Workforce implications of injury among home health workers: evidence from the National Home Health Aide Survey.

PURPOSE OF STUDY  The direct care workforce continues to rank as one of the most frequently injured employee groups in North America. Occupational health and safety studies have shown that workplace injuries translate into negative outcomes for workers and their employers. The National Institute for Occupational Safety and Health (NIOSH) Organization of Work and Occupational Safety and Health framework is used to examine (a) relationships between injuries and work outcomes as reported by home health aides (HHAs) and (b) the likely efficacy of employee training and supervisor support in reducing worker risk for injury.  DESIGN AND METHODS  Data for this analysis were drawn from the 2007 National Home Health Aide Survey, a nationally representative survey. Ordinary least squares regression and multinomial logistic regression were used to examine relationships between worker injury and (a) worker outcomes and (b) organizational outcomes and to examine ratings of training and supervisory support relative to risk of injury.  RESULTS  Injured aides had lower job satisfaction, higher turnover intent, and poor employment and care quality perceptions. HHA perceptions of poor training and poor supervisory support were significantly related to higher risk for workplace injuries.  IMPLICATIONS  The current study suggests that workplace training has an important role in helping reduce direct care worker injuries, thereby decreasing organizational expenses related to injury, such as workers' compensation, sick time, and turnover. The NIOSH Organization of Work and Occupational Safety and Health framework offers a mechanism by which occupational health and safety interventions may be derived to reduce incidents of injury.