Theoretical model of regional healthcare system resource provision for a sustainable response to global challenges
https://doi.org/10.35627/2219-5238/2024-32-9-19-30
Abstract
Introduction: Global disasters and challenges have a significant impact on the functioning of national health systems. Heterogeneous and often differing approaches to assessing the readiness of the latter for a timely and effective response to these events necessitate the development of an integrated and unified model of its functioning given the resource potential.
Objective: Based on international approaches, to develop a theoretical model of resource provision of a regional healthcare system for a sustainable response to global challenges.
Materials and methods: We conducted a six-stage analytical review of international scientific publications using PRISMA method. The first and third stages included creation of primary databases (initial sample size: 470 articles, additional sample size: 549 articles) of publications found in the National Medical Library of the National Institute of Health (NLM and NCBI) and the PubMed databases for the period of January 1, 2000 to May 2024. The second and fourth stages included peer review and selection of eligible publications. At the fifth stage, an expert analysis of the final sample (30 articles) consisting of the most informative publications was carried out. At the sixth stage, we developed a BPMN (Business Process Management Notation) model of resource provision of the healthcare system that allows it to maintain stability in the face of global challenges.
Results: We developed the theoretical model of the regional healthcare system resource provision for its sustainable response to global challenges, represented by five levels of interaction that take into account medical care types and conditions, different stages of resource reserve formation, as well as hierarchical links between health facilities.
Conclusion: The developed model has been formalized and algorithmized in terms of description of the main processes taking place in the health system structural elements under different scenarios of their functioning and can be used to elaborate plans and programs to improve the regional healthcare system emergency response to global challenges.
About the Authors
S. A. OrlovRussian Federation
Sergey A. Orlov, Cand. Sci. (Med.), Senior Researcher
Department of Lifestyle Studies and Public Health Protection; Department of Scientific and Strategic Development of Primary Health Care
105064; Bldg 1, 12 Vorontsovo Pole Street; 101990; Bldg 3, 10 Petroverigsky Lane; Moscow
O. Yu. Aleksandrova
Russian Federation
Oxana Yu. Aleksandrova, Prof., Dr. Sci. (Med.), Deputy Director for Academic Affairs
105064; Bldg 1, 12 Vorontsovo Pole Street; Moscow
T. P. Vasilieva
Russian Federation
Tatyana P. Vasilieva, Prof., Dr. Sci. (Med.), Honored Doctor of the Russian Federation, Head of the Research Direction
Research Direction “Theoretical Patterns of Public Health Formation and Health Maintenance”
105064; Bldg 1, 12 Vorontsovo Pole Street; Moscow
R. V. Gorenkov
Russian Federation
Roman V. Gorenkov, Dr. Sci. (Med.), Leading Researcher
Department of Lifestyle Studies and Public Health Protection
105064; Bldg 1, 12 Vorontsovo Pole Street; Moscow
References
1. Her M. Repurposing and reshaping of hospitals during the COVID-19 outbreak in South Korea. One Health. 2020;10:100137. doi: 10.1016/j.onehlt.2020.100137
2. Kirsch TD, Mitrani-Reiser J, Bissell R, et al. Impact on hospital functions following the 2010 Chilean earthquake. Disaster Med Public Health Prep. 2010;4(2):122-128. doi: 10.1001/dmphp.4.2.122
3. Fleming P, O’Donoghue C, Almirall-Sanchez A, et al. Metrics and indicators used to assess health system resilience in response to shocks to health systems in high income countries - A systematic review. Health Policy. 2022;126(12):1195-1205. doi: 10.1016/j.health-pol.2022.10.001
