摘要：Labor market regulation can have harmful unintended consequences. In many
markets, especially for public sector workers, pay is regulated to be the same
for individuals across heterogeneous geographical labor markets. We would
predict that this will mean labor supply problems and potential falls in the
quality of service provision in areas with stronger labor markets. In this paper
we exploit panel data from the population of English acute hospitals where pay
for medical staff is almost flat across the country. We predict that areas with
higher outside wages should suffer from problems of recruiting, retaining and
motivating high quality workers and this should harm hospital performance. We
construct hospital-level panel data on both quality - as measured by death rates
(within hospital deaths within thirty days of emergency admission for acute
myocardial infarction, AMI) - and productivity. We present evidence that
stronger local labor markets significantly worsen hospital outcomes in terms of
quality and productivity. A 10% increase in the outside wage is associated with
a 4% to 8% increase in AMI death rates. We find that an important part of this
effect operates through hospitals in high outside wage areas having to rely more
on temporary “agency staff” as they are unable to increase (regulated) wages in
order to attract permanent employees. By contrast, we find no systematic role
for an effect of outside wages of performance when we run placebo experiments in
42 other service sectors (including nursing homes) where pay is unregulated.
