Health care work force on track to recover from pandemic — with a few key exceptions, study finds

The study, published Friday in the JAMA Health Forum, found 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, along with records from the US Census. and the Bureau of Labor Statistics. They examined the records of 125,717 health 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 showed. Most jobs returned in the fall of 2020. But the following year, the health care employment rate was still 2.7% below pre-pandemic levels.

The researchers note that because of the way they conducted this study, they were unable to directly link departures from the workforce to Covid-19.

Turnover rates peaked in the early part of the pandemic, but the workforce largely recovered in the second period studied, with the exception of doctors and people working in long-term care facilities.

Turnover rates also varied by demographics. More male and female health workers with young children dropped out of the workforce. The rate was higher among women.

Turnover rates among American Indians, Alaska Natives, and Pacific Islanders were higher than among other races. Black and Latino workers experienced the slowest job recovery rates in the second period studied. The people least likely to leave were white workers.

Turnover also varied by position, with aides and assistants more likely to leave their jobs during the pandemic.

The researchers couldn’t specifically address 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. He points to the high turnover rates in long-term care as an example.

“Long-term care is a sector that is largely paid for by Medicaid, and Medicaid has pretty low reimbursement rates, and therefore wages in long-term care are pretty low. So there are a lot of reasons why the ones that people would want to leave — long-term care,” Dill said.

The problems in that part of the health care industry predate the pandemic, but the pandemic has made them much worse, he said.

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“I recently interviewed a worker who told me she could get a job at Target that paid $2 more an hour than her health care job. Who could blame her for leaving?” Dill said. “Long-term care has a lot of pressure from retail right now that just pays better.”

The Biden administration also increased the amount of money people could earn while unemployed, which may also have played a role in people leaving low-paying jobs.

It can also be a matter of risk.

Black and Latino workers tend to work more as helpers and assistants, Dill noted, occupations that are at significant risk of infection and had much less access to protective gear, particularly early in the pandemic. Those communities have also had a disproportionate number of Covid-19 cases.

White workers were more concentrated in technician, therapist, doctor, and registered nurse positions, where people could protect themselves a little better.

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Burnout and lack of childcare can also be to blame.

April Kapu, president of the American Association of Nurse Practitioners, said her group has been keeping a close eye on the workforce issue.

Turnover and retention have been a serious concern, he said. “I think the pandemic 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 in supporting 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, he said. Authorizes grants for programs that provide behavioral health services for frontline health care workers.
The act is named after a New York City emergency room doctor who killed herself in 2020. She had been working 18-hour days and treating a flood of Covid-19 patients at the start of the pandemic.

Kapu said more funding is also needed to increase the overall workforce and pay for education so more people can enter the health care profession.

One of the study’s findings that may not be explained by wages is the high level of doctors leaving their jobs. The rate is lower than any of the other positions, but the number of doctors leaving the health sector has remained high, compared to 2019, and is unusual.

“Doctors rarely leave their jobs,” Dill said. “It seems to indicate that there is some dissatisfaction in the physician workforce and that the workforce is not recovering to the same levels as it was in the pre-pandemic period.”

Tracking turnover in health care will be critical in determining where retention efforts should be focused.

“Waiting too long to understand these issues may further prolong the consequences of the covid-19 pandemic,” the study says.

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