Healthcare worker strikes
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The withdrawal of labour has moral implications for healthcare workers. When it has happened there may be implications for the entire population depending upon many factors. The effects seem to be much less than some other political decisions such as war and income distribution within a population.
Effects of Doctors Strikes
- Generally these result in the maintaining of emergency services either by the striking doctors or by colleagues. If so there does appear to be the potential for a decrease in mortality, due it is believed to the reduction in elective work.
- 20% decreased mortality (Israel 2000) [1]
- 55 to 153 deaths did not occur because of the number of elective operations not performed secondary to the strike easily hid any impact from increased patient transfer to other facilities on emergency admission mortality(California 1973)[2].
- Similar reductions were seen in California and UK decades earlier
The decrease in mortality does not affect routine perinatal statistics
- No change in the perinatal mortality (Israel 1983) [3]
And does not appear at a macro level
- No increase or decrease in population mortality (Croatia 2003)[4]
- County mortality statistics not affected(California 1973)[5]
But it is possible some of the effects are long term
- Hypertension control is worse in higher social class males[6]
Some of the effects of a junior doctors strike may be superficially attractive in a management target driven culture:
- Resident strike (Spain 2000)[7]
- Fewer clinical tests
- Pathology
- X-rays
- Shorter lengths of hospital stay
- Fewer clinical tests
- The argument that some of this effect of mortality is a result of removing from health care those felt most likely to have competency deficiencies is only partially supported by medical staff cohort turnover studies that tend to demonstrate fairly minimal or no impact on mortality.
Effects of Nurses Strikes
Midwife availability can impact perinatal care(Canada 1994)[8]:
- Adverse outcomes 10.2 vs 8.1/100 deliveries, (OR 1.27, 95% CI 1.07 to 1.52)
- Reduction in cesarean section rate to 12.5 per 100 deliveries, from 14.6 per 100 deliveries
References
- ↑ Siegel-Itzkovich J. Doctors' strike in Israel may be good for health. BMJ (Clinical research ed.). 2000 Jun 10; 320(7249):1561.
- ↑ James JJ. Impacts of the medical malpractice slowdown in Los Angeles County: January 1976. American journal of public health. 1979 May; 69(5):437-43.
- ↑ Bukovsky I, Herman A, Sherman D, Schreyer P, Arieli S, Caspi E. Perinatal outcome following physicians' strike of 1983. Israel journal of medical sciences. 1985 Oct; 21(10):804-7.
- ↑ Erceg M, Kujundzić-Tiljak M, Babić-Erceg A, Coric T, Lang S. Physicians' strike and general mortality: Croatia's experience of 2003. Collegium antropologicum. 2007 Sep; 31(3):891-5.
- ↑ James JJ. Impacts of the medical malpractice slowdown in Los Angeles County: January 1976. American journal of public health. 1979 May; 69(5):437-43.
- ↑ Marcovici OA, Slater PE, Ellencweig AY. Effects of the Israel doctors' strike on hypertension control in Ashdod. European journal of epidemiology. 1987 Mar; 3(1):30-4.
- ↑ Salazar A, Corbella X, Onaga H, Ramon R, Pallares R, Escarrabill J. Impact of a resident strike on emergency department quality indicators at an urban teaching hospital. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine. 2001 Aug; 8(8):804-8.
- ↑ Mustard CA, Harman CR, Hall PF, Derksen S. Impact of a nurses' strike on the cesarean birth rate. American journal of obstetrics and gynecology. 1995 Feb; 172(2 Pt 1):631-7.
