The effects of doctor strikes on patient outcomes: Evidence from the English NHS

The effects of doctor strikes on patient outcomes: Evidence from the English NHS
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医生罢工对患者治疗结果的影响:来自英国 NHS 的证据

DOI:
10.1016/j.jebo.2023.06.011
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发表时间:
2023
影响因子:
2.2
通讯作者:
Stoye G
Stoye G
中科院分区:
经济学3区
文献类型:
--
作者:
Stoye G

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医生罢工对医院和病人造成了严重影响。过去的尝试估计对患者的影响遭受选择问题,由于在罢工期间改变患者组成。我们通过利用2016年英国“初级”医生罢工对不同医院的影响来解决这些问题,以估计医生罢工对患者结果的影响。使用罢工前初级-高级医生比例来衡量暴露,我们显示罢工暴露增加导致选择性容量的更大减少,但不影响急诊患者的容量、平均死亡率或再入院率。然而,更大的罢工暴露确实导致黑人急诊患者的再入院率更高。这表明,虽然医院设法减轻了罢工的许多负面影响,但罢工造成的破坏仍然对一些少数群体产生了负面影响。
Doctor strikes cause major disruption for hospitals and patients. Past attempts to estimate impacts on patients suffer from selection issues due to changing patient composition during strikes. We address these issues by exploiting differential hospital exposure to a 2016 ‘junior’ doctor strike in England to estimate the impact of doctor strikes on patient outcomes. Using the pre-strike junior-senior doctor ratio to measure exposure, we show increased strike exposure led to larger reductions in elective volumes, but did not affect volumes, average mortality or readmission rates for emergency patients. However, greater exposure to the strike did lead to higher readmission rates for black emergency patients. This suggests that while hospitals managed to mitigate many of the negative effects of the strikes, disruptions from the strikes still had negative consequences for some minority groups.
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