Resilience of the acute sector in recovery from COVID-19 pressures

IF 4.9 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Social Science & Medicine Pub Date : 2025-04-10 DOI:10.1016/j.socscimed.2025.118062

Laia Bosque-Mercader , Simon Conroy , Daniel Lasserson , Russell Mannion , Catia Nicodemo , Raphael Wittenberg

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引用次数: 0

Abstract

The COVID-19 pandemic had a profound impact on the management and delivery of acute healthcare. To tackle the pandemic, hospitals redesigned their organisational models to provide a rapid increase in acute care assessment and treatment capacity for patients with COVID-19 whilst also trying to maintain delivery of care for patients with non-COVID-19 healthcare needs. This capacity to adjust and recover after COVID-19 might be shaped by both measures taken by acute hospitals and wider hospital pre-pandemic characteristics. The aim of this study is to examine how hospital characteristics in acute care are associated with recovery of elective activity after the height of the COVID-19 pandemic compared to pre-pandemic levels. Using patient-level data from Hospital Episode Statistics aggregated at monthly-trust level for all English National Health Service (NHS) acute hospital trusts in 2019 and 2021, we estimate the associations between hospital recovery rate and hospital pre-pandemic characteristics by employing linear regressions of the proportional change over time in elective activity against a set of explanatory variables related to supply factors (e.g., hospital size, workforce, type of hospital, regional location), demand factors (e.g., population need, patient case-mix) and time factors. On average, English NHS acute hospital trusts did not fully recover from the COVID-19 pandemic in 2021. The results show that the explanatory variables are not systematically associated with hospital recovery rate, excepting regional differences. Hospital trusts not located in London, especially in the North of England, are associated with a lower recovery (less resilience) of total elective activity and orthopaedic and vascular surgical elective activity. The implication for policy development is that the evolution of hospital recovery rates in elective activity varied across English regions, especially for high-volume and high-risk elective specialties, with better recovery in London than elsewhere.

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急性部门在从COVID-19压力中恢复的韧性

2019冠状病毒病大流行对紧急医疗保健的管理和提供产生了深远影响。为了应对大流行，医院重新设计了其组织模式，以快速提高COVID-19患者的急性护理评估和治疗能力，同时努力保持对非COVID-19医疗保健需求患者的护理。这种在COVID-19后进行调整和恢复的能力可能受到急性医院采取的措施和更广泛的医院大流行前特征的影响。本研究的目的是研究与大流行前水平相比，在COVID-19大流行高峰后，急性护理中的医院特征与可选活动的恢复之间的关系。利用2019年和2021年所有英国国民健康服务（NHS）急性医院信托在每月信任水平上汇总的医院事件统计中的患者水平数据，我们通过对选择性活动随时间比例变化的线性回归，对与供应因素相关的一组解释变量(例如，医院规模、劳动力、医院类型、区域位置)、需求因素（如人口需求、患者病例组合）和时间因素。平均而言，英国NHS急性医院信托在2021年没有完全从COVID-19大流行中恢复过来。结果表明，除区域差异外，各解释变量与医院康复率无系统关联。医院信托不在伦敦，特别是在英格兰北部，与较低的恢复（弹性较差）的总选择性活动和骨科和血管外科选择性活动。这对政策发展的影响是，英国各地区选择性活动的医院康复率的演变各不相同，特别是对于高容量和高风险的选择性专业，伦敦的康复情况比其他地方好。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Social Science & Medicine PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

9.10

自引率

5.60%

发文量

762

审稿时长

38 days

期刊介绍： Social Science & Medicine provides an international and interdisciplinary forum for the dissemination of social science research on health. We publish original research articles (both empirical and theoretical), reviews, position papers and commentaries on health issues, to inform current research, policy and practice in all areas of common interest to social scientists, health practitioners, and policy makers. The journal publishes material relevant to any aspect of health from a wide range of social science disciplines (anthropology, economics, epidemiology, geography, policy, psychology, and sociology), and material relevant to the social sciences from any of the professions concerned with physical and mental health, health care, clinical practice, and health policy and organization. We encourage material which is of general interest to an international readership.