Public Health Administration Research Articles

Healthcare utilization among foreign beneficiaries of the National Health Insurance program in Korea.

To explore the factors related to healthcare utilization (both inpatient and outpatient services) among foreign beneficiaries of the National Health Insurance (NHI) in Korea. The total foreign beneficiaries of the NHI in Korea 2022 were included (n = 1,386,329). For the dependent variables, utilization and either hospital stays or count of visits were used. And the independent variables were selected guided by Andersen's behavioral framework: predisposing characteristics (e.g., sex, age, nationality), enabling characteristics (e.g., insurance premium ranking, residency status, residency period, place of residency, beneficiary type), and need characteristics (e.g., disability, CCI, chronic diseases). We conducted a two-part model analysis employing Andersen's behavioral framework, using health insurance claims data from 2022. The results indicated that individual need characteristics, such as disability, CCI, and chronic diseases, had the most significant impact on total healthcare utilization and its associated costs. The next significant characteristic was the residence period; the longer the period, the higher the likelihood of healthcare utilization, but the lower the associated costs. Among the predisposing characteristics, individuals aged 65 years and older had the most significant impact on healthcare costs. Additionally, among the enabling characteristics, residency period, residency status, and beneficiary type were most significant. Foreigners residing in Korea are eligible to use the Korean healthcare system by enrolling in NHI. As the foreign population is projected to grow even faster due to Korea's aging society and low birth rate, this study can assist public health administrators in formulating evidence-based policies.

From agent-based simulations of disease dynamics to expert support on public health interventions

Abstract Agent-based epidemiological simulators have long been used to predict the dynamics of infectious diseases. They allow to combine compartment approaches with representing contact networks derived from real or synthetic populations. Often, scenario techniques are applied to model the impact of public health interventions. During the COVID-19 pandemics the agent-based simulator COVASIM has been established for modelling the spreading of SARS-CoV-2. It includes four different contact networks related to homes, schools, workplaces and environment. During the pandemic it became obvious that the current simulation techniques were not sufficient to cover important needs in public health administrations and society. While most simulations were based on scenarios predicting expected numbers for the infected, hospitalized or critically ill, these studies could not provide easily strategic options on a variety of equivalent public health interventions, which are all suitable to keep disease dynamics within acceptable bounds, set e.g. by hospital capacity. Knowing about a variety of equivalent options, however, is of crucial importance to enable a fair burden sharing throughout all groups of society. Therefore, we applied machine learning techniques to create an inverse model for epidemiological simulations based on COVASIM. For given transmission rates it outputs a range of quantitative interventions which are equivalently suitable to keep epidemiological dynamics within predefined bounds. Currently, it covers interventions like school and workplace closings and other mobility restrictions. Future work will be directed to include other interventions, like vaccination campaigns, and we will work to make the approach more generalizable for other infectious diseases. The tool may turn out helpful fur public health administrations and stimulate the public debate on the best way a society may take in a pandemic event or other situations where public health action has to be imposed. Key messages • Machine Learning allows to invert agent based simulators. • Instead of disease dynamics simulations a set of equivalent public health interventions consistent with pre-defined constraints can be calculated.

COVID-19 in Perspective: A Witness Seminar1.

In June 2023, we brought together leaders who responded to the emergency phase COVID-19 pandemic in Ontario as part of a "Witness Seminar." This approach to studying history was developed by the Institute of Contemporary British History. It has been extensively used in the history of science and medicine by the Wellcome Trust History of Twentieth Century Medicine. A witness seminar provides a collective oral history, in which participants can express diverse perspectives, build on each other's thoughts, and create a documentary record for policy makers and future historians. The published transcript provides an intimate look at how the pandemic played out in the eyes of some of key responders and raises many questions about the history of public health funding and administration in the province of Ontario, the failures in long-term care, and the need to improve pandemic communication. This article documents the success of the pandemic response.

Crisis Management In Public Health: Responding To Emergencies And Disasters

The government has a lot of chances and challenges in the twenty-first century to improve public health and provide citizens with higher-quality services. Generally speaking, administrative officers oversee and carry out a variety of government activities at the local level. They are exposed to a variety of citizen-facing issues as well as the difficulties in carrying out ground-level project execution. They regularly handle a variety of crises. Pandemics, natural disasters, and any other scenario involving law and order present a serious challenge for the government. Officers in charge of public health services handle emergencies on the front lines. Communication, scenario assessment, and teamwork are essential for crisis management to be effective. Team procedures improve crisis management's responsiveness, velocity, and effectiveness. The brief duration of crisis situations means that little time remains for planning. Therefore, public servants need to be proactive and flexible enough to handle the situation. According to this work, an effort will be made to investigate the variables and how they interact to affect the government sector's ability to manage crises effectively as well as the interactions between the variables affecting the quality of e-governance services in public health administration.

