Showing posts with label NHS. Show all posts
Showing posts with label NHS. Show all posts

Sunday, November 3, 2013

JOBS | Are Older Workers Keeping Jobs from Younger Ones?

Although not as high as European rates of >50%, the 
USA suffers from 17% youth unemployment. 
Chart by Atlantic Cities.
Before she discovered that the United States was tapping her phone and emails, German Chancellor Angela Merkel rated youth unemployment as "the biggest crisis facing Europe."

In Britain nearly one million young people are jobless. The talk in the UK is of a "lost generation" of workers, as lack of jobs creates mental-health problems in this age cohort.

The nonprofit MindFull says that 850,000 UK children, one-third of the age group, suffers from a mental-health problems and many more suffer from anxiety and depression.

Mental-health problems represent the largest single cause of disability in the UK, 23 percent of the NHS burden. Yet the NHS is spending only 1 percent of its budget addressing the causes of mental health problems, according to a member of Parliament, Nicky Morgan. The main concerns of young people in the UK are school stresses (54 percent), worrying about the future (53 percent), and feeling inadequate (52 percent).

Are Older Workers Crowding Out Younger Ones? In General, No

Like Europe, the United States has high unemployment among its young people. At the same time, with the asset meltdown in 2008, baby boomers who expected to retire at 60 or 62 have stayed on to keep working past 65. They can't afford to retire. The United States ranks third in the world for hiring over-65 workers, after Japan and Singapore. There is no maximum age for retirement, although specific jobs have age limits, like some judges in New York State.

The persistence of older workers in their jobs has been cited as a reason for high unemployment among youth. Some employers are concerned about the lack of intake of younger people and offer "buyout" arrangements – for example, extra credit toward retirement – to encourage elderly workers to retire so that more younger workers can be recruited.

But is the retaining of older workers really the reason for high unemployment of younger workers? According to a study cited by the UK Parliament, there is no evidence that older workers who stay on the job longer squeeze out opportunities for younger employees. The study by the Center for Retirement Research (CRR) at Boston College says that there may be situations where older employees crowd out younger workers in some companies or areas, but not across the workforce at large.

The report examined employment and unemployment rates, wages, and hours worked in all 50 states over time (1977-2011) for three different age groups: 20-24 ("young"), 25-54 ("prime-aged"), and 55-64 ("old"). There was a wide variation among the states in all measures.

If older workers were hampering the prospects of younger ones, states with higher employment or wages among older workers would also lead to higher unemployment or lower wages among younger workers. But it wasn't so.

The report also looked at levels of employment both before and during the Great Recession and found:
  • No support for the idea that the Recession changed the relative opportunities for younger and older workers. 
  • Evidence that the Great Recession did affect overall unemployment rates and wages, but no support for the idea that employment among older workers affected opportunities for younger workers.
  • Employment among younger workers was instead influenced by their education and skill levels, and by whether these workers were employed in the service or manufacturing industries. 
  • Younger workers may have needed to migrate to job opportunities in new locations or industries, particularly as the Great Recession ended many manufacturing jobs.
Why Employment Moves Together among Young and Old

It makes sense that having elderly people work as long as they can may be good for the country and region, and for young people. If workers stay on in the workforce, it:
  • Reduces the burden on pension systems, many of which are underfunded. 
  • Makes it more likely that consumption and therefore the economy will remain strong. 
  • Helps retain jobs that would be lost if older people who are successful at what they do and know how to serve their customers stop working. 
  • Enables entrepreneurial older people to generate ideas that result in hiring of more young people as trainees and partners.
Workers at the two ends of the age spectrum are not substitutes, they are complements.

    Friday, January 30, 2009

    UK Doctors: Fewer Hours Mean Fewer Errors

    BBC News is running a medical care story today that has implications for U.S. medical care. Residents who are put on a shorter 48 hour/week limit, in accordance with European Union regulations, made 33 percent fewer medical errors than those on a schedule of up to 56 hours a week. The sample size of National Health Service doctors was small but the results were significant. Thanks to Dr. Elisabeth Paice for the link - .

    The relevance of the study for the United States is that U.S. hospital residents are expected to work up to 80 hours a week during their training. The New York-based Commonwealth Fund has shown that patient-reported medical errors are the highest in the United States in a study comparing it with five other countries -- Australia, Canada, Germany, New Zealand and the UK. Of the six countries, the UK had the fewest patient-reported medical errors.

    The new study is reported in the Quarterly Journal of Medicine - http://qjmed.oxfordjournals.org/cgi/content/abstract/hcp004v1?ct. The sample size was 19 junior doctors in residence.
    [N]ine studied while working an intervention schedule of <48 h per week and 10 studied while working traditional weeks of <56 h scheduled hours in medical wards. Work hours and sleep duration were recorded daily. Rate of medical errors (per 1000 patient-days), identified using an established active surveillance methodology, were compared for the Intervention and Traditional wards. Two senior physicians blinded to rota independently rated all suspected errors.
    The results showed significantly lower error rates for the doctors on the new rota with fewer hours:

    Average scheduled work hours were significantly lower on the intervention schedule [43.2 (SD 7.7) (range 26.0–60.0) vs. 52.4 (11.2) (30.0–77.0) h/week; P < 0.001], and there was a non-significant trend for increased total sleep time per day [7.26 (0.36) vs. 6.75 (0.40) h; P = 0.095]. During a total of 4782 patient-days involving 481 admissions, 32.7% fewer total medical errors occurred during the intervention than during the traditional rota (27.6 vs. 41.0 per 1000 patient-days, P = 0.006), including 82.6% fewer intercepted potential adverse events (1.2 vs. 6.9 per 1000 patient-days, P = 0.002) and 31.4% fewer non-intercepted potential adverse events (16.6 vs. 24.2 per 1000 patient-days, P = 0.067). Doctors reported worse educational opportunities on the intervention rota.