Who Counts Where? COVID-19 Surveillance in Federal Countries

Rocco, Philip; Rich, Jessica A. J.; Klasa, Katarzyna; Dubin, Kenneth A.; Béland, Daniel

doi:10.1215/03616878-9349114

Cited by 17 publications

(13 citation statements)

References 46 publications

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“…The outcomes of FD on regional healthcare services highlighted by this investigation have direct policy implications on the level of emergency preparedness in the Italian SSN and – more in general – in decentralised health systems, as suggested by recent observations. 28 - 30 Preparedness concerns the ability to anticipate, respond to, and recover from the impacts of an emergency. A health system with adequate levels of trained staff and hospital resources lies at the foundation of successful preparedness, since it can guarantee continuity of care while addressing the emergency.…”

Section: Discussionmentioning

confidence: 99%

“…14,[24][25][26][27] In the context of the coronavirus disease 2019 (COVID-19) pandemic, evidence suggest that countries with a high degree of decentralisation have adopted less stringent measures than centralised countries. [28][29][30] Italy has a long history of inter-regional socio-economic disparities, reflected in a clear-cut divide between the rich, industrialised areas of the Centre-North, and the poorer regions in the South. The Italian National Health Service (Servizio Sanitario Nazionale, henceforth SSN) was established to guarantee equal and uniform access to care irrespective of income or location, based on the principle of solidarity, in the attempt to reduce some regional differences.…”

Section: Introductionmentioning

confidence: 99%

“…In the context of the coronavirus disease 2019 (COVID-19) pandemic, evidence suggest that countries with a high degree of decentralisation have adopted less stringent measures than centralised countries. 28 - 30 …”

Section: Introductionmentioning

confidence: 99%

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The Effects of Health Sector Fiscal Decentralisation on Availability, Accessibility, and Utilisation of Healthcare Services: A Panel Data Analysis

Rotulo

Paraskevopoulou

Kondilis

2021

Int J Health Policy Manag

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Background: Fiscal Decentralisation (FD) is a widely implemented decentralisation policy consisting of the allocation of pooling and spending responsibilities from the central government to lower levels of governance within a country. In 2001, The Italian National Health System (SSN) has introduced a strong element of FD, making regions responsible for their own pooling of resources and for their budgets. Despite the relevance, only few studies exist on health sector-FD in Italy, mostly looking at the effects of FD on infant mortality. Methods: This study performs a fixed-effects panel data analysis of Italian Regions and Autonomous provinces between the years 2001 and 2017, to investigate the effects of health sector-FD on availability, accessibility, and utilisation of healthcare services in Italy. Results: FD decreases availability of staff and hospital beds, decreases utilisation of care, measured by hospitalisation rates, and increases interregional patients' mobility for healthcare purposes, a finding suggesting increased disparities in access to healthcare. These effects seem to be stronger for public – rather than private – services, and are more prominent in poorer areas. Conclusion: This evidence suggest that FD has created a fragmented and unequal healthcare system, in which levels of availability, utilisation of, and accessibility to resources – as well as the extent of public sector’s retrenchment – coincide with the wealth of the area.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Effects of Health Sector Fiscal Decentralisation on Availability, Accessibility, and Utilisation of Healthcare Services: A Panel Data Analysis

Rotulo

Paraskevopoulou

Kondilis

2021

Int J Health Policy Manag

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“…Throughout the pandemic, COVID-19 surveillance systems played a key role in shaping effective responses to the pandemic [25]. Nevertheless, differences between countries, regions, and over time in how COVID-19 cases are defined, tested for, and reported have made the consistent and reliable tracking of the COVID-19 burden challenging [26][27][28]. To support an effective public health response going into the winter, countries will need to do more and more varied surveillance.…”

Section: Effective Surveillance Is the Key To An Effective Responsementioning

confidence: 99%

ASPHER Statement: Facing the Fourth Winter of the COVID-19 Pandemic

Hrzic¹,

Davidovitch²,

Barros

et al. 2022

Public Health Rev

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“…Limited availability of timely comprehensive and standardized data may have been a contributing factor [329,330]. In the US, local and state agencies have primary and statutory responsibility for collecting and organizing infectious disease surveillance data.…”

Section: Explanations For Knowledge Gapsmentioning

confidence: 99%

Missing science: A scoping study of COVID-19 epidemiological data in the United States

Bhatia

I²,

Baral

2022

PLoS ONE

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Systematic approaches to epidemiologic data collection are critical for informing pandemic responses, providing information for the targeting and timing of mitigations, for judging the efficacy and efficiency of alternative response strategies, and for conducting real-world impact assessments. Here, we report on a scoping study to assess the completeness of epidemiological data available for COVID-19 pandemic management in the United States, enumerating authoritative US government estimates of parameters of infectious transmission, infection severity, and disease burden and characterizing the extent and scope of US public health affiliated epidemiological investigations published through November 2021. While we found authoritative estimates for most expected transmission and disease severity parameters, some were lacking, and others had significant uncertainties. Moreover, most transmission parameters were not validated domestically or re-assessed over the course of the pandemic. Publicly available disease surveillance measures did grow appreciably in scope and resolution over time; however, their resolution with regards to specific populations and exposure settings remained limited. We identified 283 published epidemiological reports authored by investigators affiliated with U.S. governmental public health entities. Most reported on descriptive studies. Published analytic studies did not appear to fully respond to knowledge gaps or to provide systematic evidence to support, evaluate or tailor community mitigation strategies. The existence of epidemiological data gaps 18 months after the declaration of the COVID-19 pandemic underscores the need for more timely standardization of data collection practices and for anticipatory research priorities and protocols for emerging infectious disease epidemics.

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Who Counts Where? COVID-19 Surveillance in Federal Countries

Cited by 17 publications

References 46 publications

The Effects of Health Sector Fiscal Decentralisation on Availability, Accessibility, and Utilisation of Healthcare Services: A Panel Data Analysis

The Effects of Health Sector Fiscal Decentralisation on Availability, Accessibility, and Utilisation of Healthcare Services: A Panel Data Analysis

ASPHER Statement: Facing the Fourth Winter of the COVID-19 Pandemic

Missing science: A scoping study of COVID-19 epidemiological data in the United States

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