4. Zhong S, Clark M, Hou XY, Zang Y, FitzGerald G. Validation of a framework for measuring hospital disaster resilience using factor analysis. Int J Environ Res Public Health. 2014;11(6):6335-6353. doi: 10.3390/ijerph110606335
5. Koks EE, Rozenberg J, Zorn C, et al. A global multi-hazard risk analysis of road and railway infrastructure assets. Nat Commun. 2019;10(1):2677. doi: 10.1038/s41467-019-10442-3
6. Ferguson WJ, Kemp K, Kost G. Using a geographic information system to enhance patient access to point-of-care diagnostics in a limited-resource setting. Int J Health Geogr. 2016;15:10. doi: 10.1186/s12942-016-0037-9
7. Haldane V, Zhang Z, Abbas RF, et al. National primary care responses to COVID-19: A rapid review of the lite-rature. BMJ Open. 2020;10(12):e041622. doi: 10.1136/bmjopen-2020-041622
8. Fallah-Aliabadi S, Ostadtaghizadeh A, Ardalan A, Fatemi F, Khazai B, Mirjalili MR. Towards developing a model for the evaluation of hospital disaster resilience : A systematic review. BMC Health Serv Res. 2020;20(1):64. doi: 10.1186/s12913-020-4915-2
9. Curtis S, Fair A, Wistow J, Val DV, Oven K. Impact of extreme weather events and climate change for health and social care systems. Environ Health. 2017;16(Suppl 1):128. doi: 10.1186/s12940-017-0324-3
10. Zhong S, Clark M, Hou XY, Zang YL, Fitzgerald G. Development of hospital disaster resilience: Conceptual framework and potential measurement. Emerg Med J. 2014;31(11):930-938. doi: 10.1136/emermed-2012-202282
11. Son C, Sasangohar F, Rao AH, Larsen EP, Neville T. Resilient performance of emergency department: patterns, models and strategies. Saf Sci. 2019;120:362–373. doi: 10.1016/j.ssci.2019.07.010
12. Kruk ME, Myers M, Varpilah ST, Dahn BT. What is a resilient health system? Lessons from Ebola. Lancet. 2015;385(9980):1910-1912. doi: 10.1016/S0140-6736(15)60755-3
13. Cousins S. Syrian crisis: Health experts say more can be done. Lancet. 2015;385(9972):931-934. doi: 10.1016/S0140-6736(15)60515-3
14. Douedari Y, Howard N. Perspectives on rebuilding health system governance in opposition-controlled Syria: A qualitative study. Int J Health Policy Manag. 2019;8(4):233-244. doi: 10.15171/ijhpm.2018.132
15. Jamal Z, Alameddine M, Diaconu K, et al. Health system resilience in the face of crisis: Analysing the challenges, strategies and capacities for UNRWA in Syria. Health Policy Plan. 2020;35(1):26-35. doi: 10.1093/heapol/czz129
16. Kluge H, Martín-Moreno JM, Emiroglu N, et al. Strengthening global health security by embedding the International Health Regulations requirements into national health systems. BMJ Glob Health. 2018;3(Suppl 1):e000656. doi: 10.1136/bmjgh-2017-000656
17. Hassan EM, Mahmoud H. An integrated socio-technical approach for post-earthquake recovery of interdependent healthcare system. Reliab Eng Syst Saf. 2020;201:106953. doi: 10.1016/j.ress.2020.106953
18. Jovanović A, Klimek P, Renn O, et al. Assessing resilience of healthcare infrastructure exposed to COVID-19: Emerging risks, resilience indicators, interdependencies and international standards. Environ Syst Decis. 2020;40(2):252-286. doi: 10.1007/s10669-020-09779-8
19. Khanmohammadi S, Farahmand H, Kashani H. A system dynamics approach to the seismic resilience enhancement of hospitals. Int J Disaster Risk Reduct. 2018;31:220–233. doi: 10.1016/j.ijdrr.2018.05.006
20. Ouyang M. Review on modeling and simulation of interdependent critical infrastructure systems. Reliab Eng Syst Saf. 2014;121:43–60. doi: 10.1016/j.ress.2013.06.040
21. Taboada M, Cabrera E, Iglesias ML, Epelde F, Luque E. An agent-based decision support system for hospitals emergency departments. Procedia Comput Sci. 2011;4:1870–1879. doi: 10.1016/j.procs.2011.04.203
