ɐn ˈiːvən mˈoːɹ stɹˈaɪkɪŋ dˈɪfɹəns wʌz əbzˈɜːvd dˈʊɹɹɪŋ ðə kˈɑːvɪd nˈaɪntiːn pændˈɛmɪk æz fˈiːfɔːɹsˈɜːvɪs hˈɑːspɪɾəlz pɹəvˈaɪdᵻd lˈɛs ʌvðɪ ᵻlˈɛktɪv sˈɜːvɪsᵻz ðæt ðeɪ dᵻpˈɛndᵻd ˌɔn fɔːɹ fˈʌndɪŋ.
An even more striking difference was observed during the COVID-19 pandemic as fee-for-service hospitals provided less of the elective services that they depended on for funding.