McMaster University, Department of Economics, 1280 Main Street West, Kenneth Taylor Hall Room 426, Hamilton, Ontario, Canada, L8S 4M4.
University of Victoria, Department of Economics, Business and Economics Building, Room 360, Victoria, British Columbia, Canada, V8P 5C2.
Health Policy. 2023 Apr;130:104713. doi: 10.1016/j.healthpol.2023.104713. Epub 2023 Jan 26.
About two-thirds of Canadian COVID-19 related deaths occurred in long-term care homes (LTCHs). Multiple jobholding and excessive part-time work among staff have been discussed as vectors of transmission. Using an administrative census of registered nurses (RNs) and registered practical nurses (RPNs) in the Canadian province of Ontario, this paper contrasts the prevalence of multiple jobholding, part-time/casual work, and other job and worker characteristics across health sectors in 2019 and 2020 to establish whether the LTCH sector deviates from the norms in Ontario healthcare. Prior to COVID-19, about 19% of RNs and 21% of RPNs in LTCHs held multiple jobs. For RPNs, this was almost identical to the RPN provincial average, while for RNs this was 2.5 percentage points above the RN provincial average. In 2020, multiple jobholding fell significantly in LTCHs after the province passed a single site order to reduce COVD-19 transmission. Although there are many similarities across sectors, nurses, especially RNs, in LTCHs differ on some dimensions. They are more likely to be internationally educated and, together with nurses in hospitals, those who work part- time/casual are more likely to prefer full-time hours (involuntary part-time/casual). Overall, while multiple jobholding and part-time work among nurses are problematic for infection prevention and control, these employment practices in LTCHs did not substantially deviate from the norms in the rest of healthcare in Ontario.
大约三分之二的加拿大 COVID-19 相关死亡发生在长期护理院（LTCH）。工作人员的兼职和过度兼职工作已被讨论为传播的媒介。本文利用加拿大安大略省注册护士（RN）和注册实习护士（RPN）的行政普查数据，对比了 2019 年和 2020 年各卫生部门中兼职、非全时/临时工工作以及其他工作和工人特征的流行率，以确定 LTCH 部门是否偏离了安大略省医疗保健的规范。在 COVID-19 之前，LTCH 中约有 19%的 RN 和 21%的 RPN 从事多份工作。对于 RPN 来说，这几乎与全省平均水平相同，而对于 RN 来说，这比全省平均水平高出 2.5 个百分点。在 2020 年，该省发布了一项单一地点命令以减少 COVID-19 传播后，LTCH 中的兼职人数显著下降。尽管各部门之间有许多相似之处，但 LTCH 中的护士，尤其是 RN，在某些方面存在差异。他们更有可能接受过国际教育，与医院的护士一样，兼职/临时工更有可能喜欢全职工作（非自愿兼职/临时工）。总的来说，尽管护士的兼职和兼职工作对感染预防和控制构成了问题，但这些在 LTCH 中的就业做法并没有从安大略省其他医疗保健领域的规范中大幅偏离。
