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Difficult Choices for California’s Hospitals

As the virus spreads, the number of Covid-19 patients in hospitals rises and the number of healthcare workers available falls. Hospitals must make difficult choices about which patients to treat—those with Covid-19 or those wanting elective surgeries. In this post, we use the economic way of thinking to analyze this problem in California.

What do the data tell us?

Click here to watch a short video to see what the data tell us or work through the interactive below.

The takeaway: These data show that as the number of Covid-19 patients increases, the percentage of hospitals with a critical staffing shortage also increases.

Let’s now look at the economic problem faced by hospitals in California.

Does a hospital face a tradeoff when it treats Covid-19 patients?

Yes: A hospital faces a tradeoff between treating Covid-19 patients and other patients. To treat more Covid-19 patients, a hospital must perform fewer elective surgeries.

What is the benefit of providing medical treatment to Covid-19 patients and who receives the benefit?

The benefit of treating Covid-19 patients is improved health for the patients and a smaller spread of the virus to others. So, treating Covid-19 patients is in the self-interest of the patients and in the social interest—the interest of everyone who avoids Covid-19 by limiting its spread.

What is the cost of providing medical treatment to Covid-19 patients?

The cost of treating Covid-19 patients is the forgone alternative—an opportunity cost. When healthcare services are used to treat Covid-19 patients, they cannot be used to treat other patients. Not treating other patients is the cost of treating Covid-19 patients.

How do hospitals make a rational choice about the number of Covid-19 patients to admit?

Hospitals make a rational choice by comparing the cost and benefit of admitting one more Covid-19 patient and admitting the number of patients that achieves the greatest benefit over cost.

What incentive might a hospital offer its patients to decrease the number requesting elective surgeries?

A hospital might offer a higher price for a non-life-threatening elective surgery or a lower the price for those willing to wait longer for elective surgery.

Work these questions to check your understanding and get instant feedback.

Answer the following questions to check your understanding of the story.

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What do the data on Covid-19 patients in hospital and critical staff shortages show?

The data show that ________________.

Play the video again and notice the fluctuations in the critical shortage of staff.

Play the video again and notice that the number of Covid-19 patients in ICU was a small percentage of the total Covid-19 patients.

The critical staffing shortage decreased through June 2021 but by January 2022 it was back to 40 percent.

More beds for Covid-19 patients is a benefit from canceling elective surgeries.

Canceling elective surgeries decreases the risk of spreading Covid-19 infection. Decreasing the Covid-19 risk is a benefit of canceling elective surgeries.

The number of Covid-19 patients peaked in January 2021.

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Do hospitals in California face a tradeoff?

_____________ face a tradeoff because ____________.

Hospitals do face a tradeoff, but why? What is a tradeoff?

Hospitals are free to choose but they still face a tradeoff. What is it?

Hospitals have limited resources, so they face a tradeoff. What is the tradeoff they face?

With the resources available, hospitals must decide which patients to treat. They face a tradeoff between treating Covid-19 patients or treating those wanting elective surgeries.

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How does a hospital make a rational decision about the number of Covid-19 patients to treat?

A hospital makes a rational decision by comparing the _____________.

A hospital makes a rational decision about which patients to treat by comparing the benefit of treating each type of patient with its cost.

A hospital’s decision is a rational decision if it treats all the patients for which the marginal benefit of treatment exceeds or equals the marginal cost.

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