Organisation of the State, model of health system and COVID‐19 health outcomes in six European countries, during the first months of the COVID‐19 epidemic in 2020

Abstract

The time and type of the States' responses to the COVID‐19 pandemic varied with the severity of the epidemiological situation, the perceived risk, the political organisation and the model of health system of the country. We discuss the response of Germany, Spain, France, Italy, Portugal and the United Kingdom during the first months of the COVID‐19 epidemic in 2020, considering the political organisation of the country and its health system model. We analyse public health measures implemented to contain or mitigate the pandemic, as well as those related to governance, resources and reorganisation of services, financing mechanisms, response of the health system itself and health outcomes. To measure the burden of COVID‐19, we use several indicators. The adoption of measures, to contain and mitigate epidemic varied in degree and time of adoption. All countries reorganised their governance structure and the provision of care, despite the differences in political models and health systems (ranging from a more unitary and centralised political organisational model—France and Portugal; to a decentralised matrix—Germany, Spain, Italy and the United Kingdom). Rather than the differences in political models and health systems, the explanation for the success in tackling the epidemic seems to lay in other social determinants of health.

COVID-19 Pandemic-Revealed Consistencies and Inconsistencies in Healthcare: A Medical and Organizational View

“…The research results demonstrate the main findings provided by the scientists, which can lead to a clear view on the consistencies and inconsistencies in healthcare organization and governance, revealed by the pandemic: Traditional organizational cultures that are hierarchical and controlling need to be challenged and reoriented towards collaborative, inclusive, and participative practices of engagement and involvement. Health systems’ processes must move from a top-down approach to integrative policy, planning, and implementation processes, increasingly adopting a people-centered approach [ 80 , 81 , 82 ]. COVID-19 has brought upon us the opportunity to redesign health policy thinking and acting to stimulate new possibilities through critical debate, moving from fragmentation to adaptive self-organization, creating well-integrated, equitable, and prosperous societies resilient to sudden unexpected perturbations of any kind [ 83 , 84 , 85 , 86 ].…”

“…Traditional organizational cultures that are hierarchical and controlling need to be challenged and reoriented towards collaborative, inclusive, and participative practices of engagement and involvement. Health systems’ processes must move from a top-down approach to integrative policy, planning, and implementation processes, increasingly adopting a people-centered approach [ 80 , 81 , 82 ].…”

How do workplace stressors during COVID-19 affect health frontline employees in Iran: Investigating the role of employee resilience and constituent attachment

“…Similarly, situational variables such as the PCT lead to depleting employee's resources, ultimately emotional exhaustion. Coronavirus (COVID-19) is a highly contagious disease that has affected the world since it was declared a pandemic on March 11, 2020 ( Dinić et al ., 2021; Simões et al ., 2021). The PCT comprises fear of infection (health risks); fear that the employee or their family is a potential carrier of the virus, and thus stigmatizing the employee (social risks); and accepting the risk of contracting the virus at work (acceptance of risks) (Manzano García and Ayala Calvo, 2021).…”

The benefit of augmenting open data with clinical data-warehouse EHR for forecasting SARS-CoV-2 hospitalizations in Bordeaux area, France

“…[1][2][3] This pandemic has had a major impact on health care with an increase of the hospitalizations leading to modifications of the organization of care and to unprecedented population lockdowns to avoid health care system saturation. [4][5][6] The ability to anticipate the evolution of the epidemic at a local level is critical to manage the health care system.…”