22. Akcali E, Côté MJ, Lin C. A network flow approach to optimizing hospital bed capacity decisions. Health Care Manag Sci. 2006;9(4):391-404. doi: 10.1007/s10729-006-0002-4
23. Orlov SA, Shepel RN, Kontsevaya AV, Drapkina OM. Methodological approaches for studying the level of primary health care development. Profilakticheskaya Meditsina. 2023;26(11):14 21. (In Russ.) doi: 10.17116/profmed20232611114
24. Lamberti-Castronuovo A, Lamine H, Valente M, Hubloue I, Barone-Adesi F, Ragazzoni L. Assessing primary healthcare disaster preparedness: A study in Northern Italy. Prim Health Care Res Dev. 2024;25:e16. doi: 10.1017/S1463423624000124
25. Shi W, Chen R, Wang K, Wang Y, Gui L. Exploring hospital resilience protective or risk factors: Lessons for future disaster response efforts. Front Public Health. 2024;12:1378257. doi: 10.3389/fpubh.2024.1378257
26. Burau V, Mejsner SB, Falkenbach M, et al. Post-COVID health policy responses to healthcare workforce capacities: A comparative analysis of health system resilience in six European countries. Health Policy. 2024;139:104962. doi: 10.1016/j.health-pol.2023.104962
27. Saeed H, Hamid S, Zoukar I, et al. Post-quake call for action: Developing core competencies matrix for Syrian health workers in emergency time. Confl Health. 2024;18(1):5. doi: 10.1186/s13031-023-00567-0
28. Michenka P, Marx D. Hospital-level COVID-19 preparedness and crisis management in Czechia. Int J Public Health. 2023;68:1606398. doi: 10.3389/ijph.2023.1606398
29. Khirekar J, Badge A, Bandre GR, Shahu S. Disaster preparedness in hospitals. Cureus. 2023;15(12):e50073. doi: 10.7759/cureus.50073
30. Tippong D, Petrovic S, Akbari V. A review of applications of operational research in healthcare coordination in disaster management. Eur J Oper Res. 2022;301(1):1-17. doi: 10.1016/j.ejor.2021.10.048
31. Richmond JG, Tochkin J, Hertelendy AJ. Canadian health emergency management professionals’ perspectives on the prevalence and effectiveness of disaster preparedness activities in response to COVID-19. Int J Disaster Risk Reduct. 2021;60:102325. doi: 10.1016/j.ijdrr.2021.102325
32. Gist R, Daniel P, Grock A, et al. Use of medical reserve corps volunteers in a hospital-based disaster exercise. Prehosp Disaster Med. 2016;31(3):259-262. doi: 10.1017/S1049023X16000297
33. Errett NA, Barnett DJ, Thompson CB, et al. Assessment of medical reserve corps volunteers’ emergency response willingness using a threat- and efficacy-based model. Biosecur Bioterror. 2013;11(1):29-40. doi: 10.1089/bsp.2012.0047
34. Aruru M, Truong HA, Clark S. Pharmacy Emergency Preparedness and Response (PEPR): A proposed framework for expanding pharmacy professionals’ roles and contributions to emergency preparedness and response during the COVID-19 pandemic and beyond. Res Social Adm Pharm. 2021;17(1):1967-1977. doi: 10.1016/j.sapharm.2020.04.002
35. Pereira CCA, Soares FRG, Machado CJ, et al. Development of an index to assess COVID-19 hospital care installed capacity in the 450 Brazilian health regions. Disaster Med Public Health Prep. 2022;17:e275. doi: 10.1017/dmp.2022.214
36. Haesendonck RM, Verhoogen T, Mortelmans LJ, Desruelles D, Van De Voorde P, Sabbe MB. The incident management response of the emergency departments in Belgium during the first wave of the COVID-19 pandemic. Disaster Med Public Health Prep. 2022;16(5):2194-2197. doi: 10.1017/dmp.2021.253
37. Al-Dorzi HM, Aldawood AS, Almatrood A, et al. Managing critical care during COVID-19 pandemic: The experience of an ICU of a tertiary care hospital. J Infect Public Health. 2021;14(11):1635-1641. doi: 10.1016/j.jiph.2021.09.018
38. Martani A. Stockpiling basic medical equipment for public health emergencies and “the-right-thing-to-do.” Charting the ethical territory. Int J Public Health. 2022;67:1604679. doi: 10.3389/ijph.2022.1604679
