Systematic Review of Health Emergency Policies and Their Impact on Referral Mechanisms During the COVID-19 Pandemic

Authors

  • Rio Revaldi Naufal Ivanda Universitas Negeri Malang
  • Dewi Salma Universitas Negeri Malang
  • Adila Helga Joanna Universitas Negeri Malang
  • Anindya Fathin Sava Athadita Universitas Negeri Malang
  • Puput Saputri Universitas Negeri Malang
  • Natasya Nawa Cellia Universitas Negeri Malang
  • Bilqis Ayu Syahida Universitas Negeri Malang
  • Refiana Martha Handartiwi Universitas Negeri Malang
  • Muhammad Nur Hakim Ghozi Abdullah Universitas Negeri Malang
  • Titah Wahyu Ningrum Universitas Negeri Malang
  • Neni Fidya Santi Universitas Negeri Malang
  • Nurul Evi Universitas Negeri Malang

DOI:

https://doi.org/10.62255/mjhp.v3i1.168

Abstract


The COVID-19 pandemic placed unprecedented strain on healthcare systems worldwide, necessitating rapid policy interventions to manage patient flow, resource allocation, and referral mechanisms. This study employed a systematic literature review (SLR) using the PRISMA framework to evaluate the impact of health emergency policies on referral mechanisms during the pandemic. The review focused on understanding how policies such as lockdowns, triage protocols, and telemedicine integration influenced access, equity, system efficiency, and resilience in referral networks. A comprehensive search was conducted across databases including PubMed, Scopus, Web of Science, IEEE Xplore, and Cochrane Library, with inclusion criteria encompassing peer-reviewed studies published in English between 2020 and 2023. Studies were rigorously assessed for methodological quality using tools such as the Cochrane Risk of Bias Tool and Simulation Model Quality Assessment Framework. Key themes identified included restricted access to emergency services, healthcare system reordering, operational strain on infrastructure, and coordination gaps. The findings revealed significant challenges, such as ambulance delays, emergency department closures, protocol overload, and inequities in care access, while also highlighting adaptive strategies like AI-driven referral tools, hybrid triage systems, and community health worker networks. This study underscores the need for balanced policy design, robust technological integration, and long-term systemic reforms to strengthen referral mechanisms during health emergencies. The results provide actionable insights for policymakers and healthcare administrators to optimize referral systems and ensure equitable access to care during future crises.

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Keywords:

Health emergency policies, Referral mechanisms, COVID-19, Systematic review, Healthcare resilience

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Published

2025-07-30

How to Cite

Naufal Ivanda, R. R. ., Salma, D., Joanna, A. H. ., Sava Athadita, A. F. ., Saputri, P., Cellia, N. N. ., Syahida, B. A. ., Handartiwi, R. M. ., Ghozi Abdullah, M. N. H. ., Ningrum, T. W. ., Santi, N. F. ., & Evi, N. (2025). Systematic Review of Health Emergency Policies and Their Impact on Referral Mechanisms During the COVID-19 Pandemic. Health Frontiers: Multidisciplinary Journal for Health Professionals, 3(1), 53–64. https://doi.org/10.62255/mjhp.v3i1.168

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