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

Essex, Ryan; Weldon, Sharon Marie; Thompson, Trevor; Kalocsányiová, Erika; McCrone, Paul; Deb, Sanjoy

doi:10.1111/1475-6773.14022

Cited by 25 publications

(22 citation statements)

References 34 publications

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“…This review also sits alongside at least three recent systemic and scoping reviews that explore strike action. Two of these studies examined the impact of strike action on patient outcomes, notably mortality and a range of other patient outcomes (such as hypertension control and chlamydia rates; Essex, Milligan, et al, 2022; Essex, Weldon, et al, 2022). Notably, while each review notes a number of limitations in regard to the literatre, it was found that strike action did not result in an increase in patient mortality and did not negatively impact a range of other patient outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…This search strategy has been published and applied elsewhere (Essex, Weldon, et al, 2022) The following databases were searched: EMBASE (1980–2021), MEDLINE (1946–2021), CINAHL (1982–2001), BIOETHICSLINE (1972–1999), EconLit (1969–2021), WEB OF SCIENCE (1960–2021). In addition, grey literature was searched through OPEN GREY and SIGMA REPOSITORY.…”

Section: Methodsmentioning

confidence: 99%

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A last resort? A scoping review of patient and healthcare worker attitudes toward strike action

et al. 2022

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While strike action has been common since the industrial revolution, it often invokes a passionate and polarising response, from the strikers themselves, from employers, governments and the general public. Support or lack thereof from health workers and the general public is an important consideration in the justification of strike action. This systematic review sought to examine the impact of strike action on patient and clinician attitudes, specifically to explore (1) patient and health worker support for strike action and (2) the predictors for supporting strike action and the reasons given for engaging in strike action. A systematic scoping review was employed to identify all relevant literature, followed by a textual narrative synthesis.A total of 34 studies met inclusion criteria. Support for strike action was largely context-dependent. A range of factors impact support for strike action; broader cultural and structural factors, such as unionisation and general acceptance of strike action; systemic factors, such as the nature of the healthcare system, including infrastructure and work conditions; the strike itself and a range of individual factors, the most notable of which was being a student or in an early career stage. There were also some surprising results, for example, during doctors strike, nurses were provided with the opportunity to expand their role, which led to greater professional autonomy and job satisfaction.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

A last resort? A scoping review of patient and healthcare worker attitudes toward strike action

et al. 2022

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“…A 2022 systematic review and meta-analysis of observational studies compared patient mortality during a healthcare worker strike with that before or after the strike. Across more than 1.8 million admissions or presentations to care, in the aggregate, there were no clear negative effects of strike action on patient mortality 16. However, studies included in the systematic review were highly variable in quality and setting, and several studies included in the meta-analysis suggested the possibility of patient harm from strikes.…”

Section: Are Patients Harmed By Strikes?mentioning

confidence: 99%

Strikes, patient outcomes, and the cost of failing to act

Essex¹,

Brophy²,

Sriram³

2023

BMJ

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“…The analysis by Essex et al 1 in this issue is a thorough and much‐needed review of physician strikes across numerous countries. It addresses an important question regarding the wisdom of extending labor law to physicians: whether allowing physicians to strike would lead to undesirable public health consequences.…”

Section: Introductionmentioning

confidence: 99%

Collective bargaining: Physician unions and their implications for health care

Bowling

Richman

2022

Health Services Research

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The analysis by Essex et al. 1 in this issue is a thorough and muchneeded review of physician strikes across numerous countries. It addresses an important question regarding the wisdom of extending labor law to physicians: whether allowing physicians to strike would lead to undesirable public health consequences. In finding little evidence that physician strikes are associated with higher mortality rates, it suggests that these concerns are relatively unfounded.We applaud the authors' efforts to counter the fear-mongering regarding physician unions, and we are not surprised by their findings. This is, in part, because concern over physician unions is largely based on a misunderstanding of what unions do and how US labor law manages disputes between workers and their employers. We begin with an introduction to US labor law and describe the governance roles that unions play in navigating labor disagreements. We ultimately argue that physician unions and collective bargaining can play a constructive role in improving patient outcomes. | WHAT IS A UNION?A union is an organization elected by a group of employees to bargain with its employer over "wages, hours, and other terms and conditions of employment." 2 The National Labor Relations Act does not require the employer to agree to employee demands, but to bargain in "good faith." 2 When a collectively bargained contract is reached, it binds all parties for the life of the agreement. The Act does not specify what "other terms and conditions of employment" means, but almost all contracts include agreements on wages, benefits, hours of work, work rules, and grievance procedures, as well as a prohibition on strikes and

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

Abstract: Objective: This study sought to evaluate the impact of health care strike action on patient mortality.

Cited by 25 publications

References 34 publications

A last resort? A scoping review of patient and healthcare worker attitudes toward strike action

A last resort? A scoping review of patient and healthcare worker attitudes toward strike action

Strikes, patient outcomes, and the cost of failing to act

Collective bargaining: Physician unions and their implications for health care

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