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

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

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.

Suggested Citation

  • Bosque-Mercader, Laia & Conroy, Simon & Lasserson, Daniel & Mannion, Russell & Nicodemo, Catia & Wittenberg, Raphael, 2025. "Resilience of the acute sector in recovery from COVID-19 pressures," Social Science & Medicine, Elsevier, vol. 375(C).
    • Handle: RePEc:eee:socmed:v:375:y:2025:i:c:s0277953625003922
    DOI: 10.1016/j.socscimed.2025.118062
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    1. Nicholas Bloom & Carol Propper & Stephan Seiler & John Van Reenen, 2015. "The Impact of Competition on Management Quality: Evidence from Public Hospitals," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 82(2), pages 457-489.
    2. Reinhard Schunck, 2013. "Within and between estimates in random-effects models: Advantages and drawbacks of correlated random effects and hybrid models," Stata Journal, StataCorp LLC, vol. 13(1), pages 65-76, March.
    3. Langford, Ian H. & Bentham, Graham, 1996. "Regional variations in mortality rates in England and Wales: An analysis using multi-level modelling," Social Science & Medicine, Elsevier, vol. 42(6), pages 897-908, March.
    4. Engy Ziedan & Kosali I. Simon & Coady Wing, 2020. "Effects of State COVID-19 Closure Policy on NON-COVID-19 Health Care Utilization," NBER Working Papers 27621, National Bureau of Economic Research, Inc.
    5. Moscelli, Giuseppe & Gravelle, Hugh & Siciliani, Luigi, 2023. "The effect of hospital choice and competition on inequalities in waiting times," Journal of Economic Behavior & Organization, Elsevier, vol. 205(C), pages 169-201.
    6. Joan Costa‐Font & Edward C. Norton & Luigi Siciliani & James Gaughan & Hugh Gravelle & Luigi Siciliani, 2017. "Delayed Discharges and Hospital Type: Evidence from the English NHS," Fiscal Studies, Institute for Fiscal Studies, vol. 38, pages 495-519, September.
    7. Gaughan, James & Siciliani, Luigi & Gravelle, Hugh & Moscelli, Giuseppe, 2020. "Do small hospitals have lower quality? Evidence from the English NHS," Social Science & Medicine, Elsevier, vol. 265(C).
    8. Rachet-Jacquet, Laurie & Gutacker, Nils & Siciliani, Luigi, 2021. "Scale economies in the health sector: The effect of hospital volume on health gains from hip replacement surgery," Journal of Economic Behavior & Organization, Elsevier, vol. 190(C), pages 704-729.
    9. Fleming, Pádraic & O'Donoghue, Catherine & Almirall-Sanchez, Arianna & Mockler, David & Keegan, Conor & Cylus, Jon & Sagan, Anna & Thomas, Steve, 2022. "Metrics and indicators used to assess health system resilience in response to shocks to health systems in high income countries—A systematic review," Health Policy, Elsevier, vol. 126(12), pages 1195-1205.
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