Resilience in healthcare: an investigation into the state of the art

Background: Recent major health shocks like the 2014-16 Ebola outbreak, the Zika outbreak, and, last but not least, the Covid-19 pandemic have strongly contributed to drawing attention to the issue of resilience of health systems, because health authorities and organizations experienced severe difficulties in managing these crises. The concept of resilience is assuming a central role also in the scientific debate about healthcare management. Nevertheless, the lack of clarity on how to systematize and deal with this topic led to a highly fragmented scientific literature, which creates difficulties in the development and assimilation of incremental research in this relevant field. This study provides a comprehensive map of the extant literature and identifies the main themes and future research needs. Methods: A systematic literature review was carried out. We used the database ISI Web of Science (WoS) to extract the dataset. The material search was conducted in December 2020, using keywords derived from the literature. The final sample, obtained from the application of exclusion and inclusion criteria on the initial dataset, comprises 89 articles that are the object of this analysis. Results: The 89 articles in the final sample range from 2001 to 2020. The research on resilience in healthcare appears fragmented and linked to different research streams. Hence, effective framing existing contributions could be beneficial and help at identifying the most investigated areas and the main gaps to fill. At this aim, we proposed a novel theoretical framework, to systematize the papers dealing with the topic of ‘resilience in healthcare’ and to provide a clear picture of the state of the art in this field. Conclusions: The content analysis allowed identifying the significant dimensions defining the scope of investigation on the topic under analysis. Scrutinizing articles along these dimensions, several gaps emerge, which opens interesting paths for future research.