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March 1991, Vol. 114, No. 3
Kay Anderson and Barbara Wootton
T he hospital industry underwent a transitional period during the 1980's. Escalating health care costs led to changes in government-financed health care coverage, new forms of private health care financing, and growth in the number and diversity of alternate health care providers. Faced with an increasingly competitive economic environment, hospital managers focused on profitability and cost containment. Their strategies included decreasing the length of costly inpatient stays; eliminating or contracting out previously-offered services; diversifying into emerging health care markets; integrating into multihospital chains; and aggressively marketing their programs and services. During the 1980's, there also were significant technological developments in the hospital industry. Although frequently eliminating the need for lengthy hospital stays, new technology also contributed to rising health care costs.
Recent changes in the hospital industry have influenced the structure of occupational employment within the industry. With labor costs accounting for the largest item in hospital budgets-about one-half of their operating expenses in many cases-reducing employment and altering staffing patterns were often used as cost containment measures.1 This article examines hospital staffing patterns and their changes, reflecting both the structural transition and technological advances that have characterized the hospital industry in recent years.
Data are derived from the Occupational Employment Statistics surveys of hospitals conducted in 1983, 1986, 1989. The Occupational Employment program is a Federal-State cooperative survey of nonfarm establishments designed to develop current occupational employment data of wage and salary workers by industry. The survey follows a 3-year cycle: during the first year, it covers manufacturing industries and hospitals; during the second year, mining, construction, finance, and service industries; and during the third year, trade, transportation, communications, public utilities, education, and government services industries. The survey is based on a probability sample , stratified by industry, geographic area, and employment size of firm.2
This excerpt is from an article published in the March 1991 issue of the Monthly Labor Review. The full text of the article is available in Adobe Acrobat's Portable Document Format (PDF). See How to view a PDF file for more information.
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1 Eileen Appelbaum and Cherlyn Skromme Granrose, "Hospital employment under revised Medicare payment schedules," Monthly Labor Review, August 1986, p. 38.
2 For additional information, see BLS Handbook of Methods, Bulletin 2285 (Bureau of Labor Statistics, 1988), pp. 28-30.
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