Faculty of Economic Sciences and Administration, Universidad ESAN, Alonso Molina 1652, Monterrico Chico, Surco 33, Lima, Peru.
Netherlands Institute for Health Services Research (Nivel), PO Box 1568, 3500 BN, Utrecht, the Netherlands.
BMC Health Serv Res. 2024 Oct 8;24(1):1198. doi: 10.1186/s12913-024-11671-z.
During COVID-19, scientists advising policymakers were forced to deal with high uncertainty and risks in an environment of unknowns. Evidence on which policies and measures were effective in responding to the pandemic remains underdeveloped to answer the key question 'what worked and why?'. This study aims to provide a basis for studies to go further to answer this critical question, by starting to look efficacy or how countries ensured that health services remained available and what measures were enacted to protect and treat their populations and workers.
We applied a three-phase sequential mixed methods design. In phase one, we started with a qualitative content analysis of the EU Country Profile reports to retrieve and analyse data on COVID-19 responses taken by 29 countries in the European region. Phase two is the step of data transformation, converting qualitative data into numerical codes that can be statistically analysed, which are then used in a quantitative cross-national comparative analysis that comprises phase three. The quantifying process resulted in a numerical indicator to measure the 'response efficacy' of the 29 countries, which is used in phase three's association of the response measure with country performance indicators that were derived from European Centre for Disease Control (ECDC) COVID-19 case and death rate data.
Through comparing the frequency of COVID-19 measures taken, we found that many countries in the European region undertook similar actions but with differing effects. The cross-national analysis revealed an expected relationship: a lower COVID-19 response efficacy appeared to be related to a higher case and death rates. Still, marked variation for countries with similar response efficacy indicators was found, signalling that the combination and sequence of implementation of COVID-19 responses is possibly just as important as their efficacy in terms of which response measures were implemented.
Many European countries employed similar COVID-19 measures but still had a wide variation in their case and death rates. To unravel the question 'what worked and why?', we suggest directions from which more refined research can be designed that will eventually contribute to mitigate the impact of future pandemics and to be better prepared for their economic and human burden.
在 COVID-19 期间，为政策制定者提供建议的科学家们被迫在一个未知的环境中应对高度不确定和风险。关于哪些政策和措施在应对大流行方面有效的证据仍不发达，无法回答关键问题“什么有效，为什么有效？”。本研究旨在为进一步回答这一关键问题的研究提供基础，从开始研究各国确保卫生服务仍然可用的疗效或有效性，以及为保护和治疗其人口和工作人员而采取的措施。
我们采用了三阶段顺序混合方法设计。在第一阶段，我们对欧盟国家概况报告进行了定性内容分析，以检索和分析欧洲地区 29 个国家采取的 COVID-19 应对数据。第二阶段是数据转换步骤，即将定性数据转换为可进行统计分析的数字代码，然后用于第三阶段的定量跨国比较分析。量化过程产生了一个数值指标来衡量 29 个国家的“反应效力”，该指标用于第三阶段将反应措施与欧洲疾病预防控制中心（ECDC）COVID-19 病例和死亡率数据得出的国家绩效指标相关联。
通过比较采取的 COVID-19 措施的频率，我们发现欧洲地区的许多国家采取了类似的行动，但效果不同。跨国分析显示出一种预期的关系：较低的 COVID-19 反应效力似乎与较高的病例和死亡率有关。然而，发现具有相似反应效力指标的国家之间存在明显的差异，这表明 COVID-19 反应的实施组合和顺序可能与实施的反应措施的效力一样重要。
许多欧洲国家采取了类似的 COVID-19 措施，但病例和死亡率仍存在很大差异。为了解开“什么有效，为什么有效？”这个问题，我们建议从哪些方面可以设计更精细的研究，最终有助于减轻未来大流行的影响，并为其经济和人类负担做好更好的准备。
