Please use this identifier to cite or link to this item: https://hdl.handle.net/10419/306342 
Year of Publication: 
2024
Series/Report no.: 
Working Paper Series No. 42
Publisher: 
University of Konstanz, Cluster of Excellence "The Politics of Inequality", Konstanz
Abstract: 
This paper estimates the impact of nursing shortages in hospitals on healthcare provision and patient outcomes by exploiting a strong and stable appreciation of the Swiss franc in 2011. Due to collective bargaining hindering wage adjustments in the German healthcare sector, cross-border wage differentials increased and led to a significant outflow of German registered nurses to Switzerland, causing a 12.5% reduction in nurse staffing rates in German hospitals near the border. Using a matched difference-in-differences approach, I find that hospitals responded by decreasing care intensity, leading to a 12% decrease in surgeries. Although hospitals are increasingly performing triage, also patients with high medical needs - such as elderly and emergency cases - face a reduction in care and, consequently, a stark increase in mortality rates, resulting in a measurable decline in regional life expectancy.
Subjects: 
Labor scarcity
cross-border commuting
wage differentials
nurse shortages
healthcare provision
triage
patient outcomes
JEL: 
F22
I18
J22
J31
J61
I11
R23
Document Type: 
Working Paper

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