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The Impact of the COVID-19 Pandemic on Physicians’ Working Hours and Earnings in São Paulo and Maranhão States, Brazil

Author

Listed:
  • Bruno Luciano Carneiro Alves de Oliveira

    (Program in Public Health, Federal University of Maranhão, São Luís 65080-805, Brazil)

  • Lucas Salvador Andrietta

    (Department of Preventive Medicine, University of São Paulo, Piracicaba 13416-000, Brazil)

  • Regimarina Soares Reis

    (Joaquim Venâncio Polytechnic School of Health, Oswaldo Cruz Foundation, Rio de Janeiro 21040-900, Brazil)

  • Ruth Helena de Souza Britto Ferreira de Carvalho

    (Program in Public Health, Federal University of Maranhão, São Luís 65080-805, Brazil)

  • Maria Teresa Seabra Soares de Britto e Alves

    (Program in Public Health, Federal University of Maranhão, São Luís 65080-805, Brazil)

  • Mário César Scheffer

    (Department of Preventive Medicine, University of São Paulo, Piracicaba 13416-000, Brazil)

  • Giuliano Russo

    (Wolfson Institute of Population Health, Queen Mary University of London, London E1 4NS, UK)

Abstract

Evidence exists on the health impacts of the current COVID-19 pandemic on health workers, but less is known about its impact on their work dynamics and livelihoods. This matters, as health workers—and physicians in particular—are a scarce and expensive resource in low- and middle-income countries (LMICs). Our cross-sectional survey set out to explore changes in working hours and earnings during the second year of the pandemic in a representative sample of 1183 physicians in Brazil’s São Paulo (SP) and Maranhão (MA) states. Descriptive analysis and inferential statistics were employed to explore differences in working hours and earnings among public and private sector physicians across the two locations. The workloads and earnings of doctors working exclusively in the public sector increased the most in the second year of the epidemic, particularly in MA. Conversely, the largest proportion of private-only doctors in our sample saw a decrease in their working hours (48.4%, 95% CI 41.8–55.0), whereas the largest proportion of public-only doctors in MA saw an increase in their working hours (44.4%, 95% CI 38.0–50.8). Although earnings remained broadly stable in the public sector, a third of public sector-only physicians in MA saw an increase in their earnings (95% CI 24.4–36.2). More than half of private-only doctors across both states saw a decrease in their earnings (52.2%, 95% CI 45.6–58.8). The largest proportion of dual practitioners (the majority in Brazil and in our sample) maintained their pre-pandemic levels of income (38.8%, 95% CI 35.3–42.3). As public-sector doctors have been key in the fight against the pandemic, it is critical to invest in these cadres in order to develop epidemic preparedness in LMICs, and to find new ways to harness for-profit actors to deliver social benefits.

Suggested Citation

  • Bruno Luciano Carneiro Alves de Oliveira & Lucas Salvador Andrietta & Regimarina Soares Reis & Ruth Helena de Souza Britto Ferreira de Carvalho & Maria Teresa Seabra Soares de Britto e Alves & Mário C, 2022. "The Impact of the COVID-19 Pandemic on Physicians’ Working Hours and Earnings in São Paulo and Maranhão States, Brazil," IJERPH, MDPI, vol. 19(16), pages 1-13, August.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:16:p:10085-:d:888703
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    References listed on IDEAS

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    1. McPake, Barbara & Russo, Giuliano & Tseng, Fu-Min, 2014. "How do dual practitioners divide their time? The cases of three African capital cities," Social Science & Medicine, Elsevier, vol. 122(C), pages 113-121.
    2. Giuliano Russo & Maria Luiza Levi & Maria Teresa Seabra Soares de Britto e Alves & Bruno Luciano Carneiro Alves de Oliveira & Ruth Helena de Souza Britto Ferreira de Carvalho & Lucas Salvador Andriett, 2020. "How the ‘plates’ of a health system can shift, change and adjust during economic recessions: A qualitative interview study of public and private health providers in Brazil’s São Paulo and Maranhão sta," PLOS ONE, Public Library of Science, vol. 15(10), pages 1-20, October.
    3. Michele Gragnolati & Magnus Lindelow & Bernard Couttolenc, 2013. "Twenty Years of Health System Reform in Brazil : An Assessment of the Sistema Único de Saúde," World Bank Publications - Books, The World Bank Group, number 15801.
    4. Russo, Giuliano & Paim, Maria Luiza Levi & de Britto e Alves, Maria Teresa Seabra Soares & de Oliveira, Bruno Luciano Carneiro Alves & de Souza Britto Ferreira de Carvalho, Ruth Helena & Andrietta, Lu, 2020. "How the ‘plates’ of a health system can shift, change and adjust during economic recessions. A qualitative interview study of public and private health providers in Brazil’s São Paulo and Maranhão sta," SocArXiv qtgux, Center for Open Science.
    5. De Jaegher, Kris & Jegers, Marc, 2000. "A model of physician behaviour with demand inducement," Journal of Health Economics, Elsevier, vol. 19(2), pages 231-258, March.
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