Towards a better future: what we can do for our healthcare system

This article was exclusively written for The European Sting by Ms. Sadia Khalid, Junior researcher, and a PhD candidate at Tallinn University of Technology (TalTech), Estonia. She is affiliated with the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writers and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

The burden of chronic disease is a whopping 4 million per year and almost 86% of all deaths are related to chronic diseases in Europe. An estimated €700 billion are currently spent on chronic diseases in the EU, in addition to the substantial human distress and an enormous burden on health systems. (1)

Not to forget the additional burden contributed by the COVID-19 pandemic into the healthcare system is staggering, with more than 5.93 million deaths in the world. It created a more challenging ordeal for people with pre-existing chronic diseases seeking medical care during pandemics. As a result, underutilization of, or overutilization of in case of virus scare left profound emotional, personal impact and created various debilitating stressors in the healthcare system.

To ensure the sustained performance of health systems functionality during acute shocks such as pandemics, the implementation of strategies that protect overall system performance is extremely crucial. The key to strengthening the health system lies in the application of the concept of resilience that focuses on transparent truthful analysis, reporting, and understanding of health system preparedness in the event of acute shocks or even during chronic diseases management.

The longitudinal surveillance of the healthcare system and its ability to absorb, recover, adapt, and transform to cope with acute shocks not only pandemics but also health in war emergencies. The improvement of population health care can only be achieved by the sustainable performance of health system functions such as governance, adequate funding, resource generation, availability, and most importantly appropriate service delivery in a timely manner.

We witnessed during the COVID-19 pandemic countries reallocated funding, essential healthcare workers, and other important physical resources to combat the spread of the virus and to treat COVID-19 patients, while trying to maintain the adequate delivery of essential services for other patients. Yet chronic disease management was neglected.

There was a dramatic decline in preventive or routine screening and monitoring services for chronic diseases. The delayed acute care for patients with stroke or myocardial infarction, as well as cancer treatment and childhood vaccinations, lead to serious discussion about issues in the healthcare system. Then again, the storage of the health workers in the EU28 is anticipated to reach 4.1 million in 2030. where EU28 is needing 0.6 million physicians, 2.3 million nurses, and 1.3 million other health care professionals.

This issue was partly dealt with during the pandemic by recruitment of second and third year medical students which created, in turn, another issue of training and supervision of these students while working. A graduate diploma for disaster and emergency medicine already exists but is often less taken route for residency by medical graduates.

A clinical diploma focusing on emergency preparedness, management, and palliative care during emergencies should be offered to bachelor’s students from all medical backgrounds so these students could be recruited during emergencies or shocks such as pandemics or in humanitarian crises to aid the optimal performance of the health care system. The overall situation forces us to analyse the system for what it was before to learn, evolve, transform, and ideally for improvement of its future performance.

Although as often seen, learning from the shock for the improvement of better emergency preparedness strategies for the future is often neglected in actual practice-once the shock has passed despite all the available useful studies. The policymakers tend to distract with other routine concerns or job strains and stresses.

The emerging challenge related to chronic diseases and long-term COVID-19 sequelae requires regularly updated training on evidence-based practices for healthcare staff in geriatric and palliative care. Effective knowledge transfer between research and policy is critical for a resilient health care system. Another crucial step in managing a chronic disease burden would be implementation and policy decision-making transparency, legitimacy, accountability, and making data openly available to the community via local health associations.

This will enable local coalitions to analyse their burden of chronic disease and COVID-19, availability of the resources, and the optimal policies and practices to implement. The actors at the community level and data transparency are not only useful for local public health, governments, health care systems but will have a profound impact on better service delivery of organisations dealing with other human services and planning for economic development.

Finally, open communication via television and digital media campaigns and community engagement should be incorporated into emergency responses along with governance and resilience frameworks. It is essential for the healthcare system to view the community as an actor that can also improve the outcome of the crisis by better responses, preparedness to future emergencies concerning infectious disease and for chronic diseases as well.

References: 1.Anna Sagan, Erin Webb, Dheepa Rajan, Marina Karanikolos and Scott LGreerHEALTH SYSTEM RESILIENCE DURING THE PANDEMIC: IT’S MOSTLY ABOUT GOVERNANCE Eurohealth —  Vol.27.  No.1.  20212.Karen A. Hacker, Peter A. Briss, Lisa Richardson, Janet Wright, Ruth Petersen. COVID-19 and Chronic Disease: The Impact Now and in the Future doi 10.5888/pcd18.210086

About the author

Sadia Khalid, Junior researcher, and a PhD candidate at Tallinn University of Technology (TalTech), Estonia. She has been working on her research project “The role of Helicobacter pylori intestinal microbiota in the development of liver diseases. under supervision of Dr. Pirjo Spuul at Faculty of Science, Institute of Chemistry and Biotechnology.,TalTech. Previously, she has worked as a research specialist in biomedicine and translational medicine department in the university of Tartu, Estonia. She obtained her MD in emergency medicine in 2017 from the Dalian Medical university, China and MBChB in 2013 from the Weifang Medical university, China. Her current research interests include infectious diseases, bacteriology, hepatology, and gastroenterology.