Hospitals during economic crisis: a systematic review based on resilience system capacities framework
Zeynab Foroughi1, Parvin Ebrahimi2, Aidin Aryankhesal1
1School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
BMC Health Services Research
|July 30, 2022
Summary
Policymakers focused on short-term hospital efficiency policies during economic crises, undermining Universal Health Coverage (UHC). Adaptive and transformative strategies, though less frequent, proved more effective for hospital resilience and UHC.
Area of Science:
- Health Services Research
- Health Policy and Management
- Health Economics
Background:
- Hospitals are major consumers of health system budgets.
- Policymakers aim to enhance hospital efficiency and performance during economic downturns.
- This study examines hospital policy solutions through a resilience framework.
Purpose of the Study:
- To analyze hospital policy responses to economic crises.
- To evaluate these policies using the resilience system capacities framework.
- To understand the impact on Universal Health Coverage (UHC).
Main Methods:
- Systematic review of 78 studies across 36 countries.
- Searches conducted on major databases (Web of Science, PubMed, Embase, Scopus, Econbiz).
- Data analyzed using the resilience system capacities framework and WHO's health system building blocks.
Main Results:
- Economic crises and policies negatively impacted hospital contributions to UHC.
- Short-term absorptive capacity policies were most common; adaptive policies were least frequent yet most effective.
- Transformative policies shifted focus to integrated, community-based services.
Conclusions:
- Overemphasis on short-term policies and efficiency over quality hindered UHC.
- Ignoring contextual factors and policy interrelations compromised hospital roles in UHC.
- Effective hospital resilience requires adaptive and transformative strategies considering diverse factors.
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