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影响疫情期间医疗保健系统准备和响应能力的主要因素:SARS、MERS 和 COVID-19 病例的范围综述。

Main Factors Affecting the Readiness and Responsiveness of Healthcare Systems during Epidemic Crises: A Scoping Review on Cases of SARS, MERS, and COVID-19.

机构信息

Department of Health Care Management and Health Economics, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran.

Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Iran J Med Sci. 2021 Mar;46(2):81-92. doi: 10.30476/ijms.2020.87608.1801.

Abstract

BACKGROUND

Given the significance of the preparedness and responsiveness of healthcare systems in relation to epidemics, this study aimed to determine their influencing factors during epidemic crises with a view to utilizing the findings in the battle against the coronavirus disease 2019 (COVID-19) outbreak.

METHODS

This scoping study was conducted in 2020 via the Arksey and O'Malley approach. A systematic search was conducted on five online databases from January 2000 to June 15, 2020. Initially, 1926 English articles were retrieved based on their abstracts. After the screening process, 60 articles were considered for the final analysis. Data were charted by applying Microsoft Office Excel 2013 and were synthesized via thematic analysis.

RESULTS

Five main factors have affected the responsiveness and preparedness of countries during the epidemics of severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and COVID-19: community-related interventions, managerial interventions, socioeconomic factors, the readiness of hospitals and health centers, and environmental factors. These themes are associated with 38 related sub-themes. The thematic framework shows that interactions between these five determinantes can affect the preparedness and responsiveness of healthcare systems during pandemics/epidemics.

CONCLUSION

According to the results, healthcare systems need to pay attention to their internal capacities, managerial interventions, and health centers to overcome the current pandemic. They should also consider such external factors as socioeconomic and environmental determinants that can affect their potential preparedness against pandemic/epidemic crises. Community-related interventions such as improvement of the community health literacy, teamwork, and social responsibility can enhance the readiness of healthcare systems against the COVID-19 outbreak.

摘要

背景

鉴于医疗卫生系统在应对传染病方面的准备情况和反应能力意义重大,本研究旨在确定其在传染病危机期间的影响因素,以期在抗击 2019 年冠状病毒病(COVID-19)疫情的过程中利用这些发现。

方法

本范围界定研究于 2020 年采用 Arksey 和 O'Malley 方法进行。从 2000 年 1 月至 2020 年 6 月 15 日,在五个在线数据库中进行了系统搜索。最初,根据摘要检索到了 1926 篇英文文章。经过筛选过程,有 60 篇文章被认为适合最终分析。通过应用 Microsoft Office Excel 2013 对数据进行图表绘制,并通过主题分析对数据进行综合分析。

结果

在严重急性呼吸系统综合征(SARS)、中东呼吸系统综合征(MERS)和 COVID-19 流行期间,有五个主要因素影响了各国的反应能力和准备情况:社区相关干预措施、管理干预措施、社会经济因素、医院和保健中心的准备情况以及环境因素。这些主题与 38 个相关子主题相关联。主题框架表明,这五个决定因素之间的相互作用可能会影响大流行/传染病期间医疗卫生系统的准备情况和反应能力。

结论

根据研究结果,医疗卫生系统需要关注自身的内部能力、管理干预措施和保健中心,以克服当前的大流行。他们还应考虑可能影响其应对大流行/传染病危机潜在准备能力的社会经济和环境决定因素。社区相关干预措施,如提高社区健康素养、团队合作和社会责任,可以增强医疗卫生系统对 COVID-19 疫情的准备能力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/09c1/7966936/d02403a63fb8/IJMS-46-81-g001.jpg

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