such as location, size, and staffing levels-and resident COVID-19 mortality [18]. Two studies to date, using proprietary unionization data inconsistent with prior research, has found an association between nursing home unionization and resident COVID-19 mortality [4,5]. The results of this study, derived from national mortality and publicly available unionization data, provides no evidence to support a relationship between nursing home unionization and resident COVID-19 mortality.…”

Section: Plos Onementioning

confidence: 99%

“…Understanding the factors associated with resident mortality has important implications for infection control policies and practice [3]. Two recent study found a negative association between nursing home unionization and resident COVID-19 mortality percentage [4,5]. However, the unionization measure in these studies was obtained from a proprietary source [6,7], and these studies' categorization of all nursing homes with one or more union-affiliated employees as unionized nursing homes regardless of any actual bargaining agreements or contracts.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of resident COVID-19 mortality between unionized and nonunionized private nursing homes

2022

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Using bargaining agreement data from the Federal Mediation Conciliation Services, we found that the median national resident COVID-19 mortality percentage (as of April 24, 2022) of unionized nursing homes and that of nonunionized ones were not statically different (10.2% vs. 10.7%; P = 0.32). The median nursing home resident COVID-19 mortality percentage varied from 0% in Hawaii to above 16% in Rhode Island (16.6%). Unionized nursing homes had a statistically significant lower median mortality percentage than nonunionized nursing homes (P < 0.1) in Missouri, and had a higher median mortality percentage than nonunionized nursing homes (P < 0.05) in Alabama and Tennessee. Higher average resident age, lower percentage of Medicare residents, small size, for-profit ownership, and chain organization affiliation were associated with higher resident COVID-19 mortality percentage. Overall, no evidence was found that nursing home resident COVID-19 mortality percentage differed between unionized nursing homes and nonunionized nursing homes in the U.S.

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Section: Plos Onesupporting

confidence: 81%

Section: Discussionmentioning

confidence: 54%

Section: Data and Samplementioning

confidence: 61%

Section: Plos Onementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison of resident COVID-19 mortality between unionized and nonunionized private nursing homes

2022

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Trends in Labor Unionization Among US Health Care Workers, 2009-2021

Ahmed

Kadakia

Ahmed

et al. 2022

JAMA

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ImportanceLabor unionization efforts have resurged in the US, and union membership has been shown to improve worker conditions in some industries. However, little is known about labor unionization membership and its economic effects across the health care workforce.ObjectivesTo examine the prevalence of labor unionization among health care workers and its associations with pay, noncash benefits, and work hours.Design, Setting, and ParticipantsThis cross-sectional study was conducted using data from the Current Population Survey and Annual Social and Economic Supplement from 2009 through 2021. The US nationally representative, population-based household survey allowed for a sample of 14 298 self-identified health care workers (physicians and dentists, advanced practitioners, nurses, therapists, and technicians and support staff).ExposuresSelf-reported membership status or coverage in a labor union.Main Outcomes and MeasuresPrevalence and trend in labor unionization. Further comparisons included mean weekly pay, noncash benefits (pension or other retirement benefits; employer-sponsored, full premium–covered health insurance; and employer’s contribution to the worker’s health insurance plan), and work hours.ResultsThe 14 298 respondents (81.5% women; 7.1% Asian, 12.0% Black, 8.5% Hispanic, 70.4% White individuals; mean [SD] age, 41.6 [13.4] years) included 1072 physicians and dentists, 981 advanced practitioners, 4931 nurses, 964 therapists, and 6350 technicians and support staff. After weighting, 13.2% (95% CI, 12.5% to 13.8%) of respondents reported union membership or coverage, with no significant trend from 2009 through 2021 (P = .75). Among health care workers, those who were members of a racial or ethnic minority group (Asian, Black, or Hispanic individuals compared with White individuals) and those living in metropolitan areas were more likely to report being labor unionized. Reported unionization was associated with significantly higher reported weekly earnings ($1165 vs $1042; mean difference, $123 [95% CI, $88 to $157]; P &lt; .001) and higher likelihood of having a pension or other retirement benefits at work (57.9% vs 43.4%; risk ratio [RR], 1.33 [95% CI, 1.26 to 1.41]; P &lt; .001) and having employer-sponsored, full premium–covered health insurance (22.2% vs 16.5%; RR, 1.35 [95% CI, 1.17 to 1.53]; P &lt; .001). Union members reported more work hours (37.4 vs 36.3; mean differences, 1.11 [95% CI, 0.46 to 1.75]; P &lt; .001) per week. White workers reported mean weekly earnings that were significantly more than members of racial and ethnic minority groups among nonunionized workers ($1066 vs $1001; mean difference, $65 [95% CI, $40 to $91]; P &lt; .001), but there was no significant difference between the 2 groups among unionized workers ($1157 vs $1170; mean difference, −$13 [95% CI, −$78 to $52]; P = .70).Conclusions and RelevanceFrom 2009 through 2021, labor unionization among US health care workers remained low. Reported union membership or coverage was significantly associated with higher weekly earnings and better noncash benefits but greater number of weekly work hours.

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Nursing homes and mortality in Europe: Uncertain causality

et al. 2022

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The current health crisis has particularly affected the elderly population. Nursing homes have unfortunately experienced a relatively large number of deaths. On the basis of this observation and working with European data (from SHARE), we want to check whether nursing homes were lending themselves to excess mortality even before the pandemic. Controlling for a number of important characteristics of the elderly population in and outside nursing homes, we conjecture that the difference in mortality between those two samples is to be attributed to the way nursing homes are designed and organised. Using matching methods, we observe excess mortality in Belgium,

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Resident Mortality And Worker Infection Rates From COVID-19 Lower In Union Than Nonunion US Nursing Homes, 2020–21

Cited by 16 publications

References 23 publications

Comparison of resident COVID-19 mortality between unionized and nonunionized private nursing homes

Comparison of resident COVID-19 mortality between unionized and nonunionized private nursing homes

Trends in Labor Unionization Among US Health Care Workers, 2009-2021

Nursing homes and mortality in Europe: Uncertain causality

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