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A comparison of health system responses to COVID-19 in Bulgaria, Croatia and Romania in 2020

Džakula, Aleksandar, Banadinović, Maja, Lovrenčić, Iva Lukačević, Vajagić, Maja, Dimova, Antoniya, Rohova, Maria, Minev, Mincho, Scintee, Silvia Gabriela, Vladescu, Cristian, Farcasanu, Dana, Robinson, Susannah, Spranger, Anne, Sagan, Anna and Rechel, Bernd (2022) A comparison of health system responses to COVID-19 in Bulgaria, Croatia and Romania in 2020. Health Policy, 126 (5). pp. 456-464. ISSN 0168-8510

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Identification Number: 10.1016/j.healthpol.2022.02.003

Abstract

This article compares the health system responses to COVID-19 in Bulgaria, Croatia and Romania from February 2020 until the end of 2020. It explores similarities and differences between the three countries, building primarily on the methodology and content compiled in the COVID-19 Health System Response Monitor (HSRM). We find that all three countries entered the COVID-19 crisis with common problems, including workforce shortages and underdeveloped and underutilized preventive and primary care. The countries reacted swiftly to the first wave of the COVID-19 pandemic, declaring a state of emergency in March 2020 and setting up new governance mechanisms. The initial response benefited from a centralized approach and high levels of public trust but proved to be only a short-term solution. Over time, governance became dominated by political and economic considerations, communication to the public became contradictory, and levels of public trust declined dramatically. The three countries created additional bed capacity for the treatment of COVID-19 patients in the first wave, but a greater challenge was to ensure a sufficient supply of qualified health workers. New digital and remote tools for the provision of non-COVID-19 health services were introduced or used more widely, with an increase in telephone or online consultations and a simplification of administrative procedures. However, the provision and uptake of non-COVID-19 health services was still affected negatively by the pandemic. Overall, the COVID-19 pandemic has exposed pre-existing health system and governance challenges in the three countries, leading to a large number of preventable deaths.

Item Type: Article
Official URL: https://www.sciencedirect.com/journal/health-polic...
Additional Information: Funding Information: This research is supported by the "Health Observatory" project: UP.04.2.1.06. Thematic networks for socio-economic development and the promotion of social dialogue in the context of improving working conditions, funded by the European Social Fund under the Operational Program Effective Human Resources 2014–2020. The PUB HUB project team on behalf of the Andrija Štampar School of Public Health, Faculty of Medicine, University of Zagreb participates in the project element of examining the needs of society and conducting scientific research in the field of identified social change. Funding Information: This research is supported by the "Health Observatory" project: UP.04.2.1.06. Thematic networks for socio-economic development and the promotion of social dialogue in the context of improving working conditions, funded by the European Social Fund under the Operational Program Effective Human Resources 2014–2020. The PUB HUB project team on behalf of the Andrija Štampar School of Public Health, Faculty of Medicine, University of Zagreb participates in the project element of examining the needs of society and conducting scientific research in the field of identified social change. Publisher Copyright: © 2022
Divisions: Social Policy
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
H Social Sciences > HV Social pathology. Social and public welfare. Criminology
Date Deposited: 10 Mar 2022 12:33
Last Modified: 15 Sep 2023 17:05
URI: http://eprints.lse.ac.uk/id/eprint/114306

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