[Healthcare institution resilience and the influencing factors during infectious disease outbreaks].

Abstract

Objective: To analyze the association between healthcare workers mental health, institutional supplies and facilities, inter-organizational coordination during infectious disease outbreaks, and the healthcare institution resilience.

Methods: An online questionnaire survey was conducted among the healthcare workforce from 146 institutions in Beijing from January 13, 2023 to February 9, 2023, and a total of 1 434 eligible respondents were included. The sample comprised 408 responses from tertiary hospitals, 117 from secondary hospitals, and 909 from primary care institutions. The resilience indicator for healthcare institutions was defined as the degree to which medical services met patient demands, with influencing factors including physical factors, such as material shortages and facility space adaptation or expansion, organizational factors such as information sharing and patient referral, and psychological factors were evaluated using job satisfaction (extrinsic satisfaction, intrinsic satisfaction), burnout (emotional exhaustion, depersonalization, reduced personal accomplishment), and depression status. Ordered multiclassification Logistic regression was used to examine the impact of various factors on the degree to which healthcare services met patient needs; additionally, demographic factors that might influence institutional resilience were controlled.

Results: During the emergency response phase, 93% of hospitals maintained the capacity to meet patient needs, though tertiary hospitals demonstrated significantly higher rates of service inadequacy (21.05%). Material shortages were reported across all institutions, with tertiary hospitals experiencing more frequent multi-item shortages. Inter-institutional collaboration patterns revealed substantial variation: 87.50% of primary care facilities, 42.86% of secondary hospitals, and 31.58% of tertiary hospitals. Healthcare workers across all levels reported mild depressive symptoms and moderate-to-severe burnout levels. Regression analysis showed high satisfaction (overall satisfaction β=0.04, extrinsic satisfaction β=0.06, and intrinsic satisfaction β=0.08), low degree of job burnout (emotional exhaustion β=-0.04, depersonalization β=-0.07 and reduced personal accomplishment β=0.01), low degree of depression (β=-0.06) were significantly associated with higher healthcare institution resilience. In addition, material shortages were significantly associated with lower resilience, and renovation and expansion of treatment spaces, and information sharing, were all associated with higher resilience. Demographic factors (age, gender, marital status, educational background, etc.) had no significant impact on resilience.

Conclusion: Mental health status significantly influences healthcare institution resilience. As human resources constitute the core asset of healthcare institutions, strategic optimization of workforce allocation and psychological support interventions can effectively strengthen resilience. Moreover, healthcare institution resilience is positively impacted by orderly material supply chains, timely resource distribution, and adaptive reconfiguration of clinical spaces. Finally, facilitating information sharing also enhances institutional resilience.