Much of healthcare workforce returning to normal; long-term care is one exception

While much of the healthcare workforce is on track to return to pre-pandemic levels of turnover, turnover rates have been slower to recover among long-term care workers, health aides and assistants, marginalized racial minorities, and women with young children, according to a study published April 8 in JAMA Health Forum.

The study of 125,717 full-time U.S. healthcare workers comes from researchers at the University of Washington in Seattle and the University of Minnesota in Minneapolis. For the study, researchers examined data from the U.S. Census Bureau's Current Population Survey to compare pre-pandemic turnover rates (January 2019 to March 2020; 71,843 observations from CPS) with the first nine months of the pandemic (April 2020 to December 2020; 38,556 observations) and the next eight months of the pandemic (January 2021 to October 2021; 44,389 observations).

They defined turnover as "being unemployed or out of the labor force in a month subsequent to a month when [a respondent] reported being actively employed in the healthcare workforce."

Overall, estimated healthcare turnover rates peaked in the first nine months of the pandemic but largely recovered by the next eight months, except for long-term care workers and physicians, according to the study.

Researchers said an average of 3.2 percent of healthcare workers reported turnover in the pre-pandemic period, compared with 5.6 percent in the first nine months of the pandemic and 3.7 percent in the latter eight months of the study.

The study also showed:

  • Turnover was four times more common among jobs associated with lower wages (such as health aides or assistants) than higher wages (such as physicians).
  • Turnover was higher among workers of parents of children younger than age 5 and highest among women.
  • Turnover among healthcare workers in hospitals was not as common as workers in other settings. 
  • While many jobs had been recovered by the January 2021 to October 2021 period, turnover rates were still 0.7 percentage points higher than pre-pandemic.
  • Turnover rates for long-term care workers continued to increase over time.
  • Women in healthcare were consistently more likely to turn over compared with men throughout the study.

"The findings of this observational cross-sectional study suggest that although much of the healthcare workforce is on track to recover to pre-pandemic turnover rates, these rates have been persistently high and slow to recover among long-term care workers, health aides and assistants, workers of minoritized racial and ethnic groups, and women with young children," the researchers concluded. "Given the high demand for long-term care workers, targeted attention is needed to recruit job-seeking healthcare workers and to retain those currently in these jobs to lessen turnover."

Researchers noted various study limitations, including that they did not determine association between exiting the workforce and COVID-19.

Read the full study here.

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