Predictors of Job Satisfaction and Intent to Leave among Home Health Workers: An Analysis of the National Home Health Aide Survey. Descriptive Analyses

08/14/2015

The NHHAS represented a weighted total of 160,720 home health workers. Following the exclusion of cases with missing or anomalous values for variables required to conduct analyses, a weighted total of 119,500 aides--nearly 75 percent of the original population--were available for inclusion in this study. In order to determine the extent to which the study sample differed from the full sample in key characteristics, bivariate analyses with corresponding t-tests and chi-square were estimated to determine whether differences in aide, agency, and job characteristics, as well as satisfaction and intent to leave, were statistically significant at the 5 percent level. None of the comparisons between the full and study population were found to be statistically different, suggesting that the study population was suitably representative of the full population of home health workers for the variables included.

As shown in Table 1, across the study population approximately 47.2 percent of workers reported that they were extremely satisfied, 38.9 percent reported that they were somewhat satisfied, and 13.9 percent reported being dissatisfied with their job. Slightly less than one in four home health workers reported their intent to leave their job in the coming year. Approximately 67 percent of workers who were dissatisfied expressed the intention to leave their job compared to 8 percent of those that were extremely satisfied with their job.

As shown in Table 1, nearly two-thirds of home health workers in the study sample were between the ages of 30 and 54. Subgroups of workers, distinguished by level of job satisfaction (Table 2), did not differ in age distribution. However, a larger proportion of intended stayers (27.6 percent) than intended leavers (16.2 percent) were aged 55 or older. Subgroups differing by level of job satisfaction and intent to leave job did not differ significantly on other aide characteristics that included race, Hispanic ethnicity, and type of aide (e.g., CNA, home care aide, hospice aide).

Descriptive analyses indicated that job satisfaction was not associated with type of agency although the proportion of leavers and stayers did differ by agency type. Approximately 34.6 percent of intended leavers were employed in a for-profit chain, compared to only 22.0 percent of intended stayers. Agency location was found to be associated with both job satisfaction and intent to leave. Among those that were extremely satisfied with their job, 81.6 percent were employed by an agency located in a metropolitan area compared to 91.2 percent of those that were dissatisfied with their job. Similarly, a greater proportion of intended leavers were employed by a metropolitan-based agency. Other agency characteristics, including size and availability of career ladder positions, were not associated with job satisfaction or intent to leave.

Overall, the hourly wage for this sample of home health workers averaged $12.15. Mean wage was not statistically different across subgroups of workers that differed by level of job satisfaction or intent to leave. Nonetheless, some benefits were associated with satisfaction and intent to leave. Workers who were extremely satisfied and those who intended to stay on the job were substantially more likely to be offered paid sick days and pensions compared to those who were dissatisfied and those that intended to leave their job. Across the study population, approximately 77.0 percent of workers were offered health insurance through the workplace. Workers that differed by level of job satisfaction did not significantly differ in the proportion that was offered health insurance. Compared to intended stayers, however, intended leavers were less likely to be offered health insurance (63.6 percent versus 81.2 percent).

Nearly 70 percent of all home health workers represented in the analysis worked full-time, defined as 30 or more hours per week. A greater proportion of intended stayers than intended leavers worked full-time (73.5 percent versus 57.9 percent).

TABLE 2. Characteristics of Population in Study Sample by Job Satisfaction and Intent to Leave Job, NHHAS, 2007

