This paper examines trends in hospital employment from 1981 to 1993. A
fter controlling for changes in the inpatient and outpatient volume an
d using a proxy for changes in case mix, the number of hospital employ
ees increased steadily during this period. Most of the growth occurred
in the nonclinical areas. There was no statistically significant diff
erence in the employment growth in states with high or low penetration
of health maintenance organizations (HMOs), or in states with and wit
hout all-payer rate-setting programs, suggesting that neither competit
ive nor regulatory programs influenced employment trends in the hospit
al industry.