39. Spencer SA, Adipa FE, Baker T, et al. A health systems approach to critical care delivery in low-resource settings : A narrative review. Intensive Care Med. 2023;49(7):772-784. doi: 10.1007/s00134-023-07136-2
40. Koonin LM, Pillai S, Kahn EB, Moulia D, Patel A. Strategies to inform allocation of stockpiled ventilators to healthcare facilities during a pandemic. Health Secur. 2020;18(2):69-74. doi: 10.1089/hs.2020.0028
41. Arabi YM, Azoulay E, Al-Dorzi HM, et al. How the COVID-19 pandemic will change the future of critical care. Intensive Care Med. 2021;47(3):282-291. doi: 10.1007/s00134-021-06352-y
42. Craven RM. Managing anaesthetic provision for global disasters. Br J Anaesth. 2017;119(suppl_1):i126-i134. doi: 10.1093/bja/aex353
43. Zhao Y, Zhang L. An advanced study of urban emergency medical equipment logistics distribution for different levels of urgency demand. Int J Environ Res Public Health. 2022;19(18):11264. doi: 10.3390/ijerph191811264
44. Duncan EA, Colver K, Dougall N, Swingler K, Stephenson J, Abhyankar P. Consensus on items and quantities of clinical equipment required to deal with a mass casualties big bang incident: A national Delphi study. BMC Emerg Med. 2014;14:5. doi: 10.1186/1471-227X-14-5
45. Yuan Y, Du L, Luo L, Cui L. Allocation strategy of medical supplies during a public health emergency: A tripartite evolutionary game perspective. Sci Rep. 2023;13(1):9571. doi: 10.1038/s41598-023-36000-y
46. Schultz MJ, Roca O, Shrestha GS. Global lessons learned from COVID-19 mass casualty incidents. Br J Anaesth. 2022;128(2):e97-e100. doi: 10.1016/j.bja.2021.10.040
47. Hertelendy AJ, Ciottone GR, Mitchell CL, Gutberg J, Burkle FM. Crisis standards of care in a pandemic: Navigating the ethical, clinical, psychological and policy-making maelstrom. Int J Qual Health Care. 2021;33(1):mzaa094. doi: 10.1093/intqhc/mzaa094
48. Berben SAA, Vloet LCM, Lischer F, Pieters M, de Cock J. Medical coordination rescue members’ and ambulance nurses’ perspectives on a new model for mass casualty and disaster management and a novel terror attack mitigation approach in the Netherlands: A qualitative study. Prehosp Disaster Med. 2021;36(5):519-525. doi: 10.1017/S1049023X21000790
49. Aringhieri R, Bigharaz S, Duma D, Guastalla A. Fairness in ambulance routing for post disaster management. Cent Eur J Oper Res. 2022;30(1):189-211. doi: 10.1007/s10100-021-00785-y
50. Haghi M, Benis A, Deserno TM. Accident & emergency informatics and one digital health. Yearb Med Inform. 2022;31(1):40-46. doi: 10.1055/s-0042-1742506
51. Fitriani WR, Sutanto J, Handayani PW, Hidayanto AN. User compliance with the health emergency and disaster management system : Systematic literature review. J Med Internet Res. 2023;25:e41168. doi: 10.2196/41168
52. Madanian S, Norris T, Parry D. Disaster eHealth : Scoping review. J Med Internet Res. 2020;22(10):e18310. doi: 10.2196/18310
53. Recchia V, Aloisi A, Zizza A. Risk management and communication plans from SARS to COVID-19 and beyond. Int J Health Plann Manage. 2022;37(6):3039-3060. doi: 10.1002/hpm.3545
54. Taylor OG. The policy landscape and challenges of disaster risk financing: Navigating risk and uncertainty. Disasters. 2023;47(3):745-765. doi: 10.1111/disa.12560
55. Orlov SA. Scientific substantiation of the management decision support system for the work of a medical organization in the context of biological challenges (using the example of COVID-19). Candidate of Medical Sciences thesis. Moscow; 2022. (In Russ.) Accessed August 13, 2024. https://nriph.ru/images/assets/files/disser/2022/orlov/orlov_dissertacziya.pdf
Review
For citations:
Orlov S.A., Aleksandrova O.Yu., Vasilieva T.P., Gorenkov R.V. Theoretical model of regional healthcare system resource provision for a sustainable response to global challenges. Public Health and Life Environment – PH&LE. 2024;32(9):19-30. (In Russ.) https://doi.org/10.35627/2219-5238/2024-32-9-19-30