Tokalić Ružica, Viđak Marin, Kaknjo Mersiha Mahmić, Marušić Ana
Department of Research in Biomedicine and Health, University of Split School of Medicine, Split, Croatia.
Department of Clinical Pharmacology, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina.
Lancet Reg Health Eur. 2021 Oct 7;9:100216. doi: 10.1016/j.lanepe.2021.100216. eCollection 2021 Oct.
Acute crises, such as a war or a pandemic, are the ultimate tests for health care systems' resilience (temporary response to stress with change and adaptation) and antifragility (permanent benefit from change in response to stress). In this Health Policy paper, we analyse and discuss how the healthcare systems of two European countries - Bosnia and Herzegovina and Croatia - adapted to war as a man-made disaster, and how they adapted to COVID-19 pandemic twenty-five years later. These countries experienced full scale wars in recent history, which significantly changed their political and healthcare systems. This experience prepared the countries for the response to the pandemic, which coincided with two earthquakes in Croatia. We argue that healthcare systems in Croatia and Bosnia and Herzegovina are not only resilient but antifragile, and that they benefited from stressors they were exposed to. The antifragility of the two systems were primarily based on human effort - the strength, adaptability and resilience of health care professionals. We will look at lessons from the wars that were applied to the pandemic and discuss newly recognized opportunities and improvements.
急性危机，如战争或大流行病，是对医疗保健系统恢复力（通过变革和适应对压力做出的临时反应）和抗脆弱性（因应对压力的变化而获得的永久性益处）的终极考验。在这篇卫生政策论文中，我们分析并讨论了两个欧洲国家——波斯尼亚和黑塞哥维那以及克罗地亚——的医疗保健系统如何适应作为人为灾难的战争，以及它们在二十五年后如何适应新冠疫情。这些国家在近代历史上经历了全面战争，这极大地改变了它们的政治和医疗保健系统。这段经历为这些国家应对疫情做好了准备，而克罗地亚同时还遭遇了两次地震。我们认为，克罗地亚和波斯尼亚和黑塞哥维那的医疗保健系统不仅具有恢复力，而且具有抗脆弱性，并且它们从所面临的压力源中受益。这两个系统的抗脆弱性主要基于人力——医疗保健专业人员的力量、适应能力和恢复力。我们将探讨从战争中汲取并应用于疫情的经验教训，并讨论新发现的机遇和改进措施。
