A Closer Look

COVID and Health Systems – What we are learning ?

Beyond containment efforts, what have health systems done thus far to manage this health crisis?

Some countries have strengthened access to health care, highlighting the importance of high quality universal health coverage. Today, in 23 OECD countries, 20% of people forego care due to long waiting times or travel distance, and 17% because costs were too high. To offset this, specific measures have been introduced to cover diagnostic testing and regulate their prices, for example, in the United States, Germany and France.

To boost health workforce capacity, some countries have allowed medical students in their last year of training to start working now and have made efforts to mobilise pharmacists and care assistants. As part of a broader logistical strategy to boost efforts to diagnose people, Korea implemented a widely known drive-thru testing programme. All countries have made efforts to isolate suspected and confirmed cases, including encouraging home hospitalisation as in the United States.

Innovative digital solutions are also emerging. Access to telemedicine has been made easier in France and the United States. Israel has introduced robotic devices and telemedicine use to monitor the health status of quarantined people. Korea is trialling smartphone applications to allow those in quarantine to report the evolution of their case as well as to monitor their quarantine compliance. Artificial intelligence initiatives to track the spread of the virus and predict where it may appear next have been developed in Canada.

The crisis has exposed the need for our health systems to be more resilient to crises of such gravity. While it is too early to draw conclusions, three aspects deserve consideration.

First, there is a need to strengthen disease surveillance mechanisms and health information infrastructures. Beyond early warning and response systems based on alerts and case notification, countries with standardised national electronic health records (EHRs) can extract routine data for real-time disease surveillance, clinical trials, and health system management. However, only Finland, Estonia, Israel, Denmark, Austria, Canada, Slovakia and the United Kingdom, as well as Singapore, have high technical and operational readiness to generate information from EHRs. This calls for more efforts to lift technical and data governance barriers that prevent the effective use of such data, while respecting data privacy, in line with the OECD Council Recommendation on Health Data Governance.

Second, the crisis has exposed the importance of having adaptable health systems. Lack of any sort of excess capacity can leave countries vulnerable to an unexpected demand surge. The availability of hospital beds and their occupancy rates vary greatly across OECD countries. For acute care beds, Japan has the highest number, at nearly 8 beds per 1,000 people, followed by Korea and Germany. For selected OECD countries, intensive care unit beds vary by a factor of 6. Equipping health systems with reserve capacity will require creative approaches, such as a “reserve army” of health professionals that can be quickly mobilised; storing a reserve capacity of supplies such as personal protection equipment; and maintaining care beds that could be quickly transformed into acute care beds.

Last, there is a need for strengthened co-ordination across countries. Besides efforts to co-ordinate an international response for rapid containment, we need to be able to accelerate the development of diagnostics, treatments and vaccines. It will currently take at least 18 months to make a new vaccine available for COVID-19. Beyond the initial spike in funding to support greater R&D efforts, there is also a need to sustain such developments should the epidemic eventually subside, so that we are better prepared for future ones. Once developed, fast-track procedures for new treatments and vaccines are important to encourage approval quickly. Commitments are also necessary to ensure that these products are made available at affordable prices where needs are the highest. As OECD Secretary-General Angel Gurría put it, we need renewed “joint actions to win the war”.

Chosen excerpts by Job Market Monitor. Read the whole story @ Resilient Health Systems: What we are learning from the COVID-19 crisis | The OECD Forum Network


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