來源: Doctors' strikes and mortality: a review
Doctors' strikes and mortality: a review.
Abstract
A paradoxical pattern has been suggested in the literature on doctors' strikes: when health workers go on strike, mortality stays level or decreases. We performed a review of the literature during the past forty years to assess this paradox. We used PubMed, EconLit and Jstor to locate all peer-reviewed English-language articles presenting data analysis on mortality associated with doctors' strikes. We identified 156 articles, seven of which met our search criteria. The articles analyzed five strikes around the world, all between 1976 and 2003. The strikes lasted between nine days and seventeen weeks. All reported that mortality either stayed the same or decreased during, and in some cases, after the strike. None found that mortality increased during the weeks of the strikes compared to other time periods. The paradoxical finding that physician strikes are associated with reduced mortality may be explained by several factors. Most importantly, elective surgeries are curtailed during strikes. Further, hospitals often re-assign scarce staff and emergency care was available during all of the strikes. Finally, none of the strikes may have lasted long enough to assess the effects of long-term reduced access to a physician. Nonetheless, the literature suggests that reductions in mortality may result from these strikes.該綜述分析了1976年至2003年40年間世界各地發生的醫生罷工與死亡率之間的關係，罷工持續時間9天至17周，期間總死亡率保持不變或有降低。分析認為雖然影響死亡率的因素是複雜的，但是最重要的原因歸於罷工期間擇期手術的減少。而且，在罷工期間醫院通常保證重症醫療和急診工作正常進行，是死亡率沒有增加的重要原因。雖然，沒有任何的罷工持續了足夠長的時間用以評估長期缺乏醫療對於死亡率影響，然而，文獻分析表明，醫生罷工的確與死亡率的降低相關。
