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Coping with COVID-19: the role of hospital care structures and capacity expansion in five countries

Published online by Cambridge University Press:  10 January 2023

Mirella Cacace Open the ORCID record for Mirella Cacace [Opens in a new window] ,
Jan Böcken ,
Kristin Edquist Open the ORCID record for Kristin Edquist [Opens in a new window] ,
Tanja Klenk ,
Mario Martinez-Jimenez Open the ORCID record for Mario Martinez-Jimenez [Opens in a new window] ,
Uwe Preusker ,
Karsten Vrangbaek Open the ORCID record for Karsten Vrangbaek [Opens in a new window]  and
Ruth Waitzberg Open the ORCID record for Ruth Waitzberg [Opens in a new window]
Mirella Cacace*
Affiliation:
Catholic University of Applied Sciences, Freiburg, Germany
Jan Böcken
Affiliation:
Bertelsmann Foundation, Gütersloh, Germany
Kristin Edquist
Affiliation:
Eastern Washington University, Cheney, WA, USA
Tanja Klenk
Affiliation:
Helmut Schmidt University, Hamburg, Germany
Mario Martinez-Jimenez
Affiliation:
Imperial College London – Business School, London, UK Lancaster University, Lancaster, UK
Uwe Preusker
Affiliation:
Health System Analysis & Health Policy Research, Vantaa, Finland
Karsten Vrangbaek
Affiliation:
University of Copenhagen, Copenhagen, Denmark
Ruth Waitzberg
Affiliation:
The Smokler Center for Health Policy Research, Myers-JDC-Brookdale Institute, Jerusalem, Israel TU Berlin, Berlin, Germany
*
*Corresponding author. Email: mirella.cacace@kh-freiburg.de
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Abstract

This contribution examines the responses of five health systems in the first wave of the COVID-19 pandemic: Denmark, Germany, Israel, Spain and Sweden. The aim is to understand to what extent this crisis response of these countries was resilient. The study focuses on hospital care structures, considering both existing capacity before the pandemic and the management and expansion of capacity during the crisis. Evaluation criteria include flexibility in the use of existing resources and response planning, as well as the ability to create surge capacity. Data were collected from country experts using a structured questionnaire. Main findings are that not only the total number but also the availability of hospital beds is critical to resilience, as is the ability to mobilise (highly) qualified personnel. Indispensable for rapid capacity adjustment is the availability of data. Countries with more centralised hospital care structures, more sophisticated concepts for providing specialised services and stronger integration of the inpatient and outpatient sectors have clear structural advantages. A solid digital infrastructure is also conducive. Finally, a centralised governance structure is crucial for flexibility and adaptability. In decentralised systems, robust mechanisms to coordinate across levels are important to strengthen health care system resilience in pandemic situations and beyond.

Keywords

Capacity managementCOVID-19hospital care structuresintensive careperformance
Type
Article
Information
Health Economics, Policy and Law , Volume 18 , Issue 2 , April 2023 , pp. 186 - 203
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Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press

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