Research Article: What happened to health labour markets during COVID-19? Insights from the analysis of cross-sectional survey data on the perceptions of medical doctors in Brazil
Abstract:
Objectives To examine physicians’ perceptions of changing employment opportunities in Brazil, and gain an insight into labour markets in low/middle-income countries (LMICs) during the pandemic. Study design Descriptive and inferential analysis of a quantitative dataset from a representative cross-sectional survey of physicians of two Brazilian states. Settings São Paulo and Maranhão states in Brazil. Participants Representative sample of 1183 physicians. Outcome measures We estimated prevalence and 95% CIs for physicians’ perceptions of changes in demand and supply of doctors, as well as changes in prices of medical services for facilities of practice in the two states, stratified by public, private and dual-practice physicians. Results Most doctors reported increased job opportunities in the public sector (54.9%, 95%?CI 52.0% to 57.7%), particularly in Maranhão state (65.0%, 95%?CI 60.9% to 68.9%). For the private sector, increased opportunities were reported only in large private hospitals (46.7%, 95%?CI 43.9% to 49.6%) but not in smaller clinics. We recorded perceptions of slight increases in availability of doctors in Maranhão, particularly in the public sector (51.4%, 95%?CI 43.2% to 59.5%). Younger doctors recounted increased vacancies in the public sector (64%, 95%?CI 58.1% to 68.1%), older doctors only in walk-in clinics in Maranhão (47.5%, 95%?CI 39.9% to 55.1%). Those working directly with patients with COVID-19 saw opportunities in public hospitals (65%, 95%?CI 62.3% to 68.4%) and in large private ones (55%, 95%?CI 51.8% to 59.1%). Conclusions Our findings hint that health labour markets in LMICs may not necessarily shrink during epidemics, and that impacts will depend on the balance of public and private services in national health systems.
Introduction:
The COVID-19 pandemic and the ensuing economic crisis have had an unparalleled impact on population health, 1 national economies 2 and working modalities. 3 A recent Organisation for Economic Co-operation and Development report presents evidence on the ways labour markets have changed due to pandemic-related lockdown measures, as businesses were disrupted and workers furloughed or laid off. 4 The economic literature has so far suggested that health labour markets are ‘recession proof’, that is, one of the few…
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