Management of Public Health: A Study on Novel Strategy for Securing Health Data

The effective management and security of sensitive health data is becoming exponentially important to public health administration. This research examines and evaluates innovative ways to improve health data security in public health management systems to provide accessibility for authorized stakeholders. The study introduces the War Strategy Optimized Elliptic Curve Cryptography (WSO-ECC) encryption method for improving the security of primary healthcare medical records. The WSO-ECC technique, based on a war strategy framework, optimizes encryption and decryption processes by balancing exploration and exploitation phases, enhancing security while maintaining efficiency. It significantly reduces encryption and decryption times compared to traditional methods.The proposed method offers a robust solution for safeguarding medical information in public health management systems, demonstrating superior performance of 24.6 in encryption time, 23 decryption times, execution efficiency, and delay.

The roots and routes of public health institutes in Scandinavia

AbstractThis article aims to increase the knowledge of the roles and functions of public health institutes (PHIs) by exploring and comparing the Scandinavian PHIs, their roots, and developments over time. The research questions are the following: What was the history behind these public institutions? How have they changed over time? Have they followed divergent or parallel paths of change? How, if at all, have they been influenced by public sector reforms? Comparing the three Scandinavian countries based on an institutionalist approach, the article seeks to increase the understanding of the role of PHIs in governing public health. The article is based on documents from parliaments and governments from the public health institutes, supplemented by institution narratives and relevant public health and public administration literature. The Scandinavian PHIs have common roots from the early 1900s, have followed different routes, and have different institutional characteristics and different roles as public health institutions. However, after more than 100 years, the Scandinavian PHIs belong to the international PHI organization. They are responsible for knowledge dissemination, surveillance, and preparedness for the handling of epidemics and pandemics. The article argues for more comparative research on institutions related to public health authorities, such as the PHIs.

Analysis of the DPR'S Policy in Rejecting BPJS Health's Inclusion in the Health Law

The House of Representatives (DPR) as a legislative institution in Indonesia has a very important role in drafting and formulating laws, including approval of laws. In this article, an in-depth analysis will be carried out regarding the DPR's policy in rejecting the inclusion of BPJS Health in the Health Law in Indonesia. The DPR can consider alternative policies or improvements to the health insurance system to make it more effective and sustainable in providing health services to the community. The research aims to provide an insight into the legislative process, policy-making dynamics, and the potential consequences for public health administration and policy. The study will be conducted by combining primary, secondary, and tertiary legal materials (which are secondary data) with primary data obtained in the field, namely DPR Policy Analysis.

Upravljanje javnim zdravstvom u Gani: Fokus na Korle-Bu učiteljsku bolnicu (1923-2020)

Since the pre-colonial period to the post-colonial era, public health administration has been intertwined with several issues ranging from the inadequacy of public health facilities and health workers, improper settlement planning, insanitary conditions, inadequate laws, their implementation and enforcement of same. Using a qualitative approach of research, the study focused on the historical interpretation of the challenges and effects of public health administration on health workers and patients in Ghana. This empirical study focused on responses from workers in the Accident and Emergency Department of the Korle-Bu Teaching Hospital (KBTH), Ghana. The study teased out information from expert informants to make useful generalizations to shape public health administration in relation to similar facilities in Ghana and elsewhere in Africa. Among other things, it also studies how reported sicknesses and or medical cases such as COVID-19 and the management of same at the Korle-Bu Teaching Hospital in contemporary times. Again, based on the empirical responses, the study provided empirical prescriptions to help improve public health administration in health facilities in Ghana, which has wider ramifications for related facilities on the African continent. Attention and resources should not only be given to clinical care, to the neglect of public health. Efforts should cut across every sector of healthcare and fully equip the office of public health administration to do a more efficient work. There is also the need to make inferences from the various past challenges and effects of public health administration in the Korle-Bu Teaching Hospital and Ghana at large to know how to deal with similar challenges emanating from the day to day running of Ghana’s health institutions including the required preparednes to deal with epidemics and pandemics at the local and national levels.

