Pilevari Nazanin, Shiva Mahyar Valeh
Department of Industrial Management, West Tehran Branch, Islamic Azad University, Tehran, Iran.
Department of Management and Economics, Sciences and Research Branch, Islamic Azad University, Tehran, Iran.
Iran J Public Health. 2021 Apr;50(4):806-815. doi: 10.18502/ijph.v50i4.6007.
The outbreak of the COVID-19 virus has had many destructive impacts on socio-economic and health systems. The health systems of countries could be supportive in crisis management, but they also are affected by the impact of the crisis, consequently, their operational level has declined. This study pursued resilience in an overall national health system under pandemic stress.
Based on WHO building blocks, by interviewing informants of the Ministry of Health and Medical Education, in Tehran-Iran, early 2021 a rich picture of the current situation depicted, the resilience model was extracted via a mixed method of Soft System Methodology (SSM) and total interpretive structural modeling (TISM). Dynamic capabilities were applied for the orchestration of the Iranian health system.
Particular functional and structural suggestions applicable for designing a ubiquitous resilience model for the country-wide health system are presented in this study. The variables of crisis sensing, opportunity seizing, and reconfiguration are the cornerstones of health system resilience.
Well-suited health technology assessment (HTA) and health information system (HIS) play significant roles in the overall strengthening of the health system. All reforms for resilience will have a lasting result when the capabilities created by the resilience model are learned and reused in a dynamic cycle.
新型冠状病毒肺炎（COVID-19）病毒的爆发对社会经济和卫生系统产生了许多破坏性影响。各国的卫生系统在危机管理中可以提供支持，但它们也受到危机影响，因此其运行水平有所下降。本研究探讨了在大流行压力下国家整体卫生系统的恢复力。
基于世界卫生组织的构件，通过采访伊朗德黑兰卫生和医学教育部的 informant，于 2021 年初描绘了当前形势的丰富图景，通过软系统方法论（SSM）和全面解释结构建模（TISM）的混合方法提取了恢复力模型。应用动态能力来协调伊朗的卫生系统。
本研究提出了适用于设计全国卫生系统普遍恢复力模型的具体功能和结构建议。危机感知、机会把握和重新配置变量是卫生系统恢复力的基石。
合适的卫生技术评估（HTA）和卫生信息系统（HIS）在全面加强卫生系统方面发挥着重要作用。当恢复力模型所创造的能力在动态循环中被学习和重复使用时，所有恢复力改革都将产生持久效果。
