COVID - 19 : 10 POINT - META-ANALYSIS
RESILIENCE AND RESISTANCE OF HEALTH SYSTEMS IN THE FACE OF A PANDEMIC SUCH AS COVID-19
The meta-analysis carried out by SWISSpsy / ASPROMEL / EANA is extracted from the data collected at the European level of the CPME (Permanent Committee of European Doctors), of EANA (European Association of Free Exercise Physicians), of which ASPROMEL has the Vice-Presidency, as well as well as from ASPROMEL's own database.
THE STRENGTH OF A SANITARY SYSTEM IS BASED ON
1. PUBLIC-PRIVATE INTEGRATION
2. PRIORITY OF THE AMBULATORY SECTOR
3. CULTURE OF COOPERATION
4. AUTONOMY OF THE MEDICAL PROFESSION
5. NATIONAL RESERVES OF MATERIAL, MEDICINES AND VACCINES
6. CLEAR DIRECTIVES AND GUIDELINES
7. NATIONAL PRODUCTION OF MATERIAL, MEDICINES AND VACCINES
8. EFFECTIVE AND SYSTEMATIC MONITORING
9. NETWORKING
10. INTEGRATING AND CROSS-BORDER APPROACH
1. Health Systems of the "Bismarck" type, based on public-private integration, have proven to be better prepared and more resistant (e.g. Germany, Austria, Switzerland, Luxembourg, Eastern European countries) compared to National Health Systems of the type "Beveridge", based on a public monopoly (eg Spain, UK, Italy, Sweden).
2. Systems focused on outpatient care (eg Germany, Switzerland, Austria) have proven to be more resistant than systems focused on hospitals (eg France, Spain, United Kingdom).
3. Health Systems in cultures of cooperation have proven to be more resistant than Health Systems in a culture of confrontation. There are great differences between the two cultures in the field of health personnel planning, in their financial remuneration and in general working conditions. As an example serve Switzerland on one side and Spain on the other.
4. Health Systems based on the autonomy, competence and authority of the medical profession have proven to be more resistant than Health systems based on the civil service of medical personnel.
5. Health Systems with national reserves of means of protection, material and medicines for emergencies, "just in case of", have proved more resistant than Health Systems that operate with few reserves pointing to the agility of logistics "just in time".
6. Health Systems with clear directives "guidelines" have proven to be more resistant than Health Systems with full individual and local freedom of action.
7. Countries with national production of the essential material for a case of pandemic have proven to be more resistant than countries that opt for outsourcing production abroad.
8. Health Systems operating with systematic local and central monitoring have proven to be more resistant than Health Systems without monitoring or with poor monitoring.
9. Health Systems based on networking have proven to be more resistant than Health Systems based on exclusion and monopoly.
10. Health Systems with a cross-border and integrative approach have proven to be more resistant than Health Systems with a focus on itself.