Examining the creation of synergy in community coalitions for smoke-free environments in Armenia and Georgia.

Community coalitions depend on their members to synergistically pool diverse resources, including knowledge and expertise, community connections and varied perspectives, to identify and implement strategies and make progress toward community health improvement. Several coalition theories suggest synergy is the key mechanism driving coalition effectiveness. The Community Coalition Action Theory (CCAT) asserts that synergy depends on how well coalitions engage their members and leverage their resources, which is influenced by coalition processes, member participation and satisfaction and benefits outweighing costs. The current study used mixed methods, including coalition member surveys (n = 83) and semi-structured interviews with leaders and members (n = 42), to examine the process of creating collaborative synergy in 14 community coalitions for smoke-free environments in Armenia and Georgia. Members, typically seven per coalition representing education, public health, health care and municipal administration sectors, spent an average of 16hr/month on coalition-related work. Common benefits included making the community a better place to live and learning more about tobacco control. The greatest cost was attending meetings or events at inconvenient times. Members contributed various resources, including their connections and influence, skills and expertise and access to population groups and settings. Strong coalition processes, greater benefits and fewer costs of participation and satisfaction were correlated with leveraging of member resources, which in turn, was highly correlated with collaborative synergy. Consistent with CCAT, effective coalition processes created a positive climate where membership benefits outweighed costs, and members contributed their resources in a way that created collaborative synergy.

Situational analysis of hypertension management at primary health care level in São Paulo, Brazil: population, healthcare professional and health system perspectives

BackgroundGovernment-led, population-wide initiatives are crucial for advancing the management of hypertension − a leading cause of cardiovascular disease (CVD) morbidity and mortality. An urban population health initiative was conducted against this backdrop, focussing on hypertension in the primary health system in São Paulo, Brazil. Within the frame of the initiative and under the supervision and leadership of the municipal health authorities, a situational analysis was conducted on the needs in hypertension management, marking the first phase of a Design Thinking process. This article describes the situational analysis process and presents the identified elements to be strengthened considering hypertension diagnosis, treatment and control.MethodsFirst, a mixed-methods approach was used, starting with a literature review of municipal hypertension data followed by meetings (N = 20) with the local public health administration to assess health system level components. To investigate activities on hypertension diagnosis, treatment and control, nine primary healthcare units were selected from two districts of São Paulo city– Itaquera and Penha– which received an online form addressed to managers, participated in conversation circles of staff and patients, and underwent shadowing of community health agents.ResultsData gave rise to two main outputs: (i) a patient care journey map; and (ii) a matrix summarizing the identified needs at patient, healthcare professional and health system level for diagnosis, treatment and control of hypertension. Patient awareness and knowledge of hypertension was found to be insufficient and its management needs to be improved. For health professionals, disease awareness, technical training, more time dedicated to patients, and simplified guidelines and clinical decision-making tools for hypertension management were identified as principal needs. The situational analysis found that the healthcare systems efficiency might be improved by establishing defined treatment and care delivery goals with a focus on outcomes and implemented through action plans.ConclusionsThis situational analysis identified several needs related to hypertension control in São Paulo that are in line with global challenges to improve the control of CVD risk factors. Findings were also confirmed locally in an expansion phase of this situational analysis to additional primary care facilities. As a consequence, solutions were designed, promptly taken up and implemented by the municipal health secretariat.

The Influence Of Knowledge Towards Physicians’ Intention To Use Powered Air-Purifying Respirators As Advanced Personal Protective Equipment Mediated By Health Belief Model During Covid-19 Pandemic

The COVID-19 has become a devastating occurrence and an urgent intervention for public health in Indonesia. Until the beginning of 2021, Indonesia has the highest number of healthcare workers deaths in Asia and fifth in the world. One of the reasons that resulted in a high number of deaths is due to the lack of personal protective equipment (PPE) to be worn in high-risk environments. Powered Air-Purifying Respirator (PAPR) is one of the most advanced protective equipment and recommended by many countries for their healthcare workers in handling COVID-19 pandemic. This research is conducted to predict Indonesian physicians’ intention to use PAPR as advanced PPE using the Health Belief Model. This research is a correlational study and a quantitative research using statistical tests in processing the data collected from online questionnaires. The findings collected from 163 respondents demonstrated that physicians in Indonesia have the intention to use PAPR as advanced PPE against COVID-19 based on their knowledge, perceived susceptibility, perceived severity, and perceived benefits of using PAPR. Perceived barriers do not have a significant influence towards physicians’ intention to use. The impact of knowledge to intention to use mediated by perceived benefits has the strongest correlation. This empirical model has moderate predictive accuracy with medium predictive relevance, therefore it could be developed and tested on an extended population. There are few managerial implications that could be recommended for hospital managers, public health administrators, and medical device suppliers to encourage physicians’ behavior. Several recommendations are given for further research development.
 Keywords: Health Belief Model, Knowledge, Perceived Susceptibility, Perceived Benefits, Perceived Severity, Perceived Barriers, Powered Air-Purifying Respirator, Protective Personal Equipment

