Institutional Changes in Hospital Nursing

Throughout the 1980s, the efficiency of the healthcare delivery system in the US appeared to be threatened by recurrent shortages of registered nurses (RN). Concerns over these recurrent shortages led many economists and healthcare specialists to explore the dynamics of the nursing labor market usin...

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Bibliographic Details
Published in:Journal of economic issues 1995-03, Vol.29 (1), p.67-82
Main Authors: Krall, Lisi, Prus, Mark J.
Format: Article
Language:English
Subjects:
Administration
Economic policy
Economic theory
Employment
Health care delivery
Hospital administration
Hospital utilization rate
Hospitals
Labor market
Monopsony
Nurses
Nursing
Nursing education
Organizational change
Practice
Primary health care
Primary nursing care
Registered nurses
Relative wages
Supply & demand
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Summary:Throughout the 1980s, the efficiency of the healthcare delivery system in the US appeared to be threatened by recurrent shortages of registered nurses (RN). Concerns over these recurrent shortages led many economists and healthcare specialists to explore the dynamics of the nursing labor market using neoclassical labor market analysis. Noting that wages seemed to be depressed and slow to respond to excess demand in the nursing labor market, neoclassical analysts suggested that hospitals were exercising monopsonistic power (Yett, 1970). A discussion is presented that agrees with this monopsonistic explanation for the increased utilization of RNs. In general, neoclassical explanations fail to recognize the significance of institutional changes in the organization of the hospital workplace and historical changes in the nature of medical care delivery. Specifically, the discussion argues that the increased utilization of RNs relative to LPNs and aides resulted primarily from: 1. changes in the internal organization of nursing services, 2. cost containment pressures, and 3. advances in medical technology.
ISSN:0021-3624
1946-326X
DOI:10.1080/00213624.1995.11505641