The impact of strike action on patient morbidity: A systematic literature review

Abstract

Strike action in healthcare has been common over the last several decades. The overarching aim of this systematic review was to synthesise and analyse the empirical literature that examines the impact of strike action on patient morbidity, that is, all patient outcomes except mortality. After conducting a search and apply eligibility criteria, 15 studies were included in this review. These articles included a variety of outcomes from hypertension control to rates of chlamydia. Strikes ranged from 13 to 118 days, with a mean strike length of 56 days. A textual narrative synthesis was employed to arrange studies by whether they had a positive, mixed or neutral or negative impact on patient morbidity.Results suggest that strike action has little impact on patient morbidity. The majority of studies reported that strike action had a neutral or mixed impact of strike action on patient morbidity. One study reported positive outcomes and three studies reported negative outcomes, however in both cases, the impact that the strike had was marginal.

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

“…While our results say little about the impact that strike action has on health care delivery, our results are consistent with a broader body of work that suggests that strike action has minimal impact on a range of other patient outcomes, 37 and past work on the impact of strike action on mortality. 38 At a minimum, this review suggests that strike action by health care workers can be conducted safely as it relates to patient mortality.…”

The impact of strike action on healthcare delivery: A scoping review

“…It is also noteworthy that in many cases, emergency services were able to be maintained or contingencies put in place to continue to deliver care with minimal disruption. On the second point, patient safety, it is difficult to comment on all elements of patient safety with the findings from this review alone, however and with the evidence noted in the introduction about patient morbidity 6 and mortality 7 during strike action, this body of evidence suggests that while disruptive, strikes can generally be conducted safely. There are of course several caveats, notably the more general limitations related to this evidence and the fact that strike action can come in a range of forms and have vastly different impacts on services.…”

“…Overwhelmingly arguments both for and against have focussed on patient mortality and other outcomes 5 . Two recent systematic reviews have shed some light on these debates, with both indicating that strike action had little impact on in‐hospital patient morbidity 6 and in‐hospital and population mortality 7 . These studies alone however paint a somewhat limited picture.…”

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

“…An additional limitation of data on the health effects of strike action by healthcare workers is the narrow focus on a few specific outcomes (mostly mortality), sometimes limited to only public or only private services 20. This means other effects on the health system might have been missed.…”