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European Journal of Public Health ; 31:1, 2021.
Article in English | Web of Science | ID: covidwho-1610430
European Observatory on Health Systems and Policies. European Observatory Policy Briefs ; 2021.
Article in English | MEDLINE | ID: covidwho-1196319


COVID-19 can cause persistent ill-health. Around a quarter of people who have had the virus experience symptoms that continue for at least a month but one in 10 are still unwell after 12 weeks. This has been described by patient groups as "Long COVID". Our understanding of how to diagnose and manage Long COVID is still evolving but the condition can be very debilitating. It is associated with a range of overlapping symptoms including generalized chest and muscle pain, fatigue, shortness of breath, and cognitive dysfunction, and the mechanisms involved affect multiple system and include persisting inflammation, thrombosis, and autoimmunity. It can affect anyone, but women and health care workers seem to be at greater risk. Long COVID has a serious impact on people's ability to go back to work or have a social life. It affects their mental health and may have significant economic consequences for them, their families and for society. Policy responses need to take account of the complexity of Long COVID and how what is known about it is evolving rapidly. Areas to address include: The need for multidisciplinary, multispecialty approaches to assessment and management;Development, in association with patients and their families, of new care pathways and contextually appropriate guidelines for health professionals, especially in primary care to enable case management to be tailored to the manifestations of disease and involvement of different organ systems;The creation of appropriate services, including rehabilitation and online support tools;Action to tackle the wider consequences of Long COVID, including attention to employment rights, sick pay policies, and access to benefit and disability benefit packages;Involving patients both to foster self-care and self-help and in shaping awareness of Long COVID and the service (and research) needs it generates;and Implementing well-functioning patient registers and other surveillance systems;creating cohorts of patients;and following up those affected as a means to support the research which is so critical to understanding and treating Long COVID.

Eurohealth ; 26(2):68-72, 2020.
Article in English | GIM | ID: covidwho-942065


During the COVID-19 pandemic, hospitals face the concurrent challenges of maintaining routine services while attending to COVID-19 patients. This article shares approaches taken in six countries to resume hospital care after the first wave of the pandemic by surveying country experts and using data extracted from the COVID-19 Health Systems Response Monitor (HSRM). Four strategies were observed in all six countries: prioritisation or rationing of treatments, converting clinical spaces to separate patients, using virtual treatments, and implementing COVID-19 free hospitals or floors. Clear guidance about how to prioritise activities would support hospitals in the next phases of the pandemic.

Eurohealth ; 26(2):83-87, 2020.
Article in English | GIM | ID: covidwho-942063


COVID-19 has affected the incomes of some health professionals by reducing demand for care and increasing expenditures for treatment preparedness. In a survey of 14 European countries, we found that most countries have incentivised substitutive e-health services to avoid loss of income. Health professionals have also received financial compensation for loss of income either through initiatives specifically designed for the health sector or general self-employment schemes, and have either been reimbursed for extra COVID-19-related expenditures such as personal protective equipment (PPE) or had these provided in kind. Compensation is generally funded from health budgets, complemented by emergency funding from government revenue.

Eurohealth ; 26(2):88-92, 2020.
Article in English | GIM | ID: covidwho-942002


All countries in Europe will have to find solutions to protect hospitals from revenue shortfalls and to adequately reimburse for COVID-19-related costs of care. This article reports on changes to hospital payment systems in Belgium, Bulgaria, the Czech Republic, Finland, France, Germany, Israel, Poland, Romania, Switzerland, and the United Kingdom (England). Hospitals in these countries are paid for treating COVID-19 patients using the usual system, modified Diagnosis Related Groups or new mechanisms. In many countries, hospitals receive their usual budgets or new money to compensate for revenue shortfalls. Only a few countries are paying non-contracted providers.