Putthasri Weerasak, Lertiendumrong Jongkol, Chompook Pornthip, Tangcharoensathien Viroj, Coker Richard
International Health Policy Programme, Ministry of Public Health, Nonthaburi, Thailand.
Emerg Infect Dis. 2009 Mar;15(3):423-32. doi: 10.3201/eid1503.080872.
Southeast Asia will likely be the epicenter of the next influenza pandemic. To determine whether health system resources in Thailand are sufficient to contain an emerging pandemic, we mapped health system resources in 76 provinces. We used 3 prepandemic scenarios of clustered cases and determined resource needs, availability, and gaps. We extended this analysis to a scenario of a modest pandemic and assumed that the same standards of clinical care would be required. We found that gaps exist in many resource categories, even under scenarios in which few cases occur. Such gaps are likely to be profound if a severe pandemic occurs. These gaps exist in infrastructure, personnel and materials, and surveillance capacity. Policy makers must determine whether such resource gaps can realistically be closed, ideally before a pandemic occurs. Alternatively, explicit assumptions must be made regarding allocation of scarce resources, standards of care, and priority setting during a pandemic.
东南亚很可能成为下一次流感大流行的中心。为了确定泰国的卫生系统资源是否足以控制新出现的大流行，我们绘制了76个省份的卫生系统资源图。我们使用了3种聚集性病例的大流行前情景，并确定了资源需求、可获得性和差距。我们将这一分析扩展到中度大流行情景，并假设需要相同的临床护理标准。我们发现，即使在病例很少的情景下，许多资源类别也存在差距。如果发生严重大流行，这种差距可能会很大。这些差距存在于基础设施、人员和物资以及监测能力方面。政策制定者必须确定这些资源差距是否能够切实得到弥补，最好是在大流行发生之前。或者，必须就大流行期间稀缺资源的分配、护理标准和优先事项设定做出明确假设。
