Did Better Jobs Better Care reduce direct care worker turnover? Monika Setia

1. Did Better Jobs Better Care reduce direct care worker turnover?Monika Setia June 8, 2008 Presented at the Academy Health’s 25th Annual Research Meeting (ARM). The authors are grateful for support from The Atlantic Philanthropies and The Robert Wood Johnson Foundation

2. Research Questions • Was the decline higher among providers with higher levels of intervention? • Did Better Jobs Better Care reduce direct care worker turnover rates?

3. Methods • Analyze provider-level panel data on monthly turnover rates • Compare trend in turnover after implementation with national trend • Comparison group from BLS • Use provider level fixed effects • Control for seasonal effect • Piecewise linear regression with six-month splines • Compared high and low implementation groups

4. Data • Direct care worker hiring and termination reporting data • Submitted every pay period and end of quarter by each provider • Data collection through online secure website • Re-constructed into panel data on monthly turnover rates at each provider

5. Sample Size

6. Sample Size

7. Sample Size

8. Analytic model Yit - Ŷn = βo + β1 Tit + μi + λt + εit Y it = Turnover rate for BJBC provider ‘i’ at time ‘t’ Ŷn = Estimated national turnover rate βo = Constant term β1 = Coefficient for the variable T Tit = Months since provider participation in BJBC for provider ‘i’ at time‘t’ μi = Provider fixed effect λt = Month fixed effect

9. Monthly Change in Turnover Rates *p<=0.1, **p<=0.05, ***p<=0.01

10. Estimated Monthly Turnover Rates

11. Estimated Monthly Turnover Rates

12. High versus Low Implementation *p<=0.1, **p<=0.05, ***p<=0.01

13. Summary • No evidence that BJBC affected turnover rates • BJBC turnover rates not significantly different from national rates • No difference by level of BJBC implementation • Estimates of changes with large margins of error