[The following post is re-blogged from SAGE Insight. Click here to view the original post.]
Article title: Superbugs versus outsourced cleaners: Employment Arrangements and the Spread of Health Care–Associated Infections From ILR Review
On any given day, one in every 25 patients in U.S. hospitals has a health care–associated or hospital-acquired infection (HAI)—one of a handful of so-called superbugs that contribute to the deaths of 75,000 of these patients. Not surprisingly, health care practitioners and scholars have turned their attention to clinical and delivery-of-care factors that might account for HAIs. This article provides novel, quantitative, empirical evidence linking a specific type of employment arrangement—outsourcing—to patient safety. It shows that in addition to the more widely examined clinical culprits, the HAI challenges plaguing the U.S. health care system are also a function of the strategic employment choices that organizations make in relating to their nonclinical staff. The findings have important implications for health care scholars, practitioners, and policymakers.
On any given day, about one in 25 hospital patients in the United States has a health care–associated infection (HAI) that the patient contracts as a direct result of his or her treatment. Fortunately, the spread of most HAIs can be halted through proper disinfection of surfaces and equipment. Consequently, cleaners—“environmental services” (EVS) in hospital parlance—must take on the important task of defending hospital patients (as well as staff and the broader community) from the spread of HAIs. Despite the importance of this task, hospitals frequently outsource this function, increasing the likelihood that these workers are under-rewarded, undertrained, and detached from the organization and the rest of the care team. As a result, the outsourcing of EVS workers could have the unintended consequence of increasing the incidence of HAIs. The authors demonstrate this relationship empirically, finding support for their theory by using a self-constructed data set that marries infection data to structural, organizational, and workforce features of California’s general acute care hospitals. The study thus advances the literature on nonstandard work arrangements—outsourcing in particular—while sounding a cautionary note to hospital administrators and health care policymakers.
Superbugs versus outsourced cleaners: Employment Arrangements and the Spread of Health Care–Associated Infections
Adam Seth Litwin, Ariel c. avgar, and Edmund E. Becker
For more of the latest research from ILR Review, be sure to visit the Table of Contents for the latest May issue. Included in the newly released issue are papers that discuss the debate on the effects of minimum wage, recent labor market topics, employment effects of healthcare reform, and how underemployment will continue to affect labor market opportunities.
Sign up for email alerts through the journal homepage so you never miss the latest research.
The authors find that privately held firms owned by women were less likely than those owned by men to downsize their workforces during the Great Recession. Year-to-year employment reductions were as much as 29% smaller at women-owned firms, even after controlling for industry, size, and profitability. Using data that allow the authors to control for additional detailed firm and owner characteristics, they also find that women-owned firms operated with greater labor intensity after the previous recession and were less likely to hire temporary or leased workers. These patterns extend previous findings associating female business leadership with increased labor hoarding.
The authors revisit the long-running minimum wage–employment debate to assess new studies claiming that estimates produced by the panel data approach commonly used in recent minimum wage research are flawed by that approach’s failure to account for spatial heterogeneity. The new studies use research designs intended to control for this heterogeneity and conclude that minimum wages in the United States have not reduced employment. The authors explore the ability of the new research designs to isolate reliable identifying information, and they test the designs’ untested assumptions about the construction of better control groups. Their analysis reveals problems with the new research designs. Moreover, using methods that let the data identify the appropriate control groups, their results reaffirm the evidence of disemployment effects, with teen employment elasticities near −0.15. This evidence, they conclude, still shows that minimum wages pose a tradeoff of higher wages for some against job losses for others.
Our contribution to the ILR Review was motivated by a background study of IZA contributing to the Worldbank’s World Development Report on Jobs in 2013. We started from the observation that young people have been among those most affected by the 2008/09 financial crisis and its aftermath in many world regions. While the recession led to steep increases in youth unemployment, policies aimed at stimulating labor demand do not fully tackle the root of the problem. Rather, we also need to understand the institutions governing the transition from school to work. Vocational education and training (VET) is often viewed as the silver bullet for the youth joblessness problem. In this article, we provide a better understanding of VET in industrialized countries, proposing a typology with three types of vocational systems: 1) vocational and technical schools, 2) formal apprenticeships, and 3) dual apprenticeship systems that combine school training with a firm-based approach. We first describe the strengths and challenges of each system. Then we review the evidence of the effectiveness of VET versus general education and the relative effectiveness of the different VET systems. In our view the results indicate that VET is a valued alternative beyond the core of general education and that the use of apprenticeships combined with institutional learning tends to be more effective than school-based VET. Hence, improving the performance of VET can be one element of a medium-run solution to difficult school-to-work transitions.
The abstract for the paper:
Young people have been among those most affected by the recent financial crisis. Vocational education and training (VET) is often viewed as the silver bullet for the youth joblessness problem. In this article, the authors provide a better understanding of VET in industrialized countries, proposing a typology with three types of vocational systems: 1) vocational and technical schools, 2) formal apprenticeships, and 3) dual apprenticeship systems that combine school training with a firm-based approach. They first describe the strengths and challenges of each system. They subsequently review the evidence of the effectiveness of VET versus general education and the relative effectiveness of the different VET systems. Results indicate that VET is a valued alternative beyond the core of general education and that the use of apprenticeships combined with institutional learning tends to be more effective than school-based VET.
