Review of Economic Studies · 2020 · Benjamin Friedrich、Martin B. Hackmann
中文摘要
本文在政策引发的非预期护士短缺背景下，量化了护士对医疗服务提供和患者健康的影响。我们的实证策略利用了丹麦的一项育儿假计划，该计划允许任何家长按每名0—8岁子女休假最多一年。我们将这一政策变动与雇主—雇员匹配的行政数据相结合，发现护士对该计划的参与程度较高；尽管政府努力扩大公共教育规模和移民规模，以缓解该计划对就业的影响，但按净人数计算，休假护士留下的人员缺口仍未能补足。我们发现，该育儿假计划使医院和养老院的护士就业人数分别减少了15%和10%。利用详细的患者健康记录，我们发现该计划对医院医疗服务提供产生了不利影响，表现为急性心肌梗死患者的30天再入院率大幅上升。我们没有发现医院死亡率上升的证据。在养老院中，我们估计死亡率大幅上升。
Abstract
Abstract In this article, we quantify the effects of nurses on health care delivery and patient health in the context of an unintended and policy-induced nurse shortage. Our empirical strategy takes advantage of a parental-leave program in Denmark, which offered any parent the opportunity to take up to one year’s absence per child aged 0–8. Combining the policy variation with administrative employer–employee match data, we document substantial program take-up among nurses, who could not be replaced on net despite public education and immigration expansion efforts to mitigate the employment effects. We find that the parental leave program reduced hospital and nursing home nurse employment by 15% and 10%, respectively. Using detailed patient health records, we find detrimental effects on hospital-care delivery as indicated by a large increase in 30-day readmission rates among acute myocardial infarction patients. We find no evidence for an increase in hospital mortality. In nursing homes, we estimate a large increase in mortality.