Author(s)

M. Raich, C. Adler, V. Stühlinger, N. Lorenzoni, S. Duschek

Abstract

Major incidents have direct and indirect consequences for population health and health systems. Direct impacts refer to people who lost their life, to the number of people injured, or to resulting diseases. However, indirect consequences (e.g., losses of living conditions, damages to healthcare systems or affiliated infrastructure) including their impact on population health or health systems are often difficult to assess. The purpose of this study is to identify indirect consequences of five different major incidents in Europe on health system performance, security and health protection with focus on psycho-social support. This study is part of the international multi-disciplinary project PsyCris (PSYchosocial Support in CRISis Management), funded by the European Union with the overall objective to improve psycho-social support in crisis management.

Based on different impact models, the authors present the results of an assessment of different European major incidents. Data for assessment has been collected by conducting five case studies in Europe. The impact of these major incidents on health system performance, security and health protection has been investigated by using a questionnaire that was answered by the partners of the project based on articles, books, reports, films and photos. The literature-based questionnaire served as a foundation for a description of the basic facts and consequences of each disaster. It consisted of different topics and included questions concerning disaster management. Additionally, the collaborating partners interviewed key stakeholders who were involved in disaster/crisis management and civil protection. These interviews complemented the assessment.

Different indirect impacts of disasters on health system performance (e.g., changes and adaptions in medical, psychological or psychiatric treatment, psychosocial support), security and health protection (e.g., optimisations in contingency/preparedness planning, infrastructure, training, increase in security research funding activities, information and communication measures) have been identified that might inspire other systems.

The analysis of the case studies has shown that each major incident has various indirect impacts on population health and health systems. Indirect effects identified are often the result of a learning process subsequent to a post-disaster analysis of inadequate management decisions and strategies or insufficient system performance.

Keywords

impact of major incidents, health system performance, security, health protection, psycho-social support