*Werner Eichhorst is affiliated with IZA. Núria Rodríguez-Planas is affiliated with Queens College of CUNY and the Institute for the Study of Labor (IZA). Ricarda Schmidl is affiliated with the University of Mannheim and IZA. Klaus F. Zimmermann is affiliated with IZA and Bonn University. We thank Costanza Biavaschi, Corrado Giulietti, Michael Kendzia, Alexander Muravyev, Victoria Finn, and Janneke Pieters for their input and support. Inquiries can be directed to email@example.com or Eichhorst@iza.org.
As in recent years, work and economic issues have been on the minds of citizens worldwide – and not just on May Day. Almost on a daily basis we’ve seen or read about the challenges faced by employers, employees, unions, policy makers, and governments worldwide. From debates over raising the minimum wage, to discussions of pay equity and discrimination, workplace health risk factors and health insurance, and more, labor and work concerns are affecting us all. On this week set aside to recognize the international labor movement, we are pleased to highlight key journals in Economics, Industrial Relations & Labor.
We invite you to enjoy access to the following journals through June 30th. Click here to access the trial.
NEW TO SAGE IN 2016: We are pleased to publish The American Economist, the official journal of Omicron Delta Epsilon, the International Honor Society in Economics. The American Economist publishes original research from all fields and schools of economic thought, written by young scholars and those who are teaching the next generation of economists, as well as experienced and prominent economists whose influence has shaped the discipline. We invite you to read a special collection of articles from Nobel Peace Prize winning authors here.
The Third Globalization: Can Wealthy Nations Stay Rich in the Twenty-First Century? Edited by Dan Breznitz, John Zysman . Oxford, UK and New York: Oxford University Press, 2013. 432 pp. ISBN 978-0199917822, $105 (Cloth); ISBN 978-0199917846, $39.95 (Paperback).
A marked lack of sustainable economic growth has become an unfortunate but predominant characteristic of wealthy nations in the seven years following the financial crisis. Whether policymakers pursue fiscal stimulus or austerity, the outcome has been far from satisfactory. Notwithstanding Carmen Reinhart and Kenneth Rogoff’s argument that financial crises require a longer recovery time, is it possible that policymakers have the mix of policies wrong? The vast majority of wealthy states, after all, liberalized markets in the past two decades with the hope of emulating U.S. innovation and growth only to find instead they needed to reinsert themselves when capital and labor markets stalled. Given this failure, how prepared will the same states be for the next era of global competition, when emerging economies such as China and India that have benefited from rapid technological advances begin to leverage their economic and intellectual scale?
The authors of The Third Globalization address this question with a series of essays framed around a dilemma the editors, Dan Breznitz and John Zysman, term the “double bind.” In psychiatry, individuals face a double bind when they are unable to decide between conflicting statements from highly valued but distinct actors. In adapting the concept to political economy, the editors argue that politicians and policymakers in wealthy nations face similar indecision. On one hand, they need free markets to stimulate innovation and growth while, on the other hand, they need to reassert control of markets to foster social stability. The question is, can they do both at the same time?
Today is the day in the US when we give a shout-out to all those who labor. The first Labor Day celebration in the U.S. took place in New York City on September 5th, 1882, and in 1894 the first Monday in September was designated a national holiday to commemorate the achievements and contributions of workers. On this day we are pleased to highlight research from journals in Economics, Industrial Relations & Labor providing key insights into the world of work.
COMING IN 2016: We are pleased to begin publishing The American Economist, the official journal of Omicron Delta Epsilon, the International Honor Society in Economics. The American Economist publishes original research from all fields and schools of economic thought, written by young scholars and those who are teaching the next generation of economists, as well as experienced and prominent economists whose influence has shaped the discipline.
Over the past 15 years, there has been growing awareness that a “lock them up” strategy to crime control does not eliminate the problem of crime. The notion that “they all come back” has generated extensive conversations about the challenges returning prisoners encounter. (For example, see Joan Petersilia’s When Prisoners Come Home: Parole and Prisoner Reentry, 2003, and Jeremy Travis’ But They All Come Back: Facing the Challenges of Prisoner Reentry, 2005.) Employment inevitably plays an important role in this discussion, given that employment is normatively how most pro-social adults spend their time and support themselves. Prior academic work (some of it by Steve Raphael and his colleagues) has outlined in detail the complicated relationship between incarceration and employment (e.g., Shawn Bushway et al.’s The Impact of Incarceration on Labor Market Outcomes, 2007). Steve Raphael’s book covers most of this same ground in a short, easy-to-read, and very accessible format that hits the important highlights. As such, it represents a valuable introduction to the issues of employment for individuals with records, particularly for students and interested non-academics who are relatively new to the topic.