The underlying factors of excess mortality in 2020: a cross-country analysis of pre-pandemic healthcare conditions and strategies to cope with Covid-19

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...

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Autor principal:	Nikolaos Kapitsinis
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Excess mortality Covid-19 Healthcare expenditure Primary healthcare Test and trace Lockdown Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/c5728af2e73b4f7baf054df6c802c1e9
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spelling	oai:doaj.org-article:c5728af2e73b4f7baf054df6c802c1e92021-11-07T12:11:02ZThe underlying factors of excess mortality in 2020: a cross-country analysis of pre-pandemic healthcare conditions and strategies to cope with Covid-1910.1186/s12913-021-07169-71472-6963https://doaj.org/article/c5728af2e73b4f7baf054df6c802c1e92021-11-01T00:00:00Zhttps://doi.org/10.1186/s12913-021-07169-7https://doaj.org/toc/1472-6963Abstract 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.Nikolaos KapitsinisBMCarticleExcess mortalityCovid-19Healthcare expenditurePrimary healthcareTest and traceLockdownPublic aspects of medicineRA1-1270ENBMC Health Services Research, Vol 21, Iss 1, Pp 1-19 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Excess mortality Covid-19 Healthcare expenditure Primary healthcare Test and trace Lockdown Public aspects of medicine RA1-1270
spellingShingle	Excess mortality Covid-19 Healthcare expenditure Primary healthcare Test and trace Lockdown Public aspects of medicine RA1-1270 Nikolaos Kapitsinis The underlying factors of excess mortality in 2020: a cross-country analysis of pre-pandemic healthcare conditions and strategies to cope with Covid-19
description	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.
format	article
author	Nikolaos Kapitsinis
author_facet	Nikolaos Kapitsinis
author_sort	Nikolaos Kapitsinis
title	The underlying factors of excess mortality in 2020: a cross-country analysis of pre-pandemic healthcare conditions and strategies to cope with Covid-19
title_short	The underlying factors of excess mortality in 2020: a cross-country analysis of pre-pandemic healthcare conditions and strategies to cope with Covid-19
title_full	The underlying factors of excess mortality in 2020: a cross-country analysis of pre-pandemic healthcare conditions and strategies to cope with Covid-19
title_fullStr	The underlying factors of excess mortality in 2020: a cross-country analysis of pre-pandemic healthcare conditions and strategies to cope with Covid-19
title_full_unstemmed	The underlying factors of excess mortality in 2020: a cross-country analysis of pre-pandemic healthcare conditions and strategies to cope with Covid-19
title_sort	underlying factors of excess mortality in 2020: a cross-country analysis of pre-pandemic healthcare conditions and strategies to cope with covid-19
publisher	BMC
publishDate	2021
url	https://doaj.org/article/c5728af2e73b4f7baf054df6c802c1e9
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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

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