ОРГАНИЗАЦИОННЫЕ ПОСЛЕДСТВИЯ ПАНДЕМИИ COVID-19 И ГОТОВНОСТЬ СИСТЕМЫ ЗДРАВООХРАНЕНИЯ К БУДУЩИМ ЧРЕЗВЫЧАЙНЫМ СИТУАЦИЯМ В ОБЛАСТИ ОБЩЕСТВЕННОГО ЗДРАВООХРАНЕНИЯ: НАРРАТИВНЫЙ ОБЗОР

Актуальность: Пандемия COVID-19 выявила организационные уязвимости систем здравоохранения, нарушив устойчивость кадрового обеспечения, работу больниц, цепочки поставок и оказание плановой помощи. Уроки в области устойчивости персонала, резервных мощностей больниц, надёжности цепочек поставок и управления важны для укрепления готовности системы здравоохранения Казахстана к будущим пандемиям и другим чрезвычайным ситуациям в области общественного здравоохранения.

Цель: обобщить данные об организационных последствиях COVID-19, разграничить экстренные адаптационные меры и сохраняющиеся проблемы, а также рассмотреть применимость международного опыта обеспечения готовности к условиям Казахстана.

Материалы и методы: Проведён нарративный обзор. Поиск в PubMed/MEDLINE, Web of Science и Google Scholar охватывал работы, впервые опубликованные с января 2020 г. по июль 2026 г.; последний поиск выполнен 26 августа 2026 г. Дополнительно использованы поиск по спискам литературы, целевой поиск и отчёты организаций. В обзор вошли 90 публикаций, включая три конференционных тезиса, и пять дополнительных институциональных отчётов. Данные обобщены по тематическим направлениям.

Результаты: В метаанализе распространённость профессионального выгорания среди медицинских работников составила 52 % (95 % ДИ 40–63 %). Выгорание было связано с намерением покинуть работу, тогда как фактический уход кадров описывался преимущественно в национальных обследованиях. Глобальная модель прогнозировала отмену или перенос 28,4 млн плановых операций за 12 недель пиковых нарушений в 2020 г. В исследованиях цепочек поставок географическая концентрация производства, недостаточные резервы и ограниченные знания о цепочках поставок рассматривались как возможные факторы дефицита. Организации адаптировались за счёт перераспределения персонала, перепрофилирования коек, централизованной координации поставок и телемедицины, однако данных о долгосрочной устойчивости этих мер было недостаточно.

Выводы: Имеющиеся данные поддерживают рассмотрение мер по защите персонала, планированию резервных мощностей, диверсификации поставок и институциональному обучению на опыте реагирования в рамках повседневной работы системы здравоохранения. Сравнительная эффективность и долгосрочная устойчивость конкретных мер остаются недостаточно изученными. Данные по Казахстану ограничены; предложенные меры требуют локальной оценки.

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