Cohort study reveals declining retention and increasing self-employment among registered nurses, highlighting worsening healthcare labour supply shortages.
Many countries are facing labour shortages in nursing as reported in the literature and by statistical agencies. Using Dutch monthly administrative microdata, we analyse retention and attraction of all nursing-qualified persons who were employed in the healthcare sector in January 2016 and/or in January 2020; they are followed for one year before and three years after these baseline months. Compared to the 2016 Cohort, women and men of the 2020 Cohort were 0.3 and 1.6 percentage point, respectively, more likely to have left employment; and, conditional on still being employed, 0.8 and 1.2 percentage points more likely to have left healthcare employment three years after baseline. This decrease is a continuation of the reduction in retention rates from 2012 to 2016. Furthermore, the 2020 Cohort was more likely to transition from salaried employment to self-employment and they worked fewer hours. Retention rates of other health professionals did not change.
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Kalb et al. (2026) studied this question.
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