Gerlinger Thomas, Schmidt Phillip Florian, Lückenbach Caspar
Fakultät für Gesundheitswissenschaften Arbeitsgruppe "Gesundheitssysteme, Gesundheitspolitik, Gesundheitssoziologie", Universität Bielefeld, Postfach 10 01 31, 33501, Bielefeld, Deutschland.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2021 Apr;64(4):472-480. doi: 10.1007/s00103-021-03295-z. Epub 2021 Mar 21.
The challenges posed by the COVID-19 pandemic face different institutional structures and traditions of action in the European health systems. This article uses the example of the public health services in Sweden, France and Austria to address the question of the similarities and differences in the measures taken to combat the pandemic (status: November 2020).Among the countries presented in this article, Austria is the least affected by the pandemic and France is the most affected. In all analysed health systems there is a tension between national and regional responsibilities. France's healthcare system is particularly centralized, while Sweden's is strongly regional and municipal. Governments in the nation states are striving to obtain pandemic containment powers independent of parliamentary decisions. Sweden differs from Austria and France in that its pandemic containment strategy is based primarily on recommendations and appeals rather than directives and bans. The sequences of action during the pandemic and, apart from Sweden, the instruments used to contain the pandemic are similar. The course of the pandemic and the measures taken in Austria and France show clear parallels with those in Germany. The protection of particularly vulnerable groups has not been sufficiently successful in all countries and remains a challenge to be met.
新冠疫情带来的挑战在欧洲卫生系统中面临着不同的制度结构和行动传统。本文以瑞典、法国和奥地利的公共卫生服务为例,探讨应对疫情所采取措施的异同(状态:2020年11月)。在本文介绍的国家中,奥地利受疫情影响最小,法国受影响最大。在所有分析的卫生系统中,国家和地区责任之间都存在紧张关系。法国的医疗保健系统特别集中,而瑞典的则高度分散到地区和市政层面。民族国家的政府正在努力获得独立于议会决定的疫情防控权力。瑞典与奥地利和法国的不同之处在于,其疫情防控战略主要基于建议和呼吁,而非指令和禁令。疫情期间的行动顺序,以及除瑞典外用于遏制疫情的手段都是相似的。奥地利和法国的疫情发展过程及采取的措施与德国的情况明显相似。在所有国家,对特别弱势群体的保护都不够成功,仍然是一项有待应对的挑战。