IDEAS home Printed from https://ideas.repec.org/a/eee/jeborg/v212y2023icp689-707.html
   My bibliography  Save this article

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

Author

Listed:
  • Stoye, George
  • Warner, Max

Abstract

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.

Suggested Citation

  • Stoye, George & Warner, Max, 2023. "The effects of doctor strikes on patient outcomes: Evidence from the English NHS," Journal of Economic Behavior & Organization, Elsevier, vol. 212(C), pages 689-707.
    • Handle: RePEc:eee:jeborg:v:212:y:2023:i:c:p:689-707
    DOI: 10.1016/j.jebo.2023.06.011
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0167268123002184
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.jebo.2023.06.011?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Cunningham, Solveig Argeseanu & Mitchell, Kristina & Venkat Narayan, K.M. & Yusuf, Salim, 2008. "Doctors' strikes and mortality: A review," Social Science & Medicine, Elsevier, vol. 67(11), pages 1784-1788, December.
    2. Jonathan Gruber & Samuel A. Kleiner, 2012. "Do Strikes Kill? Evidence from New York State," American Economic Journal: Economic Policy, American Economic Association, vol. 4(1), pages 127-157, February.
    3. Manasvini Singh & Atheendar Venkataramani, 2022. "Rationing by Race," NBER Working Papers 30380, National Bureau of Economic Research, Inc.
    4. Evans, William N. & Kim, Beomsoo, 2006. "Patient outcomes when hospitals experience a surge in admissions," Journal of Health Economics, Elsevier, vol. 25(2), pages 365-388, March.
    5. Eduardo Costa, 2022. "The unintended consequences of hospital strikes on patient outcomes evidence from multiple strikes in the Portuguese National Health Service," Health Economics, John Wiley & Sons, Ltd., vol. 31(11), pages 2499-2511, November.
    6. Friedman, Willa & Keats, Anthony & Mutua, Martin Kavao, 2022. "Disruptions to healthcare quality and early child health outcomes: Evidence from health-worker strikes in Kenya," Journal of Health Economics, Elsevier, vol. 86(C).
    7. James, J.J., 1979. "Impacts of the medical malpractice slowdown in Los Angeles County: January 1976," American Journal of Public Health, American Public Health Association, vol. 69(5), pages 437-443.
    8. Thomas P. Hoe, 2022. "Does Hospital Crowding Matter? Evidence from Trauma and Orthopedics in England," American Economic Journal: Economic Policy, American Economic Association, vol. 14(2), pages 231-262, May.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Eduardo Costa, 2022. "The unintended consequences of hospital strikes on patient outcomes evidence from multiple strikes in the Portuguese National Health Service," Health Economics, John Wiley & Sons, Ltd., vol. 31(11), pages 2499-2511, November.
    2. Stefan Bauernschuster & Timo Hener & Helmut Rainer, 2017. "When Labor Disputes Bring Cities to a Standstill: The Impact of Public Transit Strikes on Traffic, Accidents, Air Pollution, and Health," American Economic Journal: Economic Policy, American Economic Association, vol. 9(1), pages 1-37, February.
    3. Bachner, Florian & Halla, Martin & Pruckner, Gerald J., 2024. "Do Empty Beds Cause Cesarean Deliveries?," IZA Discussion Papers 16981, Institute of Labor Economics (IZA).
    4. Raja, Chandni, 2023. "How do hospitals respond to input regulation? Evidence from the California nurse staffing mandate," Journal of Health Economics, Elsevier, vol. 92(C).
    5. Michael DiNardi, 2017. "Affordable Care Act Medicaid Expansions and the Impact on Nurses," 2017 Papers pdi509, Job Market Papers.
    6. Kai Fischer, 2023. "Skilled Labour Migration and Firm Performance: Evidence from English Hospitals and Brexit," CESifo Working Paper Series 10747, CESifo.
    7. Jonathan Gruber & Samuel A. Kleiner, 2012. "Do Strikes Kill? Evidence from New York State," American Economic Journal: Economic Policy, American Economic Association, vol. 4(1), pages 127-157, February.
    8. Christoph Schwierz & Boris Augurzky & Axel Focke & Jürgen Wasem, 2012. "Demand, selection and patient outcomes in German acute care hospitals," Health Economics, John Wiley & Sons, Ltd., vol. 21(3), pages 209-221, March.
    9. Cook, Andrew & Gaynor, Martin & Stephens Jr, Melvin & Taylor, Lowell, 2012. "The effect of a hospital nurse staffing mandate on patient health outcomes: Evidence from California's minimum staffing regulation," Journal of Health Economics, Elsevier, vol. 31(2), pages 340-348.
    10. Pham, Tho & Talavera, Oleksandr & Tsapin, Andriy, 2018. "Shock contagion, asset quality and lending behavior," BOFIT Discussion Papers 21/2018, Bank of Finland Institute for Emerging Economies (BOFIT).
    11. Gabriel A. Facchini Palma, 2020. "Low Staffing in the Maternity Ward: Keep Calm and Call the Surgeon," Working Papers wpdea2009, Department of Applied Economics at Universitat Autonoma of Barcelona.
    12. Mindy Marks & Moonkyung Kate Choi, 2019. "Baby Boomlets and Baby Health: Hospital Crowdedness, Hospital Spending, and Infant Health," American Journal of Health Economics, University of Chicago Press, vol. 5(3), pages 376-406, Summer.
    13. Cristina Borra & Jerònia Pons-Pons & Margarita Vilar-Rodríguez, 2020. "Austerity, healthcare provision, and health outcomes in Spain," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(3), pages 409-423, April.
    14. Siciliani, Luigi & Stanciole, Anderson & Jacobs, Rowena, 2009. "Do waiting times reduce hospital costs?," Journal of Health Economics, Elsevier, vol. 28(4), pages 771-780, July.
    15. Doyle Jr., Joseph J. & Ewer, Steven M. & Wagner, Todd H., 2010. "Returns to physician human capital: Evidence from patients randomized to physician teams," Journal of Health Economics, Elsevier, vol. 29(6), pages 866-882, December.
    16. Beomsoo Kim & Minjee Kim, 2012. "The Mortality of Newborns and Nurse Staffing Levels," Discussion Paper Series 1204, Institute of Economic Research, Korea University.
    17. Topi Miettinen & Olli Ropponen & Pekka Sääskilahti, 2020. "Prospect Theory, Fairness, and the Escalation of Conflict at a Negotiation Impasse," Scandinavian Journal of Economics, Wiley Blackwell, vol. 122(4), pages 1535-1574, October.
    18. Carol Propper & George Stoye & Ben Zaranko, 2020. "The Wider Impacts of the Coronavirus Pandemic on the NHS," Fiscal Studies, John Wiley & Sons, vol. 41(2), pages 345-356, June.
    19. Marc Beltempo & Georges Bresson & Guy Lacroix, 2020. "Using Machine Learning to Predict Nosocomial Infections and Medical Accidents in a NICU," CIRANO Working Papers 2020s-21, CIRANO.
    20. Peter McHenry & Jennifer Mellor, 2018. "Medicare hospital payment adjustments and nursing wages," International Journal of Health Economics and Management, Springer, vol. 18(2), pages 169-196, June.

    More about this item

    Keywords

    Doctor strikes; Medical strikes; Junior doctors; Healthcare inequalities;
    All these keywords.

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • J52 - Labor and Demographic Economics - - Labor-Management Relations, Trade Unions, and Collective Bargaining - - - Dispute Resolution: Strikes, Arbitration, and Mediation

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:jeborg:v:212:y:2023:i:c:p:689-707. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/locate/jebo .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.