Health-system resilience: what the evidence supports

Resilience has become a standard goal for health systems and a slippery one. To study it, we need features that can be observed before the next shock, not only after it.

Observable features

1. Surge capacity — staffed beds and trained personnel that can be mobilised, not nominal capacity on a register.
2. Supply redundancy — more than one route for essential goods.
3. Information latency — how quickly the system knows what is happening in its own facilities.

Systems that score well on these tend to absorb a shock with less disruption to routine care. Systems that recover quickly but score poorly often do so by borrowing capacity from elsewhere, which works once and less well the second time.

A measured conclusion

The comparative evidence supports investment in information latency more strongly than any single capital measure. Knowing sooner is consistently cheaper than building more, though it is harder to photograph for a ribbon-cutting.

We set out the indicators and their limits in full, so that ministries can apply them to their own data rather than to ours.