Special Issue "Economic Crisis and Healthcare Services"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Economics".

Deadline for manuscript submissions: 30 April 2021.

Special Issue Editor

Dr. Dimitris Zavras
E-Mail Website
Guest Editor
Department of Public Health Policy, School of Public Health, University of West Attica, 11521 Athens, Greece
Interests: access to healthcare services; utilization of healthcare services; unmet healthcare needs; healthcare provider choice; health status; impact of economic crises on health and healthcare

Special Issue Information

Dear Colleagues,

Economic crises cause sudden decreases in disposable income and the purchasing power of salaries and well-documented reductions in living conditions. They deplete public finance resources, including in healthcare, harm private business profitability and sustainability, and lead to increased unemployment. In such an environment of generalized uncertainty, healthcare establishments often make restructuring decisions that alter the delivery of care and the ability to care for the most vulnerable.

At the individual level, salary reductions and associated drops in disposable income, unemployment, and loss of insurance coverage all have detrimental effects on the person’s ability to seek affordable, quality, and accessible care. Reduced healthcare affordability coupled with the inability to pay for services results in unmet healthcare needs that have negative consequences on health. Some adverse effects on the population’s physical and psychological health and on overall wellbeing have been documented previously, pointing to the need for more research on the social determinants of health. 

At the global level, economic crises challenge healthcare’s ability to provide quality, affordable healthcare services that meet patients’ needs and expectations. The effects seem to be universal, although the severity of the effects does present significant variation. Decision making at the level of the healthcare system becomes more difficult due to increased uncertainty and alternatives which are more difficult to identify. The political landscape of individual countries and the boundaries on which healthcare operates make the comparison of national policies difficult. More discussion is needed along with appropriate analysis of empirical evidence to disentangle the effects of national policies and the identification of best practices.

The healthcare sector, more than any other sector of the economy, has limited margins of error or opportunities for delayed action or reaction. In addition to production goals, its complex governance must satisfy principles of equity, efficiency, effectiveness, and quality. Responding to economic downturns requires reflective, real-time collaboration at the level of policy making between governments, health professionals, researchers, academicians, patients’ communities, and stakeholders. However, this is not an easy task.

Thus, this Special Issue attempts to highlight the mechanisms upon which economic crises affect health, health outcomes, and healthcare-seeking behavior. It documents the need for expeditious and efficient interventions. In addition, it presents the empirical experience from policies that have been implemented to counterbalance the effects of a rapidly slowing economy and critically evaluates their results on health and healthcare. Evidence-based suggestions on the causes, the effects, and the response to the problem are within the scope of this Issue.

Furthermore, this Special Issue focuses on the economic consequences of the COVID-19 pandemic on individuals and households, healthcare providers, and healthcare systems. Decreases in incomes, increases in unemployment, financial uncertainty, reductions in living conditions, and the pressure exerted on healthcare systems are only some of such COVID-19 consequences, indicating humanity’s broad range of challenges attributed to the pandemic.

High-quality scientific and policy papers, both empirical and theoretical, from academicians and researchers are welcomed.


Dr. Dimitris J. Zavras
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2300 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • economic crises
  • income
  • unemployment
  • health status
  • healthcare services
  • healthcare affordability
  • healthcare seeking behavior
  • health policy
  • uncertainty
  • decision making

Published Papers (3 papers)

