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Healthcare System Recovery Post COVID-19
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Healthcare System Recovery Post COVID-19

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Coronaviruses (CoV) and COVID-19 Pandemic".

Deadline for manuscript submissions: closed (30 January 2022) | Viewed by 24240

Special Issue Editors

Dr. Tony Smith

E-Mail Website
Guest Editor
Centre for Leadership in Health and Social Care, Sheffield Hallam University, Sheffield, UK
Interests: leadership dynamics and their impact in integrated health and social care teams
Dr. Sally Fowler-Davis

E-Mail Website
Co-Guest Editor
Organisation in Health and Care, Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield S9 3TY, UK
Interests: measurement of health outcomes; measuring the quality and impact of services
Special Issues, Collections and Topics in MDPI journals
Dr. George Lueddeke

E-Mail Website
Co-Guest Editor
International One Health for One Planet Education Initiative (1 HOPE), Southampton, UK
Interests: medical education; educational transformation; innovation; leadership
Dr. Lorena Dini

E-Mail Website
Co-Guest Editor
Working Group Health Policy and Systems Research (HPSR), Institute of General Practice, Charité Universitätsmedizin Berlin, Berlin, Germany
Interests: primary health care delivery from the health systems perspective; improving the quality of healthcare delivery
Dr. Katarzyna Czabanowska

E-Mail Website
Co-Guest Editor
1. Department of International Health, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University, 6211 LK Maastricht, The Netherlands
2. Institute of Public Health, Faculty of Health Sciences, Jagiellonian University, 31-007 Krakow, Poland
Interests: public health leadership; public health workforce development and planning; capacity building; competence-based education; competency self-assessment; public health system
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue of Healthcare will focus on ‘Healthcare system recovery post COVID-19’.  Healthcare systems across the world have been put under enormous pressure throughout the COVID-19 epidemic. Not only have the direct effects of the coronavirus on morbidity and mortality consumed a large proportion of available resources, but they have also created knock-on effects regarding patient safety. The ability of healthcare systems to respond to other diseases such as cancer has been severely affected. The pandemic has also negatively impacted other areas of personal wellbeing, particularly mental health. Further, healthcare professionals have had to undertake unsustainable workloads over long periods, often without sufficient resources. This undoubtedly has led to significant challenges relating to staff health and wellbeing. This Special Issue aims to bring together evidence on these issues to generate solutions that will contribute to healthcare system recovery, resilience, and future sustainability as we gain control over the virus through vaccination programmes.

We welcome evidence-based articles that provide new insights into any of these connected issues, and can contribute not just to healthcare system recovery post COVID-19, but also to sustainable development for the future.

Dr. Tony Smith
Dr. Sally Fowler-Davis
Dr. George Lueddeke
Dr. Lorena Dini
Dr. Katarzyna Czabanowska
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • health systems
  • public health systems
  • pandemic response
  • recovery
  • rehabilitation
  • resilience
  • sustainability
  • patient safety
  • workforce wellbeing

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Published Papers (7 papers)

