Health Policy Manag.  2023 Dec;33(4):421-431. 10.4332/KJHPA.2023.33.4.421.

The Relationship between the Health System and the COVID-19 Case Fatality Rate

• Lee H
• Lee S
• Park J
• Lee Y

• KMID: 2551397
• DOI: http://doi.org/10.4332/KJHPA.2023.33.4.421

Abstract

Background
The coronavirus disease 2019 (COVID-19) pandemic has led to socio-economic issues, highlighting the importance of strengthening health systems for future infectious diseases. This study aims to analyze the relationship between health system preparedness, response levels, and COVID-19 fatality rates across 194 countries.
Methods
This study examined various indicators of national health system preparedness and response, including health service delivery, health workforce, health information systems, essential medicines and health products, health financing, and leadership and governance.
Results
A correlation was found between the health system and the COVID-19 case fatality rate (CFR). Further examination of specific indicators within health service delivery, health workforce, health information systems, health financing, and leadership/governance showed significant correlations with the CFR. Multiple regression analysis, considering aging and urbanization rates, identified reproductive/maternal/newborn and child health, infectious diseases, nursing and midwifery personnel density, birth registration coverage, and out-of-pocket health expenditure as significant factors affecting the CFR.
Conclusion
Countries with strong health system indicators experience lower case fatality rate from COVID-19. Strengthening access to essential health services, increasing healthcare personnel and resources, ensuring reliable health information, and bolstering overall health systems are crucial for preparedness against future infectious diseases.

Keyword

Health system; COVID-19; Case fatality rate; Communicable diseases