The Future Effects of COVID-19 on the Health System: Applying the Futures Wheel Method

Background: Although the evidence emphasizes that COVID-9 incurs considerable primary effects on public economics and health, it is not so clear what the future effects of this pandemic might be. This study aims to identify the primary and future effects of COVID-19 on the health system. Methods: Futures Wheel (FW) method was used to find the primary and future effects of COVID-19 on eight important dimensions of the health system, including the six building blocks. To gather relevant information, PubMed, SCOPUS, Web of Knowledge, and other sources were searched to find potential studies reporting the potential effects of COVID-19 on the health system. Following that, an expert panel with nine participants to depict the findings was held. Results: Fifty-four studies met the inclusion criteria. The participants reached a consensus on nineteen main primary effects of COVID-19 that could impose 26 main future effects with specific risk opportunities on different dimensions of the health system. Workforce, stewardship and health policy, and infrastructure and hospital capacity dimensions were the most affected by COVID-19 in both the primary and future timeframe. Most of the signals of COVID-19-related opportunities could stem from health technologies and research systems, and service delivery dimensions. Conclusion: COVID-19 comes with considerable risks, especially for the health system governance and workforce dimensions. There are some opportunities to improve the resilience of the health system by using digital health platforms, promoting health literacy of the population, and also adopting inclusive health policy-making processes.