IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v19y2022i16p10085-d888703.html
   My bibliography  Save this article

The Impact of the COVID-19 Pandemic on Physicians’ Working Hours and Earnings in São Paulo and Maranhão States, Brazil

Author

Listed:
  • Bruno Luciano Carneiro Alves de Oliveira

    (Program in Public Health, Federal University of Maranhão, São Luís 65080-805, Brazil)

  • Lucas Salvador Andrietta

    (Department of Preventive Medicine, University of São Paulo, Piracicaba 13416-000, Brazil)

  • Regimarina Soares Reis

    (Joaquim Venâncio Polytechnic School of Health, Oswaldo Cruz Foundation, Rio de Janeiro 21040-900, Brazil)

  • Ruth Helena de Souza Britto Ferreira de Carvalho

    (Program in Public Health, Federal University of Maranhão, São Luís 65080-805, Brazil)

  • Maria Teresa Seabra Soares de Britto e Alves

    (Program in Public Health, Federal University of Maranhão, São Luís 65080-805, Brazil)

  • Mário César Scheffer

    (Department of Preventive Medicine, University of São Paulo, Piracicaba 13416-000, Brazil)

  • Giuliano Russo

    (Wolfson Institute of Population Health, Queen Mary University of London, London E1 4NS, UK)

Abstract

Evidence exists on the health impacts of the current COVID-19 pandemic on health workers, but less is known about its impact on their work dynamics and livelihoods. This matters, as health workers—and physicians in particular—are a scarce and expensive resource in low- and middle-income countries (LMICs). Our cross-sectional survey set out to explore changes in working hours and earnings during the second year of the pandemic in a representative sample of 1183 physicians in Brazil’s São Paulo (SP) and Maranhão (MA) states. Descriptive analysis and inferential statistics were employed to explore differences in working hours and earnings among public and private sector physicians across the two locations. The workloads and earnings of doctors working exclusively in the public sector increased the most in the second year of the epidemic, particularly in MA. Conversely, the largest proportion of private-only doctors in our sample saw a decrease in their working hours (48.4%, 95% CI 41.8–55.0), whereas the largest proportion of public-only doctors in MA saw an increase in their working hours (44.4%, 95% CI 38.0–50.8). Although earnings remained broadly stable in the public sector, a third of public sector-only physicians in MA saw an increase in their earnings (95% CI 24.4–36.2). More than half of private-only doctors across both states saw a decrease in their earnings (52.2%, 95% CI 45.6–58.8). The largest proportion of dual practitioners (the majority in Brazil and in our sample) maintained their pre-pandemic levels of income (38.8%, 95% CI 35.3–42.3). As public-sector doctors have been key in the fight against the pandemic, it is critical to invest in these cadres in order to develop epidemic preparedness in LMICs, and to find new ways to harness for-profit actors to deliver social benefits.

