Nova School of Business and Economics, Universidade Nova de Lisboa, Carcavelos, Portugal.
Health Econ. 2022 Nov;31(11):2499-2511. doi: 10.1002/hec.4576. Epub 2022 Aug 5.
Hospital strikes in the Portuguese National Health Service (NHS) are becoming increasingly frequent. This paper analyses the effect of different health professionals' strikes (physicians, nurses, and diagnostic and therapeutic technicians (DTT) - DTT) on patient outcomes and hospital activity. Patient-level data, comprising all NHS hospital admissions in mainland Portugal from 2012 to 2018, is used together with a comprehensive strike dataset with almost 130 protests. Data suggests that hospital operations are partially disrupted during strikes, with sharp reductions in surgical admissions (up to 54%) and a decline on both inpatient and outpatient care admissions. The model controls for hospital characteristics, time and regional fixed effects, and case-mix changes. Results suggest a modest increase in hospital mortality limited for patients admitted during physicians' strikes, and a slight reduction in mortality for patients already at the hospital when a strike takes place. Increases in readmission rates and length of stay are also found. Results suggest that hospitals and legal minimum staffing levels defined during strikes are not flexible enough to accommodate sudden disruptions in staffing, regardless of hospital quality in periods without strikes.
葡萄牙国民健康服务体系（NHS）中的医院罢工越来越频繁。本文分析了不同卫生专业人员（医生、护士和诊断与治疗技师（DTT）-DTT）罢工对患者结果和医院活动的影响。该研究使用了包含 2012 年至 2018 年葡萄牙大陆 NHS 所有住院患者的患者水平数据，以及一个几乎包含 130 次抗议活动的全面罢工数据集。数据表明，在罢工期间医院运营会受到部分干扰，手术入院率急剧下降（高达 54%），住院和门诊护理入院率均有所下降。该模型控制了医院特征、时间和区域固定效应以及病例组合变化。结果表明，医生罢工期间入院的患者的医院死亡率略有增加，而在罢工期间已经住院的患者的死亡率略有下降。还发现再入院率和住院时间增加。结果表明，无论罢工期间医院的质量如何，罢工期间定义的医院和法定最低人员配置水平都不够灵活，无法适应人员配置的突然中断。
