Perceptions of Inequitable Compensation Reductions among Healthcare Workers During Covid-19

Abstract

Healthcare systems across the United States implemented compensation reductions, layoffs, and furloughs during the early phases of the COVID-19 pandemic.  However, there was a wide variety of approaches among health systems.  This paper explores the perceived inequity of compensation reductions across the entire healthcare team through the lens of distributive justice.  The study was conducted at a large academic hospital in the Southeastern United States.  A survey was distributed regarding perceived fairness of compensation reductions, preferred compensation reduction arrangements, work environment, and stressors.  Out of 715 respondents, the majority showed a preference for compensation reductions that were lowest for those physically treating patients, or physically treating COVID-19 patients.  Ordinal logistic regression was conducted to determine predictors of increased odds of perceived inequity of the compensation reductions.  Employees who had greater resiliency, greater exposure to the virus, treated COVID-19 patients and reported reduced income as a major stressor had higher odds of feeling the pay cut was inequitable.  Those with a greater sense of perceived organizational support and females were less likely to perceive the pay cuts as inequitable when controlling for other factors.  Healthcare organizations need to be mindful of perceptions of inequity on the well-being of their workforce and should engage in inclusive decision-making when allocating scarce resources within the organization.