Health system recovery from Covid-19: What policies are health systems using to tackle backlogs and bring down waiting times in the wake of the pandemic?

Abstract The pandemic has left even the most well-equipped health systems vulnerable and required difficult trade-offs to balance both Covid-19 and non-Covid-19 health services. Across the globe, planned and routine health services have been scaled down during peaks of the crisis to meet the needs of acute and Covid-19-related care, resulting in growing care backlogs and increase in the number of patients waiting for treatment. To identify potential policy solutions, we have consulted the Covid-19 Health System Response Monitor, interviewed experts and analysed recovery strategies in 16 OECD and EU countries. Many country responses display striking similarities despite very real differences in the organisation of health and care services. These include: 1) increasing the supply of workforce by widening the scope of authority for different roles, investing heavily in recruitment and training for key roles, and improving the terms and conditions of work; 2) boosting productivity by introducing financial incentives and targets, reconfiguring facilities to better separate planned and emergency work”, optimising referrals and waiting list management, and outsourcing more care to the private sector; and 3) investing in out-of-hospital alternatives to care, including expanding primary and community care models and developing digital, home care and rehabilitative capacity Policymakers will need to balance the immediate pressures of clearing backlogs with long-term measures that place services on a more sustainable footing. International experience shows how these can be at odds, especially if actions taken in the short term exhaust an already depleted workforce, or resolve Covid-19-specific problems but leave services less prepared for tomorrow's challenges.

The pandemic has left even the most well-equipped health systems vulnerable and required difficult trade-offs to balance both Covid-19 and non-Covid-19 health services. Across the globe, planned and routine health services have been scaled down during peaks of the crisis to meet the needs of acute and Covid-19-related care, resulting in growing care backlogs and increase in the number of patients waiting for treatment. To identify potential policy solutions, we have consulted the Covid-19 Health System Response Monitor, interviewed experts and analysed recovery strategies in 16 OECD and EU countries. Many country responses display striking similarities despite very real differences in the organisation of health and care services. These include: 1) increasing the supply of workforce by widening the scope of authority for different roles, investing heavily in recruitment and training for key roles, and improving the terms and conditions of work; 2) boosting productivity by introducing financial incentives and targets, reconfiguring facilities to better separate planned and emergency work'', optimising referrals and waiting list management, and outsourcing more care to the private sector; and 3) investing in out-of-hospital alternatives to care, including expanding primary and community care models and developing digital, home care and rehabilitative capacity Policymakers will need to balance the immediate pressures of clearing backlogs with long-term measures that place services on a more sustainable footing. International experience shows how these can be at odds, especially if actions taken in the short term exhaust an already depleted workforce, or resolve Covid-19-specific problems but leave services less prepared for tomorrow's challenges.

4.C. Workshop: Promoting health without borders: cross-border public health policy in the Euregio Meuse-Rhine
Abstract citation ID: ckac129.213 For more than 20 years, different public health institutions in the German-Belgian-Dutch border triangle have been involved in cross-border public health activities. The partners in the Euregio Meuse-Rhine (EMR), as this area is called, have jointly implemented studies on COVID-19 and on adolescent risk behaviour. They have established joint health reporting for various purposes and implemented prevention measures together. The special problems in the border regions during the Corona pandemic have once again impressively shown how important cross-border cooperation is -also for cross-border public health policy. In the health sector, orientation towards municipal, state and federal borders does not lead to the desired results. The results of the Euregional COVID 19 study of 2021 show that in this way a 'borderless' life -and partly also crossborder health care -cannot be adequately served. In fact, in the everyday life of a border community, there is hardly any difference between a district border and a national border. In the EMR, this is exemplary for the entire European Union, with its many national or local responsibilities. For infectious diseases, lifestyle risks, environmental toxins or climate risks, borders have no meaning. For health, however, they do. Cross-border policy and politics is the appropriate response to real European conditions. The workshop will show the possibilities and results of cross-border policy on the basis of 3 examples from the longstanding cooperation of public health actors from the Euregio Meuse-Rhine. Finally, we will present these factors and put them up for discussion. From these and other activities, the factors that enable or hinder policy along borders can be deduced. We will present these factors, classify their significance and present the possibility of generalisation for cross-border work for discussion.

Key messages:
Cross-border policy and coordination are the appropriate responses to the current realities in the European Union. National differences in culture, administration and policy can be obstacles to cooperation; but are usually inspiration for new approaches and input for best practice.
The Euregional Youth Study takes place at intervals of currently 4 years since 2001. The Dutch, German and Belgian municipalities of the Euregio Meuse-Rhine (EMR) can participate. Pupils in the 8th and 10th grades are asked about various topics in an online questionnaire. These include: physical and emotional well-being, physical activity, nutrition, media behaviour, drug use and school behaviour. In 2019, 88 schools with more than 13,500 participants took part. With its cross-border approach, the study provides the opportunity to compare the living conditions, behaviour and health situation of pupils in the three countries. Ideally, this would result in common policy and prevention approaches and best practice options. For example, there are differences between the regions of the EMR regarding drug use or overweight, while risky media use is rather universal. It is striking that the Dutch participants almost consistently show the best values. It is also important to stress the importance of insight in policy along the border. Changes in policy actions have a huge effect on border regions. Examples are: The change in drinking age in the Netherlands: from 16 to 18 resulted in organizing their parties in the neighbouring countries.
15th European Public Health Conference 2022 iii89