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Research

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20 pages, 1068 KiB  
Article
Understanding the Needs and Priorities of People Living with Persistent Pain and Long-Term Musculoskeletal Conditions during the COVID-19 Pandemic—A Public Involvement Project
by Sally Fowler Davis, Helen Humphreys, Tom Maden-Wilkinson, Sarah Withers, Anna Lowe and Robert J. Copeland
Healthcare 2022, 10(6), 1130; https://doi.org/10.3390/healthcare10061130 - 17 Jun 2022
Cited by 1 | Viewed by 3015
Abstract
Background: Critiques of public involvement (PI) are associated with failing to be inclusive of under-represented groups, and this leads to research that fails to include a diversity of perspectives. Aim: The aim of this PI project was to understand the experiences and priorities [...] Read more.
Background: Critiques of public involvement (PI) are associated with failing to be inclusive of under-represented groups, and this leads to research that fails to include a diversity of perspectives. Aim: The aim of this PI project was to understand the experiences and priorities of people from three seldom-heard groups whose musculoskeletal pain may have been exacerbated or treatment delayed due to COVID-19. Engaging representatives to report diverse experiences was important, given the goal of developing further research into personalised and integrated care and addressing population health concerns about access and self-management for people with musculoskeletal pain. Methods: The project was approved via Sheffield Hallam University Ethics but was exempt from further HRA approval. A literature review was conducted, followed by informal individual and group discussions involving professionals and people with lived experience of (a) fibromyalgia pain, (b) those waiting for elective surgery and (c) experts associated with the care home sector. Findings from the literature review were combined with the insights from the public involvement. Resulting narratives were developed to highlight the challenges associated with persistent pain and informed the creation of consensus statements on the priorities for service improvement and future research. The consensus statements were shared and refined with input from an expert steering group. Results: The narratives describe pain as a uniformly difficult experience to share with professionals; it is described as exhausting, frustrating and socially limiting. Pain leads to exclusion from routine daily activities and often resigns people to feeling and being unwell. In all cases, there are concerns about accessing and improving services and critical issues associated with optimising physical activity, functional wellbeing and managing polypharmacy. Exercise and/or mobilisation are important and commonly used self-management strategies, but opportunity and advice about safe methods are variable. Services should focus on personalised care, including self-management support and medication management, so that people’s views and needs are heard and validated by health professionals. Conclusions: More research is needed to explore the most effective pain management strategies, and public involvement is important to shape the most relevant research questions. Health and care systems evaluation is also needed to address the scale of the population health need. The pandemic appears to have highlighted pre-existing shortcomings in holistic pain management. Full article
(This article belongs to the Special Issue Healthcare System Recovery Post COVID-19)
13 pages, 1808 KiB  
Article
Towards an Understanding of Population Health Data in a Single NHS Trust during COVID-19
by Sally Fowler Davis, Simon Choppin and Shona Kelly
Healthcare 2022, 10(3), 447; https://doi.org/10.3390/healthcare10030447 - 26 Feb 2022
Cited by 2 | Viewed by 3020
Abstract
The objective of this study was to determine the further care needs of people discharged from the hospital following a COVID-19 illness from April–September 2020. Methods: In partnership with an NHS trust in the UK, data analysis was undertaken by linking data from [...] Read more.
The objective of this study was to determine the further care needs of people discharged from the hospital following a COVID-19 illness from April–September 2020. Methods: In partnership with an NHS trust in the UK, data analysis was undertaken by linking data from the Trust, to facilitated a triage process. The intention was to provide information in a format that enabled an examination of the population data and highlight any inequality in provision. Data were mapped onto the indices of multiple deprivation, and a range of text and graphical methods were used to represent the population data to the hospital leadership. The visual representation of the demographics and deprivation of people discharged during a critical period of the pandemic was intended to support planning for community services. The results demonstrated that just under half of those discharged were from the poorest fifth of the English population and that just under half were aged 75 or older. This reflected the disproportional effect of COVID-19 on those who were poorer, older or had pre-existing multiple morbidities. Referral to community or outpatient services was informed by the analysis, and further understanding of the diversity of the population health was established in the Trust. Conclusion: By identifying the population and mapping to the IMD, it was possible to show that over half of discharged patients were from deprived communities, and there was significant organisational learning bout using data to identify inequalities.. The challenge of planning services that target underserved communities remains an important issue following the pandemic, and lessons learnt from one health system are being shared. Full article
(This article belongs to the Special Issue Healthcare System Recovery Post COVID-19)
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10 pages, 448 KiB  
Article
Health System Resiliency and the COVID-19 Pandemic: A Case Study of a New Nationwide Contingency Staffing Program
by Shay Cannedy, Alicia Bergman, Melissa Medich, Danielle E. Rose and Susan E. Stockdale
Healthcare 2022, 10(2), 244; https://doi.org/10.3390/healthcare10020244 - 27 Jan 2022
Cited by 14 | Viewed by 3559
Abstract
When COVID-19 emerged, the U.S. Veterans Health Administration (VA) was in the process of implementing a national contingency staffing program called Clinical Resource Hubs (CRHs). CRHs were intended to provide regional contingency staffing for primary and mental health clinics experiencing staffing shortages primarily [...] Read more.
