The Impact of the COVID-19 Pandemic on Public Hospitals Performance Indicators in Iran: an Interrupted Time-series Analysis

Abstract

Background The Covid-19 pandemic stretched health systems globally including in Iran. Hospital demand and performance was affected both directly and indirectly as a result of the pandemic. Analyzing hospital indicators can provide insights to deal with the consequences and challenges related to various aspects of future pandemics. Objective This study aimed to investigate the impact of the Covid-19 pandemic on key performance indicators of public hospitals in Iran. Methods We used time-series analysis to examine six key indicators of hospital performance: average length of stay, hospital mortality rate, number of surgeries, hospitalization rate, emergency visits, and bed occupancy rate. Data were extracted from four public hospitals in Yazd at two time intervals, 15 months before and after the outbreak of COVID-19. Data were analysed using interrupted time series analysis models with STATA17. Results Average length of stay (p = 0.02) and hospital mortality rate (p < 0.01) increased significantly following the outbreak of COVID-19, while the mean of other indicators such as number of surgeries (p = 0.01), hospitalization rate (p < 0.01), emergency visits (p < 0.01) and bed occupancy rate (p < 0.01) decreased significantly. The Covid-19 pandemic had an immediately reverse significant impact on the level changes of "hospitalization rate", "emergency visits" and "bed occupancy rate" indicators (p < 0.05). although the trend of surgeries indicator was affected significantly (p = 0.01) after the covid-19 outbreak. Conclusion We showed significant changes in most hospital indicators after the Covid-19 pandemic, reflecting the effect of this pandemic on the performance of hospitals. Understanding the impact of a pandemic on hospital indicators is necessary for decision-makers to effectively plan an effective pandemic response and to inform resource allocation decisions.