Optimizing health system volume flexibility: key determinants and strategies during the COVID-19 crisis.

PURPOSE: The need to match highly variable demand for healthcare services with existing capacity has been a significant health system challenge experienced by the COVID-19 pandemic. Despite mounting research on various COVID-19 responses in the recent literature, there has not been a structured review examining key determinants of health system volume flexibility. The focus of the present research is to review recent literature based on a conceptual framework developed based on the volume flexibility literature on COVID-19. The review also provides a meaningful way to guide practice and future research in the area.

DESIGN/METHODOLOGY/APPROACH: A literature review was performed guided by the theoretical frameworks developed in the previous volume of flexibility literature. Selected research papers were reviewed and analyzed to identify key determinants of health system volume flexibility.

FINDINGS: Seven determinants of health system volume flexibility under three domains (demand management, capacity management, and performance) included demand management strategies, integration, capacity management strategies, workforce management, technology, quality of disease outcomes, and health system knowledge.

ORIGINALITY/VALUE: The research provides both health systems researchers as well as practitioners with a foundational conceptual framework and knowledge related to health system volume flexibility. In addition, this research identifies future research areas to expand knowledge relevant to health system volume flexibility.