Tackling the COVID-19 pandemic: Initial responses in 2020 in selected social health insurance countries in Europe

Strategic purchasing and health systems resilience: Lessons from COVID-19 in selected European countries

“…Governments, usually the central government, designed and implemented policies to respond to the pandemic with little reference to the tools of strategic purchasing. This reflects the findings of a broader study on COVID-19 health system responses in 8 social insurance countries in Europe (Austria, Belgium, France, Germany, Luxembourg, the Netherlands, Slovenia and Switzerland) that the insurers played no major role in managing the pandemic [60] .…”

“…Alternatively, policymakers could accept that strategic purchasing and purchasers will not play a key role in emergencies and assume that they can take centralizing measures as needed. In fact, several insurers were not represented in crisis management teams or pandemic plans [60] . Perhaps this reflected policymakers' expectations of their usefulness in crisis situations.…”

Health care patterns and policies in 18 European countries during the first wave of the COVID-19 pandemic: an observational study

“…However, the country also has a tradition of care provided outside of hospitals, including diagnostic laboratories and specialist consultations, and leveraged its public health structures early on to keep COVID-19 cases out of the hospital. 14 In that sense, it is not surprising that a high share of those finally admitted to the hospital required ICU treatment, as less severe cases were not hospitalized in the first place (and are thus not reflected in the hospital data). Norway, despite being on the low side of the spectrum for ambulatory contacts and among the highest for hospital discharges pre-pandemic, largely dealt with COVID patients outside of hospitals.…”

“…12 Many countries moved to change patient pathways or the way care was organized within health care facilities. 14 , 18 Uncertainty about the course of COVID-19 can in part explain the fact that this did not seem to happen everywhere, at least at the early stage of the first wave of the pandemic. For instance, it could explain the high share of hospitalizations in the UK, where pathways to keep patients out of the hospital were established early, in part combined with remote monitoring at home via oximeters distributed by general practitioners 19 and the creation of virtual COVID-19 wards operated by hospitals; 20 uncertainty could have impacted the extent to which these pathways were implemented.…”

Lessons learned from the COVID-19 pandemic

“…With Italy and Spain among the hardest hit in the early phases of the pandemic, the authors acknowledge the value of learning from others (or first movers as they call them), especially in conditions of uncertainty. Schmidt et al also cover a large country group, focusing on social health insurance (SHI) countries including Austria, Belgium, France, Germany, Luxembourg, the Netherlands, Slovenia and Switzerland [26] . They found that, perhaps surprisingly, SHI funds which play an important role as purchasers in these health systems were generally not very involved in crisis management and that their responsibilities in some countries shifted to the national government.…”