Analysis of problems and potentials for increasing pandemic resilience in public health administrations in Saxony-Anhalt, Germany—a mixed-methods approach

IntroductionThe COVID-19 pandemic has shown the importance of resilient, modern, and well-equipped public health administrations from national to communal levels. In Germany, the surveillance, contact tracing, and local adaptions went...

Age-period-cohort analysis of incidence, mortality and disability-adjusted life years of esophageal cancer in global, regional and national regions from 1990 to 2019

ObjectiveIn view of the high incidence and mortality of esophageal cancer, the latest statistical data on the disease burden of esophageal cancer can provide strategies for cancer screening, early detection and treatment, and help to rationally allocate health resources. This study provides an analysis of the global disease burden and risk factors of esophageal cancer from 1990 to 2019.MethodsUsing the 2019 Global Burden of Disease, Injury and Risk Factor (GBD) data, we present the incidence, mortality and disability-adjusted life years (DALY) of esophageal cancer in 21 regions and 204 countries and different sociodemographic index (SDI) regions from 1990 to 2019. The age-period-cohort model was used to estimate the age, period, and cohort trend of esophageal cancer in different SDI regions. The estimated proportion of DALY attributable to each risk factor from 1990 to 2019.ResultsFrom 1990 to 2019, the number of new cases of esophageal cancer, the number of deaths and DALY increased by 67.07%, 55.97% and 42.13%, respectively, but age standardized incidence rate (ASIR), age standardized mortality rate (ASMR) and age standardized DALY rate (ASDR) decreased by 19.28%, 25.32% and 88.22%, respectively. Overall, the results of the age-period-cohort model showed that the incidence, mortality, and DALY rates in countries and regions with higher SDI levels showed a downward trend over time and with the passage of time. Conversely, there were no significant changes in incidence and mortality in countries and regions with low SDI levels. In the past 30 years, the incidence and death of esophageal cancer in the world has gradually changed to people over 80 years old, but the population aged 60–79 still accounts for the largest proportion. The global DALY in esophageal cancer is mainly attributable to smoking, followed by alcohol consumption and occupational exposure.ConclusionsAlthough ASIR, ASMR and ASDR have decreased significantly, esophageal cancer is still the main factor causing the disease burden worldwide. Public health administrators in low SDI and low-middle SDI countries are high-risk areas for esophageal cancer, and preventive control measures should be implemented to raise awareness, screening, and treatment of esophageal cancer in these areas. Tobacco and alcohol control and reduction of occupational hazards are key steps in reducing the burden of esophageal cancer.

