Related Experiment Videos
Cost implications of hospital unionization: a behavioral analysis
Health Services Research
|December 1, 1984
Summary
Hospital union growth, spurred by the 1974 amendments, raises cost concerns. Studies show unionization increases hospital costs per case and per day, but impacts may lessen with prospective payment systems.
Area of Science:
- Health Economics
- Labor Relations
- Hospital Administration
Background:
- The 1974 amendments to the National Labor Relations Act significantly increased hospital worker unionization.
- Rising healthcare costs and inflationary pressures make the financial impact of hospital unions a key policy concern.
Purpose of the Study:
- To estimate the cost implications of unionization in the hospital sector.
- To analyze how union impact on costs varies by employee type and reimbursement method.
Main Methods:
- Cross-sectional regression analysis using hospital data from Maryland, Massachusetts, New York, and Pennsylvania for 1975.
- Reestimation using longitudinal data covering changes from 1971 to 1975.
Main Results:
- Unionization was associated with a 3.3% increase in total hospital costs.
- Costs per case rose by 4.1-5.9%, and costs per day increased by 6.1%.
- Impacts were lower for service employees and RNs and moderated by cost-based reimbursement.
Conclusions:
- Hospital unionization leads to measurable cost increases.
- The extent of cost impact is influenced by the type of employees unionized and the hospital's reimbursement structure.
- Prospective payment systems may mitigate future cost increases associated with union growth.