Hospital resilience in the Face of Covid-19 in France
A multilevel analysis of the impact of past practice quality on cancer surgery resumption
Bibliographic Data
| ID | 21467919 |
|---|---|
| Authors | Noémie Malléjac (0000-0002-7994-9715, Centre National de la Recherche Scientifique, corresponding author), Zeynep Or (0000-0002-6860-3735, Université Paris Cité) |
| Year | 2025 |
| Volume | 155 |
| Pages | 105309 |
| Publication date | 2025-05-01 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Health Policy (JOURNAL) |
| Journal identifiers | ISSN: 0168-8510 • E-ISSN: 1872-6054 |
| Publisher | Elsevier BV (PUBLISHER) |
| DOI | 10.1016/j.healthpol.2025.105309 |
| PMID | 40194341 |
| OpenAlex | W4408982419 |
| Language | EN |
| References cited | 64 |
The Covid-19 pandemic disrupted surgical activity and tested hospital resilience. • Hospitals with pre-pandemic surgery care protocols were more resilient. • They were quicker in resuming cancer surgery during the pandemic in 2020. • Widespread adoption of such protocols can improve both hospital quality and resilience. The COVID-19 pandemic disrupted routine hospital services, causing a substantial backlog of surgeries in 2020. This study investigates hospital resilience in resuming activities during the pandemic, focusing on the impact of pre-pandemic adoption of enhanced recovery after surgery protocols (ERAS) in digestive cancer surgery. ERAS involves patient-centered care protocols proven to improve care process and outcomes but are not systematically implemented in hospitals. We define hospital resilience as the ability to maintain and resume surgery levels in the second half of 2020 during the pandemic. Using French national hospital data for digestive cancer surgeries, we categorized hospitals by the intensity of their ERAS volume before the pandemic and estimated a multilevel model allowing to control for hospital characteristics and pandemic conditions in the area they are situated. Results show that, all else being equal, hospitals that implemented ERAS before the pandemic absorbed the surgical backlog and recovered their pre-pandemic activity level more quickly. High-volume hospitals and specialized cancer centers were also quicker than other hospitals in resuming surgical operations. The findings highlight the differences in care practices across hospitals and the importance of quality protocols in bolstering hospital resilience during health crises. Beyond improving patient outcomes, widespread adoption of such protocols could enhance healthcare resource utilization and help to mitigate broader economic and environmental pressures
2019-20 coronavirus outbreak · Cancer · Cancer surgery · Disease · Pandemic · Psychological resilience · Sociology · COVID-19 and healthcare impacts · Frailty in Older Adults · Health Systems, Economic Evaluations, Quality of Life · Medicine · Nursing · Psychology · Social Psychology · Internal Medicine · Virology
What Is Resilience and How Can It Be Nurtured? A Systematic Review of Empirical Literature on Organizational Resilience
Health-system resilience
Hospital Volume and Surgical Mortality in the United States
What is a resilient health system? Lessons from Ebola
Everyday resilience in district health systems
Fair Allocation of Scarce Medical Resources in the Time of Covid-19
Impact of Covid-19 pandemic on utilisation of healthcare services
Sufficient Sample Sizes for Multilevel Modeling
Global Cancer Statistics 2020
Role of hospitals in recovery from Covid-19
Global elective breast- and colorectal cancer surgery performance backlogs, attributable mortality and implemented health system responses during the Covid-19 pandemic
How to do (or not to do) … Assessing the impact of a policy change with routine longitudinal data
True Covid-19 mortality rates from administrative data
From bouncing back, to nurturing emergence
| Citation velocity | historical |
|---|---|
| Highly cited | No |