A new study examines the capacity of health care systems to accommodate patients - among the factors that determine public health in the face of infectious disease outbreaks like COVID-19.

One of the most crucial parts of health care facilities attempting to control infectious respiratory diseases is the negative-pressure isolation rooms (NPIR). These rooms are called "negative pressure," since they generally maintain lower air pressure levels. In the event that the door is opened, contaminated air from the admitted patient will not flow outside the rooms.

However, opening the doors allow the air from the outside to flow in. Additionally, NPIRs have layers of air filters that reduce contaminants' concentration and reduce the risks of infecting other people.

A researcher from the University of Texas at Dallas investigated the allocation process and spatial distribution of these NPIRs in South Korea for the previous outbreaks. The study was first published online last July 8 and appeared in the November print issue of the International Journal of Health Policy and Management.

Evaluating the Track Record of South Korean NPIRs

"We are experiencing a very serious pandemic with COVID-19, and the actual outcomes are directly related to the amount of resources that each country has, that each community has, and also that each hospital has," explained Dr. Dohyeong Kim, a co-author in the study. Dr. Kim is also an associate professor of public policy and political economy and of geospatial information sciences in the School of Economic, Political and Policy Sciences at the University of Texas.

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"Particularly for a very highly transmittable disease, keeping viruses within a certain confined area is really important," Dr. Kim added.

Researchers suggested that evidence-based spatial allocation methods for NPIRs could highlight the gaps in these facilities' preparedness, identifying potential weak spots that require additional funding and support.

Kim explains the choice for South Korea as the focus of the study since it has experienced infectious disease outbreaks in the past. Researchers used historical data from South Korea's experiences with severe acute respiratory syndrome (SARS) in 2003, swine flu (H1N1) in 2009, and Middle East respiratory syndrome (MERS) in 2015. Through chronological geographic information system (GIS) mapping, researchers illustrated the conditions of NPIR allocation.

Additionally, researchers used a two-step floating catchment area strategy in measuring recent NPIR coverage for varying outbreak scenarios. The study also involved population data, provided by the Korean Statistical Information Service, as well as hospital and patient data from the Korea Disease Control and Prevention Agency.

Evidence-Based Allocation of Health Resources

Researchers discovered that the existing allocation of health resources in the East Asian nation is not based on science or historic data. This was attributed to a lack of expertise in the matter, as well as politics-oriented decision-making in the relevant government agencies.

The same practice - which demonstrated a substantial disparity between supply and demand of health facilities - was exemplified by major cities, like the capital Seoul, having more and rural areas having less.

Despite the series of infectious disease outbreaks in the country, a national plan to increase NPIRs never saw completion because of a mix of budgetary constraints and need for political willpower.

"The maps in our study clearly show that depending on the type of infectious disease in the next epidemic, even in the best-case scenario, there will still be some hot spots in need of NPIRs," Kim explained. "But in the worst-case scenario, almost every region in South Korea would be concerning."

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