Hospital resilience: public versus private sector dynamics

Abstract This paper evaluates the recovery of elective admissions in Italian hospitals following the disruptions caused by the COVID-19 pandemic, with a particular focus on the dynamics between the public and private healthcare sectors. Employing a recovery metric that compares elective admission volumes in 2021 and 2022 to pre-pandemic levels, we observe significant regional variability in recovery rates, as well as disparities between public and private hospitals. Our analysis reveals that public hospitals experienced slower recovery rates, and suggests that the proximity of private healthcare providers further hindered their recovery capacity. Higher staffing intensity is positively associated with recovery, while hospitals serving older populations show weaker recovery performance. By quantifying recovery patterns and examining these influencing factors, this study enhances our understanding of healthcare system resilience. The findings highlight critical disparities in recovery across sectors and provide actionable insights for policymakers to improve coordination between public and private providers, thereby strengthening healthcare system preparedness for future crises.