From Nursing Homes to Home Care: Examining the Impact of the COVID-19 Pandemic on Direct Care Worker Transitions.

IF 4.2 2区 医学 Q2 GERIATRICS & GERONTOLOGY
Katherine E M Miller, Yang Yang, Jeromie Ballreich, Karen Shen
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引用次数: 0

Abstract

Objectives: Due to poor working conditions and low wages, workforce turnover in the long-term care industry has been a longstanding issue. Increased risks to workers caused by the COVID-19 pandemic exacerbated these issues. Thus, many states offered wage supports (eg, hazard pay) to try to stabilize the workforce. Our objective was to examine how exits of direct care workers employed in the long-term care industry changed during the COVID-19 pandemic, and whether hazard pay policies mediated the impact of the pandemic on worker exits.

Design: We used the Annual Social and Economic Supplement to identify direct care workers and PHI reports to identify states offering hazard pay during the pandemic.

Setting and participants: The analytical sample consisted of 8164 direct care workers employed in long-term care between 2016-2018 and 2020-2022 in 2 settings: (1) home settings and (2) residential care settings (nursing homes and assisted living).

Methods: We decomposed direct care worker exits using the Annual Social and Economic Supplement survey responses to (1) unemployment or exiting the labor force, (2) a different health care job or industry, and (3) non-healthcare job (eg, retail). We compared the rates of these components for direct care workers prepandemic (2016-2019) and during the pandemic (2020-2023), and the association of these rates with state wage-support policies.

Results: Direct care worker exits were highest in 2020, with most workers becoming unemployed or leaving the labor force. In 2021-2022, worker exits decreased relative to prepandemic periods, driven by fewer people switching jobs. Among those who switched jobs, we found that workers during the pandemic were more likely to stay in a health care industry relative to prepandemic. We found no evidence that wage support policies influenced direct care worker exits during or after the pandemic.

Conclusions and implications: Our findings suggest that broader economic trends of a shrinking workforce may be the primary driver of direct care worker exits during the pandemic.

从养老院到家庭护理:研究COVID-19大流行对直接护理人员过渡的影响。
由于工作条件差,工资低,长期护理行业的劳动力流动一直是一个长期存在的问题。COVID-19大流行给工人带来的风险增加加剧了这些问题。因此,许多州提供工资支持(如危险津贴),试图稳定劳动力。我们的目的是研究在COVID-19大流行期间,长期护理行业雇用的直接护理人员的出口是如何变化的,以及危险工资政策是否介导了大流行对工人出口的影响。设计:我们使用年度社会和经济补充来确定直接护理人员,并使用PHI报告来确定在大流行期间提供危险工资的州。环境和参与者:分析样本包括2016-2018年至2020-2022年期间在两种环境中从事长期护理的8164名直接护理人员:(1)家庭护理机构和(2)住宿护理机构(疗养院和辅助生活)。方法:我们使用年度社会和经济补充调查(1)失业或退出劳动力,(2)不同的医疗保健工作或行业,以及(3)非医疗保健工作(如零售)对直接护理人员的退出进行了分解。我们比较了大流行前(2016-2019年)和大流行期间(2020-2023年)直接护理人员的这些组成部分的比率,以及这些比率与国家工资支持政策的关系。结果:2020年直接护理员离职率最高,大部分护理员失业或离职。与大流行前相比,2021-2022年期间,由于换工作的人数减少,工人离职率下降。在那些换工作的人中,我们发现,与大流行前相比,大流行期间的工人更有可能留在医疗保健行业。我们没有发现证据表明工资支持政策在大流行期间或之后影响了直接护理人员的退出。结论和影响:我们的研究结果表明,劳动力萎缩的更广泛经济趋势可能是大流行期间直接护理人员退出的主要原因。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
11.10
自引率
6.60%
发文量
472
审稿时长
44 days
期刊介绍: JAMDA, the official journal of AMDA - The Society for Post-Acute and Long-Term Care Medicine, is a leading peer-reviewed publication that offers practical information and research geared towards healthcare professionals in the post-acute and long-term care fields. It is also a valuable resource for policy-makers, organizational leaders, educators, and advocates. The journal provides essential information for various healthcare professionals such as medical directors, attending physicians, nurses, consultant pharmacists, geriatric psychiatrists, nurse practitioners, physician assistants, physical and occupational therapists, social workers, and others involved in providing, overseeing, and promoting quality
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