Managing COVID-19 within and across health systems: why we need performance intelligence to coordinate a global response
Managing COVID-19 within and across health systems: why we need performance intelligence to coordinate a global response
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DOI：
10.1186/s12961-020-00593-x
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发表时间：
2020-07-14
影响因子：
4
通讯作者：
Klazinga, N.
中科院分区：
文献类型：
--
作者：
Kringos, D.;Carinci, F.;Klazinga, N.
2019冠状病毒病大流行是一场复杂的全球公共卫生危机，给临床、组织和系统带来了挑战。为了管理和监测这一危机，需要从不同的角度研究卫生问题。绩效情报是一种方法，它强调在支持卫生系统决策者根据充分知情的选择确定政策时需要不同的研究视角。在本文中，我们提出了医疗绩效情报专业人员创新培训网络（HealthPros）关于如何在COVID-19大流行期间和之后使用绩效情报的观点。缺乏标准化的信息，加上各国之间的讨论和协调有限，造成了所有国家决策的不确定性。因此，在世界范围内发现了大量不同的非数据驱动和不协调的方法来应对疫情。需要进行比较卫生系统研究，以帮助各国在大流行的不同阶段形成其在社会保健、公共卫生、初级保健、医院保健和长期护理方面的应对模式。在每个阶段都需要比较针对具体情况的一揽子措施，这些措施对健康结果的影响可以使用有针对性的数据和先进的统计方法进行建模。性能智能可以用于比较数据、构建指标和确定最佳策略。采用系统视角将使各国能够采取协调一致的战略决策，同时减轻系统崩溃的风险。HealthPros网络为性能智能的开发和实施概述了一个框架，具有针对性。卫生系统需要更好和更及时的数据，以便在大流行引起的过渡期进行管理，在这个时期，世界各地的护理需求、需求和能力之间的紧张关系异常严重。卫生系统面临的挑战是确保向所有患者提供基本水平的卫生保健，包括那些需要常规援助的患者。绩效情报作为更广泛的公共卫生战略的一部分，在指导卫生系统行为体就实施应对COVID-19或任何未来流行病的具体措施及其对整个卫生系统的影响做出决策方面发挥着至关重要的作用。这应以共同商定的标准化数据和适合用途的指标为基础，充分利用现有的卫生信息基础设施。HealthPros网络可以做出有意义的贡献。
Background The COVID-19 pandemic is a complex global public health crisis presenting clinical, organisational and system-wide challenges. Different research perspectives on health are needed in order to manage and monitor this crisis. Performance intelligence is an approach that emphasises the need for different research perspectives in supporting health systems' decision-makers to determine policies based on well-informed choices. In this paper, we present the viewpoint of the Innovative Training Network for Healthcare Performance Intelligence Professionals (HealthPros) on how performance intelligence can be used during and after the COVID-19 pandemic. Discussion A lack of standardised information, paired with limited discussion and alignment between countries contribute to uncertainty in decision-making in all countries. Consequently, a plethora of different non-data-driven and uncoordinated approaches to address the outbreak are noted worldwide. Comparative health system research is needed to help countries shape their response models in social care, public health, primary care, hospital care and long-term care through the different phases of the pandemic. There is a need in each phase to compare context-specific bundles of measures where the impact on health outcomes can be modelled using targeted data and advanced statistical methods. Performance intelligence can be pursued to compare data, construct indicators and identify optimal strategies. Embracing a system perspective will allow countries to take coordinated strategic decisions while mitigating the risk of system collapse.A framework for the development and implementation of performance intelligence has been outlined by the HealthPros Network and is of pertinence. Health systems need better and more timely data to govern through a pandemic-induced transition period where tensions between care needs, demand and capacity are exceptionally high worldwide. Health systems are challenged to ensure essential levels of healthcare towards all patients, including those who need routine assistance. Conclusion Performance intelligence plays an essential role as part of a broader public health strategy in guiding the decisions of health system actors on the implementation of contextualised measures to tackle COVID-19 or any future epidemic as well as their effect on the health system at large. This should be based on commonly agreed-upon standardised data and fit-for-purpose indicators, making optimal use of existing health information infrastructures. The HealthPros Network can make a meaningful contribution.