During the 1980s California hospitals responded to selective contracti
ng, growth in managed care, and the Medicare prospective payment syste
m (PPS) by controlling their level of spending. This DataWatch examine
s whether these hospitals achieved these savings by changing the numbe
r and/or the mix of hospital employees. We examined employment trends
because wages represent the largest component of hospital budgets and
because the number and mix of personnel can be changed in the short ru
n. Analysis of the California Health Facilities Cost Report data shows
that employment increased steadily during 1982-1994. There is no evid
ence that hospitals responded to growing competition by altering the r
ate of growth in hospital personnel and only weak evidence that they a
ltered the mix of personnel by hiring a greater proportion of nonclini
cal staff. We conclude that increased competition had only a minor eff
ect on hospital employment decisions.