High turnover among nursing staff in private nursing homes for dependent elderly people (EHPADS) in France: Impact of the local environment and the wage

Abstract

The high turnover among nursing staff working in nursing homes for dependent elderly people (EHPADs) in France has negative consequences in terms both of cost and of quality of care for the residents. We study the causes of this staff turnover using the estimate from a probit model estimated on two samples, one of 5,478 nurses and the other of 13,444 nursing auxiliaries working in private EHPADs under open-ended contracts. The probability of the nurses and nursing auxiliaries leaving is significantly influenced by factors related to the environment around the employee’s place of residence, computed at a highly disaggregated geographical level, including closeness to a hospital, competition between residential care facilities for elderly people, shortage of nursing staff, and attractiveness of the self-employed professional sector for nurses. The wage level, corrected for endogeneity, has a positive effect on the retention of nursing auxiliaries working in EHPADs, but it does not seem to have an influence in the case of nurses.