The US healthcare workforce saw huge turnover at the start of the Covid-19 pandemic, but appears to be returning to pre-pandemic levels, although not there yet, according to a new study .
The study, published Friday in the journal JAMA Health Forumfound that the recovery has been largely uneven.
Researchers from the University of Washington and the University of Minnesota compared turnover rates between April-December 2020 and January-October 2021, using records from the US Current Population Survey, as well as census records American and the Bureau of Labor Statistics. They examined the records of 125,717 healthcare workers.
When hospitals postponed elective surgeries and clinics closed during the first peak of the pandemic, around 1.5 million healthcare workers lost their jobs, other research has shown. Most jobs returned in the fall of 2020. But the following year, the healthcare employment rate was still 2.7% below pre-pandemic levels.
The researchers note that due to the way they conducted this study, they were unable to directly link labor outflows to Covid-19.
Turnover rates peaked in the first part of the pandemic, but the workforce largely recovered in the second study period, with the exception of doctors and people who worked in long-term care facilities. duration.
Turnover rates also varied by demographic characteristics. More healthcare workers – men and women – with young children have left the workforce. The rate was higher in women.
Turnover rates among Native Americans, Alaska Natives, and Pacific Islanders were higher than among other races. Black and Latino workers experienced the slowest rates of re-employment during the second study period. Those least likely to leave were white workers.
Turnover also varied by position, with helpers and assistants most likely to leave their jobs throughout the pandemic.
The researchers weren’t able to determine precisely why people quit smoking, but study co-author Janette Dill, an associate professor in the Division of Health Policy and Management at the University of Minnesota School of Public Health, had some ideas.
Wages may be part of the problem. She cites high turnover rates in long-term care facilities as an example.
“Long-term care is a largely Medicaid-funded industry, and Medicaid has pretty low reimbursement rates, and as a result, salaries in long-term care are pretty low. So there are a lot of reasons why people would want to leave long-term care,” Dill said.
The problems in this part of the health care industry predate the pandemic, but the pandemic has made them much worse, she said.
“I recently interviewed a worker who told me she could get a job at Target that paid $2 an hour more than her healthcare job. Who could blame her for leaving? ?” said Dill. “Long-term care is under a lot of pressure right now from retail that pays better.”
The Biden administration also increased the amount of money people could get while unemployed, which may also have played a role in people leaving jobs that didn’t pay well.
It can also be a matter of risk.
Black and Latino workers tend to work more as helpers and assistants, Dill noted, occupations that pose a significant risk of infection and had much less access to protective gear, especially early in the pandemic. These communities have also had a disproportionate number of Covid-19 cases.
White workers were more concentrated in the positions of technicians, therapists, doctors and registered nurses, where people were somewhat better able to protect themselves.
Burnout and a lack of childcare may also be to blame.
April Kapu, president of the American Association of Nurse Practitioners, said her group is following the workforce issue closely.
Turnover and retention have been a serious concern, she said. “I think the pandemic has really highlighted a lot of what was already there,” said Kapu, who was not involved in the new research. “We have a lot of work to do in the area of mental health and to support the mental health of our healthcare workers.”
the Dr. Lorna Breen Health Care Provider Protection Act, which President Biden signed into law in March, is a step in that direction, she said. It authorizes grants for programs that provide behavioral health services to frontline health care workers.
The deed is named after a New York ER doctor who died by suicide in 2020. She was working 18 hour days and treating an onslaught of Covid-19 patients early in the pandemic.
Kapu said more funds are also needed to increase the workforce in general and to pay for education so that more people can enter the health profession.
One of the findings of the study that cannot be explained by salaries is the high number of physicians who quit their jobs. The rate is lower than all other positions, but the number of doctors leaving the health sector remained high compared to 2019, and this is unusual.
“Doctors rarely quit their jobs,” Dill said. “This seems to indicate that there is some dissatisfaction among doctors and that the workforce is not recovering to the same levels of the pre-pandemic period.”
Tracking turnover in healthcare will be critical in determining where retention efforts should be focused.
“Waiting too long to understand these issues can further lengthen the consequences of the Covid-19 pandemic,” the study says.
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