  Job Satisfaction Intent to Leave
Extremely Satisfied Somewhat Satisfied Dissatisfied   Intended Leavers Intended Stayers  
Population Weighted N 56,430 46,476 165,94   28,940 90,560  
Percent sample Percent (%) 47% 39% 14%   24% 76%  
Distribution (%) and P-Values
  Percent Percent Percent P-Value Percent Percent P-Value
Job Satisfaction & Intent to Leave Job
Job
satisfaction
Extremely         15.6 57.6 <0.01
Somewhat       45.8 36.4  
Dissatisfied       38.5 5.9  
Intend to leave job Yes 8 29 67 <0.01      
Worker Characteristics
Age (years) <30 9.4 15.2 14.4 0.17 18.2 10.4 0.05
30-54 60.5 64.6 65.1 65.5 61.8
>55 30.0 20.1 20.4 16.2 27.6
Race White only 58.8 48.6 51.4 0.45 46.8 56.1 0.29
Black only 29.6 41.0 37.8 43.6 32.5
Other 11.5 10.3 10.7 9.5 11.3
Hispanic Yes 7.4 7.8 7.0 0.96 6.2 7.9 0.51
Aide
household's
poverty
status
<100% FPL 16.6 19.5 27.6 0.84 28.1 16.4 0.19
100-199% FPL 33.6 35.9 34.9 28.5 36.7
200-299% FPL 30.9 24.7 25.5 21.9 29.6
Above 300% FPL 18.7 19.7 11.8 21.3 17.1
Aide has more than 1 job Yes 20.3 22.9 27.5 0.77 23.9 21.8 0.72
Education <HS 4.9 6.4 11.7 0.19 4.8 6.9 0.46
HS Grad or GED 59.3 47.6 47.0 49.5 54.3
At least some college 35.6 45.9 41.2 45.6 38.7
Aide only worker in household with dependent children Yes 14.2 21.6 13.3 0.25 18.5 16.5 0.68
Agency Structure & Policies
Type of
ownership of
agency
Chain, for-profit 21.4 31.3 20.0 0.06 34.6 22.0 <0.01
Standalone for-profit 30.9 26.7 52.9 38.5 30.4
Not-for-profit 47.6 41.8 26.9 26.7 47.5
Location of
agency
Metropolitan 81.6 81.3 91.2 0.03 86.0 81.8 <0.01
Micropolitan 11.0 14.4 4.7 10.3 11.8
Neither 7.3 4.2 4.0 3.6 6.3
Size of Agency Mean FTE nursing and direct care staff 54.7 56.0 64.3 0.44 60.8 55.2 0.43
Assignment Same patients 83.3 81.0 83.9 0.52 77.4 84.1 0.32
of patients Patients change 6.7 11.2 8.2   12.1 7.5  
each week Combination 9.9 7.7 7.8   10.4 8.2  
Aide encouraged by agency to talk with patient's family Yes 62.2 52.1 39.4 0.03 49.0 57.1 0.19
Compensation
Mean hourly wage (2007) $/hour $11.73 $12.26 $13.27 0.42 $12.68 $11.98 0.49
Health insurance Yes 83.1 72.5 68.4 0.90 63.6 81.2 <0.01
Pension or retirement plan Yes 61.9 55.6 26.7 0.01 39.3 59.3 0.01
No 30.9 37.7 65.0 54.6 33.1
Don't know 7.1 6.6 8.2 6.0 7.5
Personal days Yes 73.8 62.6 52.1 0.07 61.0 68.2 0.25
Sick days Yes 68.5 51.4 36.3 <0.01 45.3 61.3 0.01
Paid holidays Yes 66.9 49.3 46.1 <0.01 52.2 58.8 0.29
Availability of career ladder positions Yes 7.8 10.3 14.8 0.41 11.1 9.3 0.37
Job & Workplace Characteristics
Hours worked per week Mean 33.0 32.0 30.4 0.43 28.6 33.4 <0.01
Works FT >30 hours 73.0 69.8 57.3 0.28 57.9 73.5 0.01
Received formal training Yes 87.5 85.0 74.6 0.22 78.9 86.5 0.09
On-the-job injury in past 12 months Yes 9.3 15.6 17.5 0.11 18.7 11.0 0.10
Satisfaction with hours and FT (>30 hours per week) PT, want more hours 9.3 17.2 22.7 0.06 26.9 10.3 <0.01
PT/wants fewer Hours OR FT/wants more hours 10.4 10.0 9.1 5.1 11.6
FT, fewer hours 0.9 2.7 13.0 6.3 2.3
Hours about right 79.3 69.9 55.0 61.5 75.6
Adequacy of time to assist
patients with
ADLs
More than enough time 45.0 41.9 33.4 0.29 39.2 43.2 0.06
Enough time 52.7 54.0 55.3 50.5 54.6
Not enough time 2.1 4.0 11.2 10.2 2.1
Aide feels respected by supervisor as part of the health care team A great deal 92.9 67.2 47.9 <0.01 64.9 80.4 <0.01
Somewhat or not at all 7.0 32.7 52.0 35.0 19.4
Aide feels organization values their work A great deal 89.4 52.4 35.9 <0.01 47.4 74.0 <0.01
Somewhat or not at all 10.6 47.5 63.9 52.5 25.8
Aide feels respected by patients as part of the health care team A great deal 93.1 89.3 89.9 0.39 88.2 92.1 0.22
Somewhat/not at all 6.8 10.6 10.0 11.7 7.8
Aide feels involved in challenging work Strongly agree 83.5 57.3 50.8 <0.01 56.1 72.8 <0.01
Somewhat agree 13.2 33.2 15.5 20.9 21.4
Somewhat/strongly disagree 3.1 9.3 33.6 22.9 5.6
Aide feels trusted with patient care decisions Strongly agree 86.9 69.8 68.4 <0.01 68.4 80.7 0.03
Somewhat agree 10.6 24.2 9.4 15.9 15.6
Somewhat/strongly disagree 2.3 6.0 22.1 15.6 3.6

 

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