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Research

Open AccessArticle
Competency Model for the Middle Nurse Manager (MCGE-Logistic Level)
Int. J. Environ. Res. Public Health 2021, 18(8), 3898; https://doi.org/10.3390/ijerph18083898 - 08 Apr 2021
Viewed by 424
Abstract
Healthcare systems are immersed in transformative processes, influenced by economic changes, together with social and health instability. The middle nurse manager plays a fundamental role, since he or she is responsible for translating the strategic vision, values and objectives of the organization. The [...] Read more.
Healthcare systems are immersed in transformative processes, influenced by economic changes, together with social and health instability. The middle nurse manager plays a fundamental role, since he or she is responsible for translating the strategic vision, values and objectives of the organization. The objective of this study was to propose the model of competencies to be developed by the middle nurse manager in the Spanish healthcare system. Our methodology consisted in the application of the Delphi method in order to reach an agreement on the necessary competencies, and principal component analysis (PCA) was used to determine the construct validity, reducing the dimensionality of the set of data. Fifty-one competencies were identified for the definition of the model, highlighting decision-making, leadership and communication. The PCA pointed out the structural validity of the proposed model through the saturation of the main components (α Cronbach > 0.631). The results show the model of competencies which the middle nurse manager in the Spanish healthcare system must develop. Middle nurse managers may use these as criteria to plan their professional strategies in the context of management. This model of competencies can be applied to establishing selection processes or training programs for the role of middle nurse manager. Full article
(This article belongs to the Special Issue Economic Crisis and Healthcare Services)
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Open AccessArticle
How Do Pharmaceutical Companies Overcome a Corporate Productivity Crisis? Business Diversification into Medical Devices for Growth Potential
Int. J. Environ. Res. Public Health 2021, 18(3), 1045; https://doi.org/10.3390/ijerph18031045 - 25 Jan 2021
Viewed by 600
Abstract
The purpose of this study was to analyze the performance of pharmaceutical companies’ business diversification into medical devices in terms of their technical efficiency (TE) as compared to that of traditional pharmaceutical companies. For a total of 174 externally audited pharmaceutical companies engaged [...] Read more.
The purpose of this study was to analyze the performance of pharmaceutical companies’ business diversification into medical devices in terms of their technical efficiency (TE) as compared to that of traditional pharmaceutical companies. For a total of 174 externally audited pharmaceutical companies engaged in the drug product business between 2008 and 2019, pharmaceutical companies were classified into two groups according to medical device business diversification. The TE of pharmaceutical companies that diversify the medical device business was lower than that of traditional pharmaceutical companies. However, in terms of the meta-technology ratio (MTR) calculated using meta-frontier analysis, pharmaceutical companies diversified into medical devices showed higher MTR than the traditional pharmaceutical company group. The results imply that the corporate performance growth potential of traditional pharmaceutical companies is lower than that of pharmaceutical companies that have diversified into the medical device business. Full article
(This article belongs to the Special Issue Economic Crisis and Healthcare Services)
Open AccessArticle
Studying Healthcare Affordability during an Economic Recession: The Case of Greece
Int. J. Environ. Res. Public Health 2020, 17(21), 7790; https://doi.org/10.3390/ijerph17217790 - 24 Oct 2020
Cited by 1 | Viewed by 564
Abstract
The significant deterioration of economic prosperity in Greece during the economic crisis decreased patients’ ability to pay. Thus, the objective of this study is to determine the factors affecting healthcare affordability in Greece during an economic recession. This study used data from the [...] Read more.
The significant deterioration of economic prosperity in Greece during the economic crisis decreased patients’ ability to pay. Thus, the objective of this study is to determine the factors affecting healthcare affordability in Greece during an economic recession. This study used data from the European Union Statistics on Income and Living Conditions (EU-SILC) 2016. The sample consisted of 18,255 households. Healthcare affordability was regressed on geographic characteristics as well as several variables that refer to the households’ financial condition. Region of residence, ability to make ends meet, and capacity to cope with unexpected financial expenses were found to be statistically significant. Using sample sizes of 1000 and 1096 adults, respectively, the European Quality of Life Surveys (EQLS) of 2007 and 2016 were also used as data sources. Economic crisis was expressed with a dummy variable: (1) 0: 2007, and (2) 1: 2016. Difficulty in responding to healthcare costs was regressed on survey year and several demographic, socioeconomic, and health characteristics, revealing that individuals were more likely to face difficulties in responding to healthcare costs during the economic crisis. These results confirm the mechanism on the basis of which economic crises affect healthcare access: primarily through the effects of demand-side barriers. Full article
(This article belongs to the Special Issue Economic Crisis and Healthcare Services)
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