Elsevier

Journal of Clinical Epidemiology

Volume 139, November 2021, Pages 255-263
Journal of Clinical Epidemiology

Review
Allocation of scarce resources in a pandemic: rapid systematic review update of strategies for policymakers

https://doi.org/10.1016/j.jclinepi.2021.04.021Get rights and content

Highlights

  • The 201 identified studies evaluate strategies to reducing demand for healthcare, optimizing existing resources, augmenting resources, and adopting crisis standards of care.

  • Most research exists for countermeasures to reduce demand. Of 15 COVID-19 studies, five higher quality studies reported on combinations of policy interventions and benefit of community-wide mask policies.

  • In pandemics like COVID-19, the need for medical resources quickly outpaces available supply.

  • The review provides policymakers with a comprehensive overview of the effects of strategies to allocate resources and provides critical appraisal to direct them to the best available evidence.

Abstract

Objective

In pandemics like COVID-19, the need for medical resources quickly outpaces available supply. policymakers need strategies to inform decisions about allocating scarce resources.

Study design and setting

We updated a systematic review on evidence-based approaches and searched databases through May 2020 for evaluation of strategies for policymakers.

Results

The 201 identified studies evaluated reducing demand for healthcare, optimizing existing resources, augmenting resources, and adopting crisis standards of care. Most research exists to reduce demand (n = 149); 39 higher quality studies reported benefits of contact tracing, school closures, travel restrictions, and mass vaccination. Of 28 strategies to augment resources, 6 higher quality studies reported effectiveness of establishing temporary facilities, use of volunteers, and decision support software. Of 23 strategies to optimize existing resources, 12 higher quality studies reported successful scope of work expansions and building on existing interagency agreements. Of 15 COVID-19 studies, 5 higher quality studies reported on combinations of policies and benefits of community-wide mask policies.

Conclusion

Despite the volume, the evidence base is limited; few strategies were empirically tested in robust study designs. The review provides a comprehensive overview of the effects of strategies to allocate resources and provides critical appraisal to identify the best available evidence.

Keywords

Systematic review
Scarce resources
Mass casualty
policymakers
Rapid review

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