The impact of health care strikes on patient mortality: A systematic review and meta-analysis of observational studies

Essex, R (通讯作者),Univ Greenwich, Old Royal Naval Coll, Pk Row, London SE10 9LS, England.
2022-12
Objective This study sought to evaluate the impact of health care strike action on patient mortality. Data Sources EMBASE, PubMed CINAHL, BIOETHICSLINE, EconLit, WEB OF SCIENCE, and grey literature were searched up to December 2021. Study Design A systematic review and meta-analysis were utilized. Data Collection/Extraction Random-effects meta-analysis was used to compare mortality rate during strike versus pre- or post-strike, with meta-regression employed to identify factors that might influence the potential impact of strike action. Studies were included if they were observational studies that examined in-hospital/clinic or population mortality during a strike period compared with a control period where there was no strike action. Principal Findings Seventeen studies examined mortality: 14 examined in-hospital mortality and three examined population mortality. In-hospital studies represented 768,918 admissions and 7191 deaths during strike action and 1,034,437 admissions and 12,676 deaths during control periods. The pooled relative risk (RR) of in-hospital mortality did not significantly differ during strike action versus non-strike periods (RR = 0.91, 95% confidence interval 0.63, 1.31, p = 0.598). Meta-regression also showed that mortality RR was not significantly impacted by country (p = 0.98), profession on strike (p = 0.32 for multiple professions, p = 0.80 for nurses), the duration of the strike (p = 0.26), or whether multiple facilities were on strike (p = 0.55). Only three studies that examined population mortality met the inclusion criteria; therefore, further analysis was not conducted. However, it is noteworthy that none of these studies reported a significant increase in population mortality attributable to strike action. Conclusions Based on the data available, this review did not find any evidence that strike action has any significant impact on in-hospital patient mortality.
HEALTH SERVICES RESEARCH
卷号:57|期号:6|页码:1218-1234
ISSN:0017-9124|收录类别:SCIE
语种
英语
来源机构
University of Greenwich; University of Greenwich; Barts Health NHS Trust; University of London; Queen Mary University London; Imperial College London; University of Greenwich; University of Westminster
被引频次(WOS)
4
被引频次(其他)
4
180天使用计数
0
2013以来使用计数
0
EISSN
1475-6773
出版年
2022-12
DOI
10.1111/1475-6773.14022
学科领域
循证公共卫生
关键词
health policy health systems health care worker mortality protest strike
WOS学科分类
Health Care Sciences & Services Health Policy & Services