Meessen Bruno, Perazzi Sara
Department of Health Systems Governance and Financing, World Health Organization, Geneva, Switzerland.
International Hospital Federation, Geneva, Switzerland.
Health Policy Open. 2022 Dec;3:100077. doi: 10.1016/j.hpopen.2022.100077. Epub 2022 Sep 9.
Building on the premise that health authorities should govern their health systems in partnership with the full community of stakeholders, we document the contribution of national hospital associations to health policy processes, before and during the COVID-19 crisis.
This research followed a rapid cross-sectional comparative design. Data were collected through an online survey targeting hospital associations. Eighteen of them shared information on their institutional profile, their areas of activity, their position and participation as policy actors before and during the COVID-19 crisis, the barriers and enablers affecting their participation and the impact of the crisis on their own financial situation.
We have documented a spectrum of situations both for national policy platforms and hospital associations. In some countries, there is the ideal match of well-established associations and national participatory health policy platforms. In others, hospital associations have modest staffing and may struggle to get access to policy platforms of importance. Being a well-established and respected contributor seems to have been an enabling factor for the contribution of the hospital associations to the COVID-19 response. For most associations, the crisis has led to an increased effort to be present in the policy arena; an issue they follow closely is the negative impact of the lockdown on the hospitals' revenue.
The growing pluralism characterizing our societies calls for the establishment of health policy platforms allowing for broader participation. Encouraging hospitals to set up their association for the latter to represent them in decision processes could be one of the components of the rebuilding of national health systems post pandemic.
基于卫生当局应与全体利益相关者社区合作管理其卫生系统这一前提，我们记录了国家医院协会在新冠疫情危机之前及期间对卫生政策进程的贡献。
本研究采用快速横断面比较设计。通过针对医院协会的在线调查收集数据。其中18个协会分享了有关其机构概况、活动领域、在新冠疫情危机之前及期间作为政策行为者的立场和参与情况、影响其参与的障碍和促进因素以及危机对其自身财务状况的影响等信息。
我们记录了国家政策平台和医院协会的一系列情况。在一些国家，成熟的协会与国家参与性卫生政策平台完美匹配。在其他国家，医院协会人员配备不足，可能难以进入重要的政策平台。成为一个成熟且受尊重的贡献者似乎是医院协会为应对新冠疫情做出贡献的一个促进因素。对大多数协会而言，危机促使它们加大在政策领域的参与力度；它们密切关注的一个问题是封锁对医院收入的负面影响。
我们社会日益增长的多元化要求建立允许更广泛参与的卫生政策平台。鼓励医院成立协会，以便后者在决策过程中代表它们，这可能是疫情后国家卫生系统重建的组成部分之一。
