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The underlying factors of excess mortality in 2020: a cross-country analysis of pre-pandemic healthcare conditions and strategies to cope with Covid-19
- Source :
- BMC Health Services Research, Vol 21, Iss 1, Pp 1-19 (2021), BMC Health Services Research
- Publication Year :
- 2021
- Publisher :
- BMC, 2021.
-
Abstract
- Background Government responses to the pandemic varied in terms of timing, duration, and stringency, seeking to protect healthcare systems, whose pre-pandemic state varied significantly. Therefore, the severity of Covid-19 and, thus, excess mortality have been unequal across counties. This paper explores the geography of excess mortality and its underlying factors in 2020, highlighting the effects of health policies pre-pandemic and strategies devised by governments to cope with Covid-19. Methods Excess mortality is estimated for 79 high, medium and low-income countries. The factors of excess mortality are examined employing median quantile regression analysis. Results Health privatization, healthcare underfunding, and late implementation of containment and mitigation strategies were powerful drivers of excess mortality. By contrast, the results suggest a negative association of excess mortality with health expenditure, number of doctors and hospital beds, share of population covered by health insurance and test and trace capacity. Conclusions The evidence highlights the importance of sufficiently funded healthcare systems with universal access and strong primary healthcare in the battle against the pandemic. An early response to Covid-19, including borders’ controls and a strong test and trace capacity, could improve epidemiological surveillance and minimize excess mortality, with stringent and lengthy lockdowns not providing a significant benefit.
- Subjects :
- medicine.medical_specialty
Population
Excess mortality
Health informatics
Health Services Accessibility
Health administration
Environmental health
G1
Pandemic
Health care
I3
Lockdown
medicine
Humans
Mortality
education
Pandemics
Test and trace
Government
education.field_of_study
Primary Health Care
I18
business.industry
I11
Health Policy
Public health
Research
Healthcare expenditure
Quantile regression
Communicable Disease Control
Public aspects of medicine
RA1-1270
business
Covid-19
Delivery of Health Care
Primary healthcare
Subjects
Details
- Language :
- English
- ISSN :
- 14726963
- Volume :
- 21
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- BMC Health Services Research
- Accession number :
- edsair.doi.dedup.....84e90646f33a52a1c36ad7a745670ad7