Healthcare services re-organization based on lessons learned during COVID-19 pandemic. Conceptual frameworks and measurement and assessment tools for public health emergency preparedness.

Public health emergency preparedness (PHEP) is a core element for health systems, which involves a coordinated and continuous process of planning and implementation based on measuring performance and taking corrective actions. The COVID-19 pandemic highlighted critical areas within health systems, with the need of a revision of previous logic models and the implementation of new assessment tools for PHEP. On this basis, the European Union (EU) promoted an evolution of the legislative context on PHEP and the mandate of its main institutions, mainly the European Centre for Disease Prevention and Control (ECDC). Building on collaborative efforts between international organizations and research centers, the aim of the current PhD thesis is to study and upgrade conceptual frameworks of PHEP in response to pandemic emergencies and identify assessment models relating to the organization of care pathways, with a specific focus on the hospital setting and on the integration with primary care systems related to the rearrangements induced by the COVID-19 pandemic. The findings of the thesis provided elements for the revision of the current ECDC Logic Model for PHEP and evidence for improvements in the area of healthcare coordination; additionally, they suggested methodological approaches for standardized assessment and evaluation tools for PHEP systems within the EU.