The COVID-19 pandemic has disrupted the U.S. healthcare workforce owing to changes in the use and finances of healthcare offices and institutions, increased health risks, burnout from increased patient burdens, and child care disruptions. While federal programs have provided financial assistance to hospitals and institutions, the net effect of these forces on healthcare employment levels and wages has not been examined. Understanding trends in employment levels by health care settings and locations is critical for planning and responding to public health crises.

Cantor, et al. (2022) used industry- and county-level data from the US Bureau of Labor Statistics Quarterly Census of Employment and Wages (QCEW, which covers more than 95% of U.S. jobs). The researchers conducted two analyses to quantify changes in employment and average wages of employees of six key healthcare organizations (offices of physicians, offices of dentists, home health care services, hospitals, skilled nursing facilities [SNFs], and combined other facilities) during 2020 and the first six months of 2021.

First, they examined quarterly national trends in healthcare employment and average wages between March 31, 2020 (2020-Q1), and June 30, 2021 (2021-Q2), relative to 2019 (pre-COVID levels). Second, they examined associations between the 12-month changes in employment levels during 2019 to 2021, COVID-19 burden, and pre-COVID physician-to-population ratio. Multivariable linear regression models were conducted with Stata, version 17.0.

Healthcare employment levels declined suddenly, from 22.2 million in 2019 to 21.1 million, in 2020-Q2—a 5.2% decline (vs a 9.0% decline in all industries), and considerably rebounded to 21.8 million in 2021-Q2. Average wages within the healthcare sector increased at a lower rate relative to all industries’ changes (2020: 5.0% vs 6.7%; and 2021-Q2: 1.5% vs 6.9%).

Employment declines varied by types of healthcare organizations (Figure), with the largest declines in 2020-Q2 among offices of dentists (10.0%) and SNFs (8.4%). The smallest declines were among hospitals (2.5%) and offices of physicians (4.6%). While the employment level of most health care sectors rebounded to the pre-COVID levels in 2021-Q2, there were more declines in employment among SNFs (13.6% decline compared with 2019). Employees in SNFs exhibited the largest wage increases in 2020 (9.5%) and 2021 (6.3%), compared with 2019.

Reference: Cantor J, et al. US Health Care Workforce Changes During the First and Second Years of the COVID-19 Pandemic. JAMA Health Forum. 2022;3(2):e215217. doi:10.1001/jamahealthforum.2021.5217