Carrot Health: digitizing health care through consumer analytics

Theoretical basis The case is designed to be used with the digital business model framework developed by Peter Weill and Stephanie Woerner of Massachusetts Institute of Technology (MIT) (Weill and Woerner, 2015) and is referred to as the W & W framework. This approach provides a useful structure for thinking through the strategic options facing environments ripe for digital transformation. Research methodology Research for this case was conducted through face-to-face interviews with the protagonist, as well as through a review of their business planning documents and other data and documentation provided by the founder. Some of the market and industry data were obtained using secondary research and industry reports. Interviews were digitally recorded and transcribed to ensure accuracy. Case overview/synopsis The case follows the story of Kurt Waltenbaugh, a Minnesota entrepreneur who shared the dream of using data analytics to reduce costs within the US health-care system. In early 2014, Waltenbaugh and a physician colleague founded Carrot Health to bring together their personal experience and expertise in both consumer data analytics and health care. From the beginning, they focused on how to use data analytics to help identify high-risk/high-cost patients who had not yet sought medical treatment. They believed that they could use these insights to encourage early medical interventions and, as a result, lower the long-term cost of care. Carrot’s initial success found them in a consultative role, working on behalf of insurance companies. Through this work, they honed their capabilities by helping their clients combine existing claims data with external consumer behavioral data to identify new potential customers. These initial consulting contracts gave Carrot the opportunity to develop its analytic tools, business model and, importantly, to earn some much-needed cash flow during the start-up phase. However, they also learned that, while insurance companies were willing to purchase data insights for one-off market expansion projects, it was much more difficult to motivate them to use data proactively to eliminate costs on an ongoing basis. Waltenbaugh believed that Carrot’s greatest potential lay in their ability to develop predictive models of health outcomes, and this case explores Carrot’s journey through strategic decisions and company transformation. Complexity academic level This case is intended for either an undergraduate or graduate course on entrepreneurial strategy. It provides an effective introduction to the unique structure and constraints which apply to an innovative start-up within the health-care industry. The case also serves as a platform to explore the critical criteria to be considered when developing a digital transformation strategy and exposing students to the digital business model developed by Weill and Woerner (2015) at MIT (referred to in this instructor’s manual as the W&W framework). The case was written to be used in an advanced strategy Master of Business Administration (MBA) class, an undergraduate specialty health-care course or as part of a health-care concentration in a regular MBA, Master of Health Care Administration (MHA) or Master of Public Health (MPH). It may be taught toward the end of a course on business strategy when students are building on generic strategy frameworks and adapting their strategic thinking to the characteristics of specific industries or sectors. However, the case can also be taught as part of a course on health-care innovation in which case it also serves well as an introduction to the health-care payments and insurance system in the USA. Finally, the case can be used in a specialized course on digital transformation strategy in which case it serves as an introduction to the MIT W&W framework. The case is particularly well-suited to students who are familiar with traditional frameworks for business strategy and business models. The analysis builds on this knowledge and introduces students interested in learning about the opportunities and challenges of digital strategy. Equally, the case works well for students with clinical backgrounds, who are interested in how business strategy can influence changes within the health-care sphere. Finally, an important aspect of the case design was to develop students’ analytical confidence by encouraging them to “get their hands dirty” and to carry out some basic exploratory data analytics themselves. As such, the case requires students to combine and correlate data and to experience the potentially powerful combination of clinical and consumer data. Instructors should find that the insights from these activities give students unique insights into the potential for of data analytics to move health care from a reactive/treatment ethos to a proactive/intervention ethos. This experience can be particularly revealing for students with clinical backgrounds who may initially be resistant to the use of clinical data by commercial organizations.

Tele Rehabilitation Procedures Using Mobile for Physiotherapy Services

Telerehabilitation is a part of the telehealth revolution, a concept which was first described in 1997 by the World Health Organization as “the use of electronic information and telecommunication technologies to support and promote long-distance clinical health care, patient and professional health-related education, public health and health administration. Rehabilitation is a major element of health sciences, and is the process of restoring an incapacitated individual to a normal life through training and therapy. Worldwide, 2.4 billion people may currently require rehabilitation. In 60 to 70% countries, existing rehabilitation services have been disrupted due to the corona virus disease 2019 (COVID-19) pandemic. Even after lockdowns and with vaccinations, some form of physical distancing is likely to be part of the new normal. Contemporaneously, there is an exponential growth of telehealth. This global overview will demonstrate that telerehabilitation is likely to be a distinct standalone sub specialty of tele health.

Tele Rehabilitation Procedures Using Mobile for Physiotherapy Services

Telerehabilitation is a part of the telehealth revolution, a concept which was first described in 1997 by the World Health Organization as “the use of electronic information and telecommunication technologies to support and promote long-distance clinical health care, patient and professional health-related education, public health and health administration. Rehabilitation is a major element of health sciences, and is the process of restoring an incapacitated individual to a normal life through training and therapy. Worldwide, 2.4 billion people may currently require rehabilitation. In 60 to 70% countries, existing rehabilitation services have been disrupted due to the corona virus disease 2019 (COVID-19) pandemic. Even after lockdowns and with vaccinations, some form of physical distancing is likely to be part of the new normal. Contemporaneously, there is an exponential growth of telehealth. This global overview will demonstrate that telerehabilitation is likely to be a distinct standalone sub specialty of tele health.

Global health concern on the rising dengue and chikungunya cases in the American regions: Countermeasures and preparedness.

