Woodward Kyla F, Dill Janette, Trotter LaTonya, Frogner Bianca K
Center for Health Workforce Studies, Department of Family Medicine, University of Washington, Box 354982, Seattle, WA, 98195, USA.
Division of Health Policy and Management, University of Minnesota School of Public Health, Mayo Mail Code 197, Minneapolis, MN, 55455, USA.
BMC Health Serv Res. 2025 May 2;25(1):637. doi: 10.1186/s12913-025-12780-z.
While the COVID-19 pandemic undoubtedly catalyzed healthcare workforce challenges, alone it does not explain ongoing workforce shortages. This study examines how broader economic trends and industry competition may influence worker movement in and out of healthcare. This analysis aims to (1) examine healthcare worker leaver rates over time, (2) quantify the strength of the relationship between national unemployment and healthcare worker leaver rates, and (3) describe variation in this relationship by worker characteristics.
This observational, repeated cross-sectional study used nationally representative data from the 2003-2022 Annual Social and Economic Supplement of the Current Population Survey. Respondents are adult US civilian individuals employed in the healthcare industry. For each year, we defined healthcare leavers as individuals in healthcare-specific occupations who reported exiting the healthcare industry between the prior and current year, including workers who (1) changed industry, termed "industry leavers", (2) left the labor market, or (3) became unemployed. We compared healthcare leaver rates among healthcare workers to unemployment rates for all US workers with particular focus on industry leavers. Leaver rates were analyzed by worker sociodemographic and occupational characteristics.
Healthcare industry leaver rates had a moderate negative correlation with the US unemployment rate (r=-0.58, p = 0.007) and unemployment rates in several competing industries of professional services (r=-0.61, p = 0.005) and retail (r=-0.58, p = 0.008), but weaker insignificant negative correlations with hospitality (r=-0.29, p = 0.215) and educational services unemployment (r=-0.21, p = 0.375). Weak to moderate negative correlations were noted between the US unemployment rate and industry leaver rates of workers in high (r=-0.32, p = 0.169) and medium (r=-0.52, p = 0.020) education groups, while industry leaver rates in low education groups had a stronger negative correlation with the unemployment rate (r=-0.60, p = 0.005).
The easing of pandemic-era stresses on healthcare has not resolved healthcare workforce shortages. The findings of this study on historical employment trends suggest that when overall unemployment remains low, healthcare employers may struggle to recruit and retain workers due to competition from other sectors. Findings suggest that healthcare employers should take a long-range, cyclical view of worker shortages by tailoring their workforce strategies to current economic conditions while planning for the next cycle.
虽然新冠疫情无疑引发了医疗劳动力方面的挑战，但仅凭这一点并不能解释持续存在的劳动力短缺问题。本研究探讨更广泛的经济趋势和行业竞争如何可能影响医疗行业员工的进出流动。该分析旨在：（1）研究医疗工作者离职率随时间的变化情况；（2）量化全国失业率与医疗工作者离职率之间关系的强度；（3）按工作者特征描述这种关系的差异。
这项观察性重复横断面研究使用了来自2003 - 2022年《当前人口调查年度社会和经济补充调查》的具有全国代表性的数据。受访者为受雇于医疗行业的美国成年平民。每年，我们将医疗行业离职者定义为从事特定医疗职业、报告在前一年和当年之间退出医疗行业的个人，包括以下几类工作者：（1）更换行业，即“行业离职者”；（2）离开劳动力市场；或（3）失业。我们将医疗工作者中的离职率与所有美国工作者的失业率进行比较，特别关注行业离职者。离职率按工作者的社会人口统计学和职业特征进行分析。
医疗行业离职率与美国失业率（r = -0.58，p = 0.007）以及专业服务（r = -0.61，p = 0.005）和零售（r = -0.58，p = 0.008）等几个竞争行业的失业率呈中度负相关，但与酒店业（r = -0.29，p = 0.215）和教育服务行业失业率（r = -0.21，p = 0.375）的负相关较弱且不显著。美国失业率与高学历（r = -0.32，p = 0.169）和中等学历（r = -0.52，p = 0.020）工作者的行业离职率之间存在弱至中度负相关，而低学历群体的行业离职率与失业率的负相关更强（r = -0.60，p = 0.005）。
疫情时代对医疗行业压力的缓解并未解决医疗劳动力短缺问题。这项关于历史就业趋势的研究结果表明，当总体失业率保持较低时，由于来自其他行业的竞争，医疗雇主在招聘和留住员工方面可能会面临困难。研究结果表明，医疗雇主应通过根据当前经济状况调整劳动力战略并为下一个周期做好规划，对劳动力短缺问题采取长远的、周期性的看法。
