Working Paper: NBER ID: w30960
Authors: David C. Grabowski; Jonathan Gruber; Brian McGarry
Abstract: Although debates over immigration remain contentious, one important sector served heavily by immigrants faces a critical labor shortage: nursing homes. We merge a variety of data sets on immigration and nursing homes and use a shift-share instrumental variables analysis to assess the impact of increased immigration on nursing home staffing and care quality. We show that increased immigration significantly raises the staffing levels of nursing homes in the U.S., particularly in full time positions. We then show that this has an associated very positive effect on patient outcomes, particularly for those who are short stayers at nursing homes, and particularly for immigration of Hispanic staff.
Keywords: immigration; nursing homes; long-term care; elder outcomes; staffing levels
JEL Codes: I11; I18; J61
Edges that are evidenced by causal inference methods are in orange, and the rest are in light blue.
| Cause | Effect |
|---|---|
| Increased immigration (K37) | Higher staffing levels (M51) |
| Increased immigration (K37) | Improved quality of care (L15) |
| Increased immigration (K37) | Decrease in hospitalizations (I19) |