ArticleHealth affairs (Project Hope)2026
The Effects Of Labor Unions On Nurse Staffing Ratios And Quality Of Care In US Nursing Homes, 2013-21.
Article in Health affairs (Project Hope), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
Labor unions representing workers in US nursing homes bargain for higher wages and safer working conditions, which may reduce staff turnover and increase the quality of care. However, if higher labor costs lead employers to reduce nurse staffing, unionization may reduce care quality. We used a difference-in-differences event study design to estimate the effects of unionization on nurse staffing ratios for total nurse staffing and separately for registered nurses (RNs), licensed practical nurses (LPNs), and certified nursing assistants (CNAs), as well as the effects of unionization on the quality of care, during the period 2013-21. We found that unionization had no effect on total nurse staffing levels but had opposing effects on RNs and LPNs. Unionization increased LPN staffing by roughly 2.7 nurse hours per day in the average nursing home, but it decreased RN staffing by roughly 3.2 nurse hours per day. Despite this substitution from RNs to LPNs, we found that unionization did not appear to reduce the quality of care, a result consistent with unions increasing nurse productivity.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.