When COVID-19 emerged, the U.S. Veterans Health Administration (VA) was in the process of implementing a national contingency staffing program called Clinical Resource Hubs (CRHs). CRHs were intended to provide regional contingency staffing for primary and mental health clinics experiencing staffing shortages primarily through telehealth. Long-term plans (year 2) included emergency management support. Early in the implementation, we conducted semi-structured interviews with CRH directors and national program leaders (n = 26) and used a rapid analysis approach to identify actions taken by CRHs to support the resiliency of the VA healthcare system during the pandemic. We found that the CRH program was flexible and nimble enough to allow VA to leverage providers at hubs to better respond to the demands of COVID-19. Actions taken at hubs to sustain patient access and staff resiliency during the pandemic included supporting call centers and training VA providers on virtual care delivery. Factors that facilitated CRH’s emergency response included hub staff expertise in telehealth and the increased acceptability of virtual care among key stakeholders. We conclude that hub providers serving as contingency staff, as well as specialization in delivering virtual outpatient and inpatient care, enabled VA health system resiliency and recovery during the COVID-19 pandemic. Full article
(This article belongs to the Special Issue Healthcare System Recovery Post COVID-19)
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14 pages, 244 KiB  
Article
Lessons Learnt from the EU Response to NCDs: A Content Analysis on Building Resilient Post-COVID Health Systems
by Rana Orhan, Martina Paric and Katarzyna Czabanowska
Healthcare 2021, 9(12), 1659; https://doi.org/10.3390/healthcare9121659 - 30 Nov 2021
Cited by 6 | Viewed by 3124
Abstract
Non-communicable diseases (NCDs) impose a heavy burden on the healthcare system of countries in the European Union (EU). An estimated 91.3% of all deaths and 86.6% of DALYs in the EU-28 were attributable to NCDs. It is imperative that the EU act on [...] Read more.
Non-communicable diseases (NCDs) impose a heavy burden on the healthcare system of countries in the European Union (EU). An estimated 91.3% of all deaths and 86.6% of DALYs in the EU-28 were attributable to NCDs. It is imperative that the EU act on mitigating this challenging health issue and help create trajectories for building resilient health systems. Using qualitative analysis, this study examines the question of how the European Commission 2019–2024 is planning to mitigate the impact of NCDs on health systems, while taking into account the COVID-19 pandemic. A content analysis of 44 documents communicating the European Commission’s position on the issue was done. In vivo coding was performed using the software package ATLAS.ti 9. Unique codes were simplified and grouped into main themes. Five main themes were identified: ‘health plan’, ‘COVID-19’, ‘future direction’, ‘collaboration and solidarity’, and ‘persuasion’. This study shows that the European Commission is emphasising the impact of the pandemic and the relevance of policies tackling NCDs. By calling for more cross- and multi-sectoral collaboration, the Commission hopes to create the right climate for a European framework for cooperation, which can help develop EU-wide resilient health systems. Full article
(This article belongs to the Special Issue Healthcare System Recovery Post COVID-19)
12 pages, 1790 KiB  
Article
Inpatient Mental Healthcare before and during the COVID-19 Pandemic
by Alan B. McGuire, Mindy E. Flanagan, Marina Kukla, Angela L. Rollins, Laura J. Myers, Emily Bass, Jennifer M. Garabrant and Michelle P. Salyers
Healthcare 2021, 9(12), 1613; https://doi.org/10.3390/healthcare9121613 - 23 Nov 2021
Cited by 5 | Viewed by 2388
Abstract
Prior studies have demonstrated disruption to outpatient mental health services after the onset of the COVID-19 pandemic. Inpatient mental health services have received less attention. The current study utilized an existing cohort of 33 Veterans Health Affairs (VHA) acute inpatient mental health units [...] Read more.
Prior studies have demonstrated disruption to outpatient mental health services after the onset of the COVID-19 pandemic. Inpatient mental health services have received less attention. The current study utilized an existing cohort of 33 Veterans Health Affairs (VHA) acute inpatient mental health units to examine disruptions to inpatient services. It further explored the association between patient demographic, clinical, and services variables on relapse rates. Inpatient admissions and therapeutic services (group and individual therapy and peer support) were lower amongst the COVID-19 sample than prior to the onset of COVID-19 while lengths of stay were longer. Relapse rates did not differ between cohorts. Patients with prior emergent services use as well as substance abuse or personality disorder diagnoses were at higher risk for relapse. Receiving group therapy while admitted was associated with lower risk of relapse. Inpatient mental health services saw substantial disruptions across the cohort. Inpatient mental health services, including group therapy, may be an important tool to prevent subsequent relapse. Full article
(This article belongs to the Special Issue Healthcare System Recovery Post COVID-19)
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17 pages, 705 KiB  
Article
Effects of Leisure Obstacles, Job Satisfaction, and Physical and Mental Health on Job Intentions of Medical Workers Exposed to COVID-19 Infection Risk and Workplace Stress
by Hsiao-Hsien Lin, Jan-Wei Lin, Chao-Chien Chen, Chin-Hsien Hsu, Bing-Sen Lai and Tzu-Yun Lin
Healthcare 2021, 9(11), 1569; https://doi.org/10.3390/healthcare9111569 - 18 Nov 2021
Cited by 8 | Viewed by 2725
Abstract
The purpose of this study was to investigate the effects of leisure obstacles, job satisfaction, physical and mental health, and work intentions of medical workers in Taiwan. SPSS 26.0 and AMOS 24.0 statistical software were used to analyze 208 questionnaires by basic statistical [...] Read more.
The purpose of this study was to investigate the effects of leisure obstacles, job satisfaction, physical and mental health, and work intentions of medical workers in Taiwan. SPSS 26.0 and AMOS 24.0 statistical software were used to analyze 208 questionnaires by basic statistical tests, t-tests, and structural model analysis. Results: Under the epidemic, medical workers were unable to develop job identity due to low promotion opportunities and low job achievement. The lack of recreational exercise skills, time, and information created leisure obstacles. In addition, they were unable to express their true selves freely at work, which led to health problems such as reduced enthusiasm, mental weakness, and emotional irritability. In particular, female medical workers felt more strongly about the issues of leisure obstacles and the intention to stay in their jobs. The study found that the higher their job satisfaction, the higher their intention to stay in the job, while the more pronounced the leisure obstacles and physical and mental health problems, the more pronounced their intention to leave. Full article
(This article belongs to the Special Issue Healthcare System Recovery Post COVID-19)
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Review

