Hospitals now represent one of the largest union sectors of the US economy, and there is particular concern about the impact of strikes on patient welfare. We analyze the effects of nurses’ strikes in hospitals on patient outcomes in New York State. Controlling for hospital specific heterogeneity, the results show that nurses’ strikes increase in-hospital mortality by 18.3 percent and 30-day readmission by 5.7 percent for patients admitted during a strike, with little change in patient demographics, disease severity or treatment intensity. The results suggest that hospitals functioning during nurses’ strikes do so at a lower quality of patient care.

Hospitals are one of the most important employers in the United States. 35 percent of US health care workers, and 3.61 percent of all US workers work in hospitals.

Due to the importance of hospitals in providing health care to our nation, and fears that work stoppages could place patient health in jeopardy, hospitals were excluded from collective bargaining laws for almost three decades after other sectors were allowed to unionize. Once allowed to do so in 1974, however, hospitals quickly became one of the most important sources of union jobs in the United States. Over 15 percent of hospital employees are members of a union,2 representing six percent of all union employees in the United States.

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