PDF(Pubmed)
Abstract：
This article is part of the Research Topic \'Health Systems Recovery in the Context of COVID-19 and Protracted Conflict\'.
COVID-19 has highlighted existing health inequalities and health system deficiencies both in Ireland and internationally; however, understanding of the critical opportunities for health system change that have arisen during the pandemic is still emerging and largely descriptive. This research is situated in the Irish health reform context of Sláintecare, the reform programme which aims to deliver universal healthcare by strengthening public health, primary and community healthcare functions as well as tackling system and societal health inequities.
This study set out to advance understanding of how and to what extent COVID-19 has highlighted opportunities for change that enabled better access to universal, integrated care in Ireland, with a view to informing universal health system reform and implementation.
The study, which is qualitative, was underpinned by a co-production approach with Irish health system leadership. Semi-structured interviews were conducted with sixteen health system professionals (including managers and frontline workers) from a range of responses to explore their experiences and interpretations of social processes of change that enabled (or hindered) better access to universal integrated care during the pandemic. A complexity-informed approach was mobilized to theorize the processes that impacted on access to universal, integrated care in Ireland in the COVID-19 context.
A range of circumstances, strategies and mechanisms that created favorable system conditions in which new integrated care trajectories emerged during the crisis. Three key learnings from the pandemic response are presented: (1) nurturing whole-system thinking through a clear, common goal and shared information base; (2) harnessing, sharing and supporting innovation; and (3) prioritizing trust and relationship-building in a social, human-centered health system. Policy and practice implications for health reform are discussed.
COVID-19 has highlighted existing health inequalities and health system deficiencies both in Ireland and internationally; however, understanding of the critical opportunities for health system change that have arisen during the pandemic is still emerging and largely descriptive. This research is situated in the Irish health reform context of Sláintecare, the reform programme which aims to deliver universal healthcare by strengthening public health, primary and community healthcare functions as well as tackling system and societal health inequities.
This study set out to advance understanding of how and to what extent COVID-19 has highlighted opportunities for change that enabled better access to universal, integrated care in Ireland, with a view to informing universal health system reform and implementation.
The study, which is qualitative, was underpinned by a co-production approach with Irish health system leadership. Semi-structured interviews were conducted with sixteen health system professionals (including managers and frontline workers) from a range of responses to explore their experiences and interpretations of social processes of change that enabled (or hindered) better access to universal integrated care during the pandemic. A complexity-informed approach was mobilized to theorize the processes that impacted on access to universal, integrated care in Ireland in the COVID-19 context.
A range of circumstances, strategies and mechanisms that created favorable system conditions in which new integrated care trajectories emerged during the crisis. Three key learnings from the pandemic response are presented: (1) nurturing whole-system thinking through a clear, common goal and shared information base; (2) harnessing, sharing and supporting innovation; and (3) prioritizing trust and relationship-building in a social, human-centered health system. Policy and practice implications for health reform are discussed.
摘要：
本文是研究主题“COVID-19和旷日持久的冲突背景下的卫生系统恢复”的一部分。
UNASSIGNED：COVID-19强调了爱尔兰和国际上现有的卫生不平等和卫生系统缺陷；然而，对大流行期间出现的卫生系统变化的关键机会的理解仍在出现，并且在很大程度上是描述性的。这项研究位于Sláintecare的爱尔兰医疗改革背景下，旨在通过加强公共卫生来实现全民医疗保健的改革方案，初级和社区医疗保健功能，以及解决系统和社会健康不平等问题。
UNASSIGNED：这项研究旨在加深对COVID-19如何以及在多大程度上强调了改变的机会，从而使人们能够更好地获得通用，综合护理在爱尔兰，以期为全民卫生体制改革和实施提供信息。
未经批准：这项研究，这是定性的，以爱尔兰卫生系统领导层的联合生产方式为基础。对来自一系列回应的16名卫生系统专业人员（包括管理人员和一线工作人员）进行了半结构化访谈，以探索他们对社会变化过程的经验和解释，这些变化过程使人们能够（或阻碍了）在大流行期间更好地获得普遍综合护理。动员了一种了解复杂性的方法，对影响普及的过程进行理论化，COVID-19背景下爱尔兰的综合护理。
未经评估：一系列情况，战略和机制创造了有利的系统条件，在危机期间出现了新的综合护理轨迹。提出了从大流行应对中获得的三个关键经验：（1）通过清晰的，共同目标和共享信息库；(2)利用，分享和支持创新；(3)优先考虑社会中的信任和关系建设，以人为中心的卫生系统。讨论了卫生改革的政策和实践意义。
UNASSIGNED：COVID-19强调了爱尔兰和国际上现有的卫生不平等和卫生系统缺陷；然而，对大流行期间出现的卫生系统变化的关键机会的理解仍在出现，并且在很大程度上是描述性的。这项研究位于Sláintecare的爱尔兰医疗改革背景下，旨在通过加强公共卫生来实现全民医疗保健的改革方案，初级和社区医疗保健功能，以及解决系统和社会健康不平等问题。
UNASSIGNED：这项研究旨在加深对COVID-19如何以及在多大程度上强调了改变的机会，从而使人们能够更好地获得通用，综合护理在爱尔兰，以期为全民卫生体制改革和实施提供信息。
未经批准：这项研究，这是定性的，以爱尔兰卫生系统领导层的联合生产方式为基础。对来自一系列回应的16名卫生系统专业人员（包括管理人员和一线工作人员）进行了半结构化访谈，以探索他们对社会变化过程的经验和解释，这些变化过程使人们能够（或阻碍了）在大流行期间更好地获得普遍综合护理。动员了一种了解复杂性的方法，对影响普及的过程进行理论化，COVID-19背景下爱尔兰的综合护理。
未经评估：一系列情况，战略和机制创造了有利的系统条件，在危机期间出现了新的综合护理轨迹。提出了从大流行应对中获得的三个关键经验：（1）通过清晰的，共同目标和共享信息库；(2)利用，分享和支持创新；(3)优先考虑社会中的信任和关系建设，以人为中心的卫生系统。讨论了卫生改革的政策和实践意义。