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13 pages, 461 KiB  
Review
The European Health Union: European Union’s Concern about Health for All. Concepts, Definition, and Scenarios
by Marie Nabbe and Helmut Brand
Healthcare 2021, 9(12), 1741; https://doi.org/10.3390/healthcare9121741 - 17 Dec 2021
Cited by 8 | Viewed by 3809
Abstract
The COVID-19 pandemic brought visibility and intensified the discussions on the European Union’s (EU) health mandate. The proposals of the European Commission (EC) to move towards a European Health Union (EHU) can be seen as a starting point towards more integration in health. [...] Read more.
The COVID-19 pandemic brought visibility and intensified the discussions on the European Union’s (EU) health mandate. The proposals of the European Commission (EC) to move towards a European Health Union (EHU) can be seen as a starting point towards more integration in health. However, the definition of what the EHU will look like is not clear. This paper searches to find a common definition, and/or features for this EHU through a systematic literature review performed in May 2021. “European Union’s concern about health for all” is suggested as a definition. The main drivers identified to develop an EHU are: surveillance and monitoring, crisis preparedness, funding, political will, vision of public health expenditures, population’s awareness and interest, and global health. Based on these findings, five scenarios were developed: making a full move towards supranational action; improving efficiency in the actual framework; more coordination but no real change; in a full intergovernmentalism direction; and fragmentation of the EU. The scenarios show that the development of a EHU is possible inside the current legal framework. However, it will rely on increased coordination and has a focus on cross-border health threats. Any development will be strongly linked to political choices from Member States. Full article
(This article belongs to the Special Issue Healthcare System Recovery Post COVID-19)
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