Severe morbidity and mortality due to seasonal infectious diseases are common global public health issues. Vector-borne viral illnesses like dengue and chikungunya overload the healthcare systems leading to critical financial burden to manage them. There is no effective drug or vaccine currently available to control these two diseases. The review was formulated by incorporating relevant reports on chikungunya and dengue in the Americas regions through a comprehensive search of literature that were available on dedicated scientific publication portals such as PubMed, ScienceDirect, and Web of Science. The strategies of public health administrations to control largely the mosquito vectors during tropical monsoon seem to be effective. Yet, it seems practically impossible to completely eliminate them. The mosquito vector disseminates the virus via transovarian route thereby internalising the virus through generations, a reason behind reappearing and recurring outbreaks. The numerous factors associated with industrialisation, urbanisation, population density, and easy transboundary movements appear to have contributed to the spread of vectors from an endemic region to elsewhere. The article made a state-of-affair comprehensive analysis of the rising dengue and chikungunya cases in the tropics, particularly the tropical Americas, as a human health concern, the countermeasures undertaken and the overall preparedness. The viral transmission is a hard situation to tackle as the vector survives in diverse temperature and ecology, is resistant to insecticides, and the unavailability of drugs. Better vector-control measures and improved understanding of the reemerging arboviral infections could offer an extended reaction time to counter outbreaks, and minimise associated morbidity/mortality.

Editorial Note from Editor-in-Chief

In the face of an ever-evolving healthcare landscape, public health and health administration have witnessed significant changes in recent times. These changes, driven by technological advancements, social dynamics, and global health challenges, have necessitated a proactive approach in addressing emerging issues. In this editorial, we delve into the recent changes impacting the field and highlight innovative solutions to effectively navigate these challenges. The field of public health and health administration is witnessing rapid changes that demand innovative solutions. Embracing technology, addressing social determinants of health, strengthening global health preparedness, and promoting health systems integration are crucial steps in adapting to these changes. By embracing these strategies, we can effectively navigate the evolving landscape, drive positive health outcomes, and ensure equitable access to quality healthcare for all. It is through collaborative efforts, research, and implementation of evidence-based practices that we can shape a healthier future for generations to come.

Administrative Procedure in the Field of Public Health

The relevance of the proposed study is due to the parallel significant update of medical legislation and the entry into force of the Law of Ukraine "On Administrative Procedure". The purpose of the proposed research is to assess the quality of legal regulation of certain administrative proceedings in the field of public health, which has undergone significant changes in the last months of 2023. The results of the study, on the one hand, will help to identify shortcomings and legal conflicts that have formed, and on the other hand, to develop and suggest ways to overcome some of them. The research methodology consists of the following methods of scientific cognition: dialectical, theoretical-prognostic, comparative-legal, system-structural, formal-logical, analysis, legal modeling, and others. In the course of the work, the importance of proper legal regulation and effective public administration in the field of public health is emphasized. The place of administrative bodies in the system has been establishedsubjects of relations in the field of public health. A classification of measures used by specialized administrative bodies in their activities has been proposed. The significance of administrative proceedings and administrative acts used in the process of public administration of public health is disclosed and the most significant among them are highlighted: control and supervision, on the application of termination measures, registration. The essence of each of these proceedings has been investigated and the shortcomings of their regulation have been identified, due to the inconsistency of the norms of the Laws of Ukraine "On the Public Health System" and "On the Administrative Procedure". Significant shortcomings in the legal regulation of administrative proceedings on the application of temporary measures to stop violations of the requirements of sanitary legislation are noted and possible problems in its application are indicated. Attention is also focused on the shortcomings of the terminology used in the Law "On the Public Health System". The results of the study can contribute to the improvement of legislation in the field of public health, as well as to improve the quality of formation law enforcement practice of administrative bodies that are subjects of the public health system.

What Can Public Health Administration Learn from the Decision-Making Processes during COVID-19?

Human decision-making is prone to biases and the use of heuristics that can result in making logical errors and erroneous causal connections, which were evident during COVID-19 policy developments and potentially contributed to the inadequate and costly responses to COVID-19. There are decision-making frameworks and tools that can improve organisational decision-making. It is currently unknown as to what extent public health administrations have been using these structured organisational-level decision-making processes to counter decision-making biases. Current reviews of COVID-19 policies could examine not just the content of policy decisions but also how decisions were made. We recommend that understanding whether these decision-making processes have been used in public health administration is key to policy reform and learning from the COVID-19 pandemic. This is a research and practice gap that has significant implications for a wide range of public health policy areas and potentially could have made a profound difference in COVID-19-related policy responses.