Immigration, the Long-Term Care Workforce, and Elder Outcomes in the U.S.

Increased immigration to the U.S. significantly raises staffing levels and improves patient outcomes in nursing homes. David Grabowski and colleagues utilized a variety of data sets in order to reach this conclusion in their paper “Immigration, the Long-Term Care Workforce, and Elder Outcomes in the U.S.” The authors highlight that immigrants represent a disproportionate share of long-term care workers, making up 25 percent of home care and 19 percent of nursing home workers. In addition, the labor market for nursing home workers faces persistent excess demand, resulting in a lack of compliance with required staffing levels. The authors go on to analyze the effect of immigration on the quality of care in nursing homes. They found that higher levels of immigration led to reductions in the use of physical restraints, the development of urinary tract infections, and rehospitalization among short-stay rehabilitative residents. Within the long-stay population, they found reductions in the use of physical and chemical (i.e., inappropriate antipsychotic medications) restraints and the development of pressure sores. The authors conclude that inadequate staffing in nursing homes is a pressing policy issue, probably only resolved through increased levels of immigration.

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