Workers' Illness, Injury, and Exit From the Home Health Care Services Industry

High workforce turnover is among the main challenges facing home health care services industries (HHCS) in many countries. Illness and injury are often mentioned among the main reasons for leaving HHCS. We examine the impact of illness and injury on Canadian workers' exit from HHCS and discuss the implications.

We use linked Canadian longitudinal administrative employment and health microdata from 2009 to 2022, also linked to 2016 Census microdata. Our longitudinal analysis uses the event study framework. We identify HHCS workers' health events using three sources: Records of Employment issued to ill or injured workers, workers' compensation payments, and acute hospitalization records. We use inverse propensity score weighting to balance the characteristics of workers who experienced a health event with those of workers who did not. Estimates for HHCS workers are compared with estimates for workers in long-term care facilities (LTC).

Illness and injury rates appear similar in the HHCS and LTC industries. HHCS workers who experience a health event at time t₀ have a lower probability of staying in the industry in t₀ + 1 year (0.839) and in t₀ + 5 (0.472) than comparable HHCS workers who do not (0.880 and 0.524, respectively). However, the differences in the post-t₀ survival profiles between the two groups are small.

Illness and injury are unlikely to play a major role in HHCS workers' decision to leave the industry. Our results highlight the complexity of workforce retention in HHCS and suggest that factors beyond individual health may be more influential in shaping career trajectories.