生物威胁防范国家医疗保健评估的当前问题(文献综述)

S. Orlov, O. Y. Aleksandrova
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摘要

导言。生物威胁经常给国家医疗保健带来挑战,从而成为阻碍医疗保健工作取得成功的最关键问题。高感染性和高效力的新型生物制剂促使人们重新审视医疗保健管理方法,并改变医疗基础设施的基础,以确保医疗保健做好准备,及时、充分地应对新出现的挑战。与此同时,国际或国内研究期刊的出版物中仍然缺乏对医疗保健领域生物威胁准备工作的明确定义和具体前提条件的理解。采用 PRISMA 检查表、内容分析和专家评审等方法对国际和俄罗斯的相关出版物进行了分析评审。VOSviewer 1.6.20--用于文献计量学网络构建和可视化的软件工具--可以突出显示同行研究人员在描述生物威胁对公共卫生和医疗保健整体以及医疗保健规划和医疗机构开展的其他活动的影响时最常使用的关键术语和概念。本文介绍了对 29 篇最有意义的国际和俄罗斯出版物进行内容分析和专家评审的结果,重点关注决定医疗保健应对生物威胁准备程度的关键参数。决定医疗保健应对生物威胁准备程度的 7 个关键领域包括规划、医院活动设计和组织、储备潜力、有效沟通、医务人员培训、及时准确的医疗护理、卫生和流行病学监测以及遵守标准操作程序。对医疗保健准备工作面临的挑战进行分类时,通常只考虑医疗机构内部数量有限的具体活动和可用资源。目前,还没有完整的通用方法来全面核查医疗机构应对生物威胁的活动,尤其是在住院环境中提供医疗服务的医疗机构。考虑到各种功能框架的不断发展,有效应对生物威胁的医疗准备评估需要进一步研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Current issues of national healthcare assessment for biological threats preparedness (literature review)
Introduction. Biological threats regularly challenge national healthcare, thus becoming a most critical problem that impedes successful performance. New biological agents with high infectivity and potency have promoted a review of approaches to medical care management, as well as changes in the fundaments of medical infrastructure in order to ensure healthcare readiness to provide a timely and adequate response to emerging challenges. Meanwhile, a clear definition, as well as understanding of specific prerequisites to such biological threats readiness in healthcare is still missing in either international or domestic publications in research journals.The objective is to provide a systemic overview of the problems and approaches to national health assessment for biological threats preparedness.Methods. The analytical review of international and Russian publications was performed using the PRISMA checklist, content analysis, and expert review of the most informative publications on the dedicated research. VOSviewer 1.6.20 – the software tool for bibliometric networks construction and visualization – allowed to highlight the most frequent key terms and concepts used by fellow investigators to characterize the impact of biological threats on public health and healthcare overall, as well as healthcare planning and other activities performed by medical organizations.Results and discussion. The paper presents the results of the content analysis and expert review of 29 most meaningful international and Russian publications with a focus on key parameters determining the healthcare readiness to respond to biological threats. The 7 key areas that determine healthcare readiness for biological threats include planning, hospital activities design and organization, reserves potential, effective communication, medical personnel training, timely and accurate medical care, sanitary and epidemiological surveillance, and compliance with standard operating procedures.Conclusions. Classification of challenges in healthcare readiness usually considers a limited number of specific activities within medical organizations and available resources. Currently, there are no integral common methods for comprehensive verification of activities to counter biological threats in healthcare, especially in medical organizations providing medical care in inpatient settings. Healthcare preparedness assessment to respond effectively to biological threats requires further study, considering the ongoing development of various functional frameworks.
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