Department for Healthcare Management, Technische Universität Berlin, Berlin, Germany.
European Observatory on Health Systems and Policies, Brussels, Belgium.
Eur J Public Health. 2022 Aug 1;32(4):557-564. doi: 10.1093/eurpub/ckac059.
The coronavirus disease 2019 (COVID-19) pandemic has developed into an unprecedented global challenge. Differences between countries in testing strategies, hospitalization protocols as well as ensuring and managing ICU capacities can illustrate initial responses to a major health system shock, and steer future preparedness activities.
Publicly available daily data for 18 European countries were retrieved manually from official sources and documented in an Excel table (March-July 2020). The ratio of tests to cases, the share of hospitalizations out of all cases and the share of ICU admissions out of all hospitalizations were computed using 7-day rolling averages per 100 000 population. Information on country policies was collected from the COVID-19 Health System Response Monitor of the European Observatory on Health Systems and Policies. Information on health care capacities, expenditure and utilization was extracted from the Eurostat health database.
There was substantial variation across countries for all studied variables. In all countries, the ratio of tests to cases increased over time, albeit to varying degrees, while the shares of hospitalizations and ICU admissions stabilized, reflecting the evolution of testing strategies and the adaptation of COVID-19 health care delivery pathways, respectively. Health care patterns for COVID-19 at the outset of the pandemic did not necessarily follow the usual health service delivery pattern of each health system.
This study enables a general understanding of how the early evolution of the pandemic influenced and was influenced by country responses and clearly demonstrates the immense potential for cross-country learning.
2019 年冠状病毒病（COVID-19）大流行已成为一场前所未有的全球挑战。各国在检测策略、住院治疗方案以及确保和管理重症监护病房（ICU）容量方面存在差异，这些差异可以说明各国对重大卫生系统冲击的初步应对情况，并为未来的备灾活动提供指导。
从官方来源手动检索了 18 个欧洲国家的公开可用的每日数据，并将其记录在 Excel 表格中（2020 年 3 月至 7 月）。使用每 10 万人 7 天滚动平均值计算了检测与病例的比例、住院患者在所有病例中的比例以及 ICU 入院患者在所有住院患者中的比例。从欧洲卫生系统和政策观察站的 COVID-19 卫生系统应对监测中收集了有关国家政策的信息。从 Eurostat 卫生数据库中提取了卫生保健能力、支出和利用方面的信息。
在所研究的所有变量中，各国之间存在很大差异。在所有国家中，检测与病例的比例随着时间的推移而增加，尽管程度不同，而住院和 ICU 入院的比例趋于稳定，这分别反映了检测策略的演变和 COVID-19 卫生保健提供途径的调整。大流行初期 COVID-19 的卫生保健模式并不一定遵循每个卫生系统通常的卫生服务提供模式。
本研究使人们能够大致了解大流行的早期演变如何影响各国的应对措施以及如何受到各国应对措施的影响，并清楚地表明了跨国学习的巨大潜力。
