Assessment of the impact of the COVID-19 pandemic on the productivity of teaching hospitals in Brazil.

IF 2.5 Q1 Multidisciplinary
Epidemiologia e Servicos de Saude Pub Date : 2024-12-06 eCollection Date: 2024-01-01 DOI:10.1590/S2237-96222024v33e20231176.en
Maria Stella de Castro Lobo, Marcos Pereira Estellita Lins, Henrique de Castro Rodrigues, Gabriel Martins Soares
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引用次数: 0

Abstract

Objectives: To analyze the influence of the COVID-19 pandemic on the productivity of general teaching hospitals in Brazil, by region and legal entity, and to propose parameters of care.

Methods: This was an observational study by means of mathematical modeling with data envelopment analysis and Malmquist index, using data on inputs and healthcare output before (2019) and during (2021) the pandemic.

Results: A total of 149 general teaching hospitals were analyzed, 32 of which were considered efficient. There was a decrease in productivity across all regions and legal entity. To bring all inefficient hospitals to the efficiency frontier generated by the model, there is a need to increase output by 2,205,856 (96.5%) hospitalizations and 872,264 (107.4%) surgeries.

Conclusion: The decline in hospital productivity resulted from the social commitment of hospitals during the pandemic, with a change in the care delivery pattern. The mathematical model used allows for the generation of parameters to facilitate the efficient recovery of care services after the end of public health emergency, and can be applied to hospital planning.

Main results: The COVID-19 pandemic led to a reduction in productivity of general teaching hospitals in Brazil across all regions and in all legal entity types. In order to recover, these hospitals will need to increase their average hospitalizations by 96.5% and surgeries by 107.4%.

Implications for services: The study presents a methodology that can be adapted and replicated in the management of healthcare services in the country, by defining an efficiency score and calculating the parameters, in a scenario of care recovery following the end of the public health emergency.

Perspectives: Additional qualitative analysis and application of DEA- Malmquist in subsequent years will validate dynamic planning, which considers multiple fluctuations and the influence of new factors and contexts that impact productivity (such as the pandemic).

评估COVID-19大流行对巴西教学医院生产力的影响。
目的:分析新冠肺炎大流行对巴西综合教学医院生产力的影响,并按地区和法人单位划分,提出护理参数。方法:本研究是一项观察性研究,采用数据包络分析和Malmquist指数的数学建模,使用大流行之前(2019年)和期间(2021年)的投入和医疗产出数据。结果:共对149家综合教学医院进行分析,其中32家为高效医院。所有地区和法人实体的生产力都有所下降。为了使所有效率低下的医院都达到该模型所产生的效率边界,需要增加住院人数2,205,856人次(96.5%)和手术人数872,264人次(107.4%)。结论:大流行期间医院的社会承诺导致了医院生产力的下降,并改变了医疗服务模式。所使用的数学模型允许生成参数,以促进公共卫生紧急事件结束后护理服务的有效恢复,并可应用于医院规划。主要结果:2019冠状病毒病大流行导致巴西所有地区和所有法人实体类型的综合教学医院的生产力下降。为了恢复,这些医院的平均住院人数需要增加96.5%,手术人数需要增加107.4%。对服务的影响:该研究提出了一种方法,通过确定效率评分和计算参数,在公共卫生紧急情况结束后的护理恢复情况下,可以在该国的医疗保健服务管理中加以调整和复制。展望:在随后的几年中,进一步的定性分析和DEA- Malmquist的应用将验证动态规划,该规划考虑了多重波动以及影响生产力的新因素和背景(如大流行)的影响。
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来源期刊
Epidemiologia e Servicos de Saude
Epidemiologia e Servicos de Saude PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
4.90
自引率
0.00%
发文量
88
审稿时长
21 weeks
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