Beishuizen Berend H H, Stein Mart L, Buis Joeri S, Tostmann Alma, Green Caroline, Duggan James, Connolly Máire A, Rovers Chantal P, Timen Aura
Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, Gelderland, The Netherlands.
BMJ Open. 2024 Dec 15;14(12):e079609. doi: 10.1136/bmjopen-2023-079609.
The COVID-19 pandemic highlighted the crucial role of healthcare and public health resource management, where scarcity impairs pandemic response resulting in increased disease transmission, delayed patient care and poorer health outcomes. In the EU PANDEM-2 project, we aimed to identify essential resource parameters for pandemic preparedness and response in the context of an emerging viral respiratory illness.
After performing a systematic literature review, we conducted a Delphi study consisting of a structured questionnaire and consensus round with two separate panels of European public health experts (PHEs) and clinicians, respectively. Resources were categorised as material (n=23), human (n=18) or pharmaceutical (n=12). Data were analysed descriptively for both panels.
Participants were 17 PHEs and 16 clinicians from nine countries. Consensus between the two panels was found on 40 resource parameters (17 material, 14 human, 9 pharmaceutical; 33 accepted and 7 rejected). Notably, clinicians selected three home care resources while PHEs did not, and PHEs selected two pharmaceutical resources which clinicians did not. No consensus was observed on 13 resources. Eleven additional resources were suggested and included (five for PHE and six for clinicians) among which were personal protective equipment for mobile teams, resources for primary care and resources related to mechanical ventilation.
The high level of consensus between the two expert panels indicates common goals in pandemic resource planning. The disagreement on 13 resource parameters reflects the different priorities between PHEs and clinicians in pandemic planning. This study has demonstrated the core components of resource modelling required for pandemic preparedness planning and shows the importance of consulting experts with both public health and clinical backgrounds. Including our proposed resources in pandemic models allows for more enhanced planning and training activities for future pandemics.
新冠疫情凸显了医疗保健和公共卫生资源管理的关键作用,资源短缺会削弱疫情应对能力,导致疾病传播增加、患者护理延迟和健康结果恶化。在欧盟PANDEM - 2项目中,我们旨在确定在新型病毒性呼吸道疾病背景下大流行防范和应对所需的基本资源参数。
在进行系统的文献综述后,我们开展了一项德尔菲研究,包括一份结构化问卷以及分别与两组欧洲公共卫生专家(PHE)和临床医生进行的共识轮询。资源被分为物资(n = 23)、人力(n = 18)或药品(n = 12)三类。对两组的数据均进行了描述性分析。
参与者包括来自9个国家的17名公共卫生专家和16名临床医生。两组在40个资源参数上达成了共识(17个物资、14个人力、9个药品;33个被接受,7个被否决)。值得注意的是,临床医生选择了3种家庭护理资源,而公共卫生专家未选;公共卫生专家选择了2种临床医生未选的药品资源。在13种资源上未达成共识。另外还提出了11种资源(5种针对公共卫生专家,6种针对临床医生),其中包括移动团队的个人防护装备、初级保健资源以及与机械通气相关的资源。
两个专家小组之间的高度共识表明在大流行资源规划中有共同目标。在13个资源参数上的分歧反映了公共卫生专家和临床医生在大流行规划中的不同优先事项。本研究展示了大流行防范规划所需资源建模的核心组成部分,并表明咨询具有公共卫生和临床背景专家的重要性。将我们提议的资源纳入大流行模型可使未来大流行的规划和培训活动得到更有效的开展。