摘要
气候变化对人口健康有重大影响，并对医疗保健系统的运作产生负面影响。医疗系统必须在业务上做好准备，以应对环境变化带来的挑战。要快速适应关键的环境条件并减少碳排放，就必须具备复原力。本系统综述研究了医疗系统应对气候变化影响的准备和恢复策略，以及实施这些策略时面临的障碍和挑战。为了确定研究，我们采用 PRISMA（系统综述和元分析首选报告项）方法，对 Scopus、PubMed 和 Google Scholar 数据库进行了三次检索（从 2024 年 4 月到 10 月，分别为 4 月 21 日、6 月 15 日和 9 月 9 日），时间跨度为 2018 年到 2024 年。具体而言，检索发现了 471 篇文章，其中十六（16）项研究符合规定的纳入和排除标准（符合纳入标准的二次研究、英语等）。根据所审查的研究结果，适应战略的重点是结构变革、培训计划的制定、监控系统的开发以及适当的运营计划。领导者激励员工实现既定目标的能力、对目标和干预措施的持续评估，以及从以往灾害中吸取的经验教训，在实施过程中发挥着重要作用。同样，关键的减灾政策和战略包括采用可持续的做法，如回收利用和文化变革。然而，资源（人力、物力、财力）的缺乏以及对卫生服务需求的增加使得适应和减灾战略难以实施。审查结果主要是理论性的，并得到了其他研究的证实。建议进一步研究卫生系统的抗灾和备灾能力，以实现其可持续性并制定适当的政策。Climate change has a significant impact on the population's health and negatively affects the functioning of healthcare systems. Health systems must be operationally prepared to handle the challenges posed by environmental change. Resilience is required to adapt quickly to critical environmental conditions and reduce carbon emissions. In this systematic review strategies, for health system preparedness and resilience are examined to address the impacts of climate change, and the barriers and challenges faced when implementing them. To identify studies, the Scopus, PubMed and Google Scholar databases were searched three times (from April to October 2024, 21 April, 15 June, and 9 September) for the years 2018 to 2024, using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology. Specifically, the search identified 471 articles, of which the specified inclusion and exclusion criteria (secondary studies with inclusion criteria, being in English, etc.) were met by sixteen (16) studies. According to the findings of the studies reviewed, adaptation strategies focus on structural changes, the development of training programs, the development of surveillance systems, and appropriate operational plans. The leader's ability to motivate employees to achieve defined goals, continuous evaluation of goals and interventions, and learning from previous disasters play an important role in their implementation. Similarly, key policies and strategies for mitigation include the adoption of sustainable practices, such as recycling and cultural change. However, lack of resources (human, material, financial) and increased demand for health services make it difficult to implement adaptation and mitigation strategies. The findings of the review are mainly theoretical in nature and are confirmed by other studies. It is suggested that further research on resilience and preparedness of health systems should be pursued, leading to their sustainability and the formulation of appropriate policies.
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