Suggested Citation

  • Bruno Luciano Carneiro Alves de Oliveira & Lucas Salvador Andrietta & Regimarina Soares Reis & Ruth Helena de Souza Britto Ferreira de Carvalho & Maria Teresa Seabra Soares de Britto e Alves & Mário C, 2022. "The Impact of the COVID-19 Pandemic on Physicians’ Working Hours and Earnings in São Paulo and Maranhão States, Brazil," IJERPH, MDPI, vol. 19(16), pages 1-13, August.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:16:p:10085-:d:888703
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/19/16/10085/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/19/16/10085/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Giuliano Russo & Maria Luiza Levi & Maria Teresa Seabra Soares de Britto e Alves & Bruno Luciano Carneiro Alves de Oliveira & Ruth Helena de Souza Britto Ferreira de Carvalho & Lucas Salvador Andriett, 2020. "How the ‘plates’ of a health system can shift, change and adjust during economic recessions: A qualitative interview study of public and private health providers in Brazil’s São Paulo and Maranhão sta," PLOS ONE, Public Library of Science, vol. 15(10), pages 1-20, October.
    2. Michele Gragnolati & Magnus Lindelow & Bernard Couttolenc, 2013. "Twenty Years of Health System Reform in Brazil : An Assessment of the Sistema Único de Saúde," World Bank Publications - Books, The World Bank Group, number 15801, December.
    3. De Jaegher, Kris & Jegers, Marc, 2000. "A model of physician behaviour with demand inducement," Journal of Health Economics, Elsevier, vol. 19(2), pages 231-258, March.
    4. Russo, Giuliano & Paim, Maria Luiza Levi & de Britto e Alves, Maria Teresa Seabra Soares & de Oliveira, Bruno Luciano Carneiro Alves & de Souza Britto Ferreira de Carvalho, Ruth Helena & Andrietta, Lu, 2020. "How the ‘plates’ of a health system can shift, change and adjust during economic recessions. A qualitative interview study of public and private health providers in Brazil’s São Paulo and Maranhão sta," SocArXiv qtgux, Center for Open Science.
    5. McPake, Barbara & Russo, Giuliano & Tseng, Fu-Min, 2014. "How do dual practitioners divide their time? The cases of three African capital cities," Social Science & Medicine, Elsevier, vol. 122(C), pages 113-121.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Bernard Fortin & Nicolas Jacquemet & Bruce Shearer, 2008. "Policy Analysis in Health-Services Market: Accounting for Quality and Quantity," Annals of Economics and Statistics, GENES, issue 91-92, pages 293-319.
    2. ILes, Richard, 2017. "Government Doctor Absenteeism And Its Effects On Consumer Demand In Rural North India," Working Papers 2018-9, School of Economic Sciences, Washington State University, revised 12 2018.
    3. Lê, Gillian & Morgan, Rosemary & Bestall, Janine & Featherstone, Imogen & Veale, Thomas & Ensor, Tim, 2016. "Can service integration work for universal health coverage? Evidence from around the globe," Health Policy, Elsevier, vol. 120(4), pages 406-419.
    4. Bhalotra, Sonia & Rocha, Rudi & R. Soares, Rodigo, 2016. "Does universalization of health work? Evidence from health systems restructuring and maternal and child health in Brazil," ISER Working Paper Series 2016-16, Institute for Social and Economic Research.
    5. Giuliano Russo & Maria Luiza Levi & Maria Teresa Seabra Soares de Britto e Alves & Bruno Luciano Carneiro Alves de Oliveira & Ruth Helena de Souza Britto Ferreira de Carvalho & Lucas Salvador Andriett, 2020. "How the ‘plates’ of a health system can shift, change and adjust during economic recessions: A qualitative interview study of public and private health providers in Brazil’s São Paulo and Maranhão sta," PLOS ONE, Public Library of Science, vol. 15(10), pages 1-20, October.
    6. Maurus Rischatsch & Maria Trottmann, 2009. "Physician dispensing and the choice between generic and brand-name drugs – Do margins affect choice?," SOI - Working Papers 0911, Socioeconomic Institute - University of Zurich.
    7. Kris De Jaegher & Marc Jegers, 2001. "The physician–patient relationship as a game of strategic information transmission," Health Economics, John Wiley & Sons, Ltd., vol. 10(7), pages 651-668, October.
    8. J. G. Smythe, 2002. "Reputation, public information, and physician adoption of an innovation," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 3(2), pages 103-110, June.
    9. Winand Emons, 2013. "Incentive-Compatible Reimbursement Schemes for Physicians," Journal of Institutional and Theoretical Economics (JITE), Mohr Siebeck, Tübingen, vol. 169(4), pages 605-620, December.
    10. Leo Turcotte & John Robst & Solomon Polachek, 2006. "Medical interventions among pregnant women in fee-for-service and managed care insurance: a propensity score analysis," Applied Economics, Taylor & Francis Journals, vol. 38(13), pages 1513-1525.
    11. Bhalotra, Sonia R. & Rocha, Rudi & Soares, Rodrigo R., 2019. "Does Universalization of Health Work? Evidence from Health Systems Restructuring and Expansion in Brazil," IZA Discussion Papers 12111, Institute of Labor Economics (IZA).
    12. Laura Botega & Mônica Viegas Andrade & Gilvan Ramalho Guedes, 2020. "Brazilian hospitals’ performance: an assessment of the unified health system (SUS)," Health Care Management Science, Springer, vol. 23(3), pages 443-452, September.
    13. dos Santos, Anderson Moreira Aristides & Triaca, Lívia Madeira & Tejada, Cesar Augusto Oviedo, 2021. "Evolution of inequalities in health care use among older people in Brazil: Evidence for the period 1998–2019," The Journal of the Economics of Ageing, Elsevier, vol. 20(C).
    14. Philippe Batifoulier & Nicolas Da Silva, 2014. "The economic behaviour of doctors: medical altruism without an ethic?," EconomiX Working Papers 2014-9, University of Paris Nanterre, EconomiX.
    15. Sisira Sarma & Wayne Simpson, 2006. "A microeconometric analysis of Canadian health care utilization," Health Economics, John Wiley & Sons, Ltd., vol. 15(3), pages 219-239, March.
    16. Ferreira-Batista, Natalia N. & Postali, Fernando Antonio Slaibe & Diaz, Maria Dolores Montoya & Teixeira, Adriano Dutra & Moreno-Serra, Rodrigo, 2022. "The Brazilian Family Health Strategy and adult health: Evidence from individual and local data for metropolitan areas," Economics & Human Biology, Elsevier, vol. 46(C).
    17. Christel E. van Dijk & Bernard van den Berg & Robert A. Verheij & Peter Spreeuwenberg & Peter P. Groenewegen & Dinny H. de Bakker, 2013. "Moral Hazard And Supplier‐Induced Demand: Empirical Evidence In General Practice," Health Economics, John Wiley & Sons, Ltd., vol. 22(3), pages 340-352, March.
    18. Soroush Saghafian & Wallace J. Hopp, 2020. "Can Public Reporting Cure Healthcare? The Role of Quality Transparency in Improving Patient–Provider Alignment," Operations Research, INFORMS, vol. 68(1), pages 71-92, January.
    19. Maurus Rischatsch & Maria Trottmann & Peter Zweifel, 2013. "Generic substitution, financial interests, and imperfect agency," International Journal of Health Economics and Management, Springer, vol. 13(2), pages 115-138, June.
    20. Adam Wagstaff & Daniel Cotlear & Patrick Hoang-Vu Eozenou & Leander R. Buisman, 2016. "Measuring progress towards universal health coverage: with an application to 24 developing countries," Oxford Review of Economic Policy, Oxford University Press and Oxford Review of Economic Policy Limited, vol. 32(1), pages 147-189.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:gam:jijerp:v:19:y:2022:i:16:p:10085-:d:888703. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.