Willingness to pay for improved working conditions of nurses: Results from a factorial survey experiment in Germany

Background: Many countries face substantial shortages of skilled nurses. With an aging population and global demographic changes, developing a skilled workforce of nurses has become one of the central challenges for public health care. The recent COVID-19 pandemic has exacerbated labor shortages, which pose a threat to the quality of publicly provided health care. Improving nurses' working conditions could be a means by which to address the global shortages of nurses. However, in countries with public health care, such improvements may come with additional costs in the form of higher taxes or social security contributions. Therefore, such improvements partly depend on people's willingness to pay (WTP) for them. Objective: In this paper, we investigate workers' willingness to pay for improvements in the working conditions of nurses. Design: This study is a factorial survey experiment included as part of an online survey. Setting(s): The factorial survey experiment was implemented within the high-frequency online panel survey "Life and Employment in Times of Corona" (IAB-HOPP) conducted by the Institute for Employment Research (Germany). Participants: We analyze data from N = 2128 survey participants; our main analysis consists of N = 6384 responses from those participants. Methods: Our research is based on a factorial survey experiment (vignette analysis) designed to quantitatively measure the willingness to pay for various improvements in the working conditions of nurses. We use random effect models and mixed models to estimate the individual-level willingness to pay for these improvements. Results: Our results show that the survey participants are generally willing to pay for particular policies aimed at improving the working conditions of nurses. However, the amount that respondents are willing to pay varies with the type of policy changes. Survey participants exhibit a high willingness to pay for increases in minimum wages for nurses and wage-related improvements in general. We find, however, a lower willingness to pay for the right to participate in training courses aimed at reducing work-related stress. Conclusions: The broad support for improvements in the working conditions of nurses provides policymakers with some guidance in implementing policy measures that might address labor shortages in the nursing sector. Registration: There was no preregistration. Tweetable abstract: Many people are willing to pay extra to improve the working conditions of nurses. Wagerelated increases for nurses show the highest willingness to pay. (c) 2024 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC license (http://creativecommons.org/licenses/by-nc/4.0/).