Do strikes harm patients? Evidence is limited

The narrative that strikes threaten patient safety is not substantiated by current evidence, researchers wrote in a March 10 analysis published in The BMJ. 

Available research on the relationship between strikes and patient harm is limited and offers mixed results, most of which are not widely generalizable across different care settings, researchers said. 

A 2022 meta-analysis of studies covering more than 1.8 million admissions or care interactions globally found "no clear negative effects of strike action on patient mortality," researchers wrote. However, one 2012 study included in the analysis — which assessed more than 20 years' worth of patient mortality data from hospitals in New York state — found in-hospital mortality was 18 percent higher for patients treated during a nurses' strike.

Overall, researchers involved in The BMJ study observed a substantial decrease in the number of admissions or care visits during strikes, with broader care delivery changes varying based on who is striking. For example, when early-career physicians strike, research suggests wait times and length of stay are unaffected or become shorter. 

"While patient safety obviously matters, the overly narrow framing of strikes as harmful to patients is not supported by current evidence; this also shifts focus away from the structural failings that drive strike action in the first place," researchers wrote. "When health workers lack other avenues to enact change, failing to strike against suboptimal working conditions may actually be more harmful to patient health in the long run."

The analysis' authors are affiliated with the University of Greenwich in London, Columbia University in New York City and the University of British Columbia in Vancouver, Canada. 

Read the full analysis here.

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