This research project will permit a natural experiment: a unique study of the labor supply of registered nurses (RNs) during a period of rapid and unprecedented change in the structure and financing of the health care market. Nursing is facing a major drop in demand due to shifts in utilization of hospital beds. The Pew Health Professions Commission (1995) has predictioned a loss of up to 300,000 hospital jobs for RNs. The PRIMARY AIM for this project is to describe and specify a labor supply model of RNs in Western New York, based on survey data, which is sensitive to changes in annual hours of work and participation (full-time, part-time and nonworking nurses). We also will examine differences in rural and urban RN labor supply behavior, shifts in employment settings, and entry and exit decisions over the prior 2 years. The DESIGN is a cross- sectional survey design, preceded by a pretest of the survey instrument. The initial baseline cross-sectional survey will capture labor behavior occurring now and over the last 2 years. Additionally, the baseline (cross-sectional) survey will be designed as the first wave of a 5 year panel study, to be funded separately. The SAMPLING FRAME is the registration list for RNs maintained by the N.Y. Dept. of Education, Dept. of Professional Licensing. The survey instrument will be pretested on a random sample of the RNs in Western New York (N=125 Rns): the baseline survey will use a random sample of 1500 RNs. Determinants of labor supply fall into two groups: economic and socio- demographic variables. A major goal is to improve on the economic data available in other surveys (Moses, 1994) and add questions about work history and preferences which are more directly indicative of personal preferences than are socio-demographic variables. ANALYSIS will include descriptive statistics and logistic analysis of the part-time, full-time, and part-time work decisions. Depending on the data obtained, we may examine work history data with hierarchical linear modelling or survival analysis. IMPLICATIONS: Nursing practice based to a significant degree in non-hospital settings will require increased versatility and adaptability to new roles. Wage differentials across vertically integrated hospital, outpatient or long- term care settings, may result in more uniform wages across various settings, affecting the total costs of hospitals in an unknown direction.
