{
  "abstract": "Background/Objectives: Post-pandemic reforms have expanded the EU/EEA health-security architecture across surveillance, crisis coordination, medical countermeasures, workforce mobilisation, civil protection and cybersecurity. Preparedness structures do not themselves establish operational performance. We mapped publicly available documentary evidence of operationalisation across eight health-readiness domains. Methods: We applied structured qualitative documentary analysis and a capability-based Framework Method to 35 primary public sources dated or accessed between 1 January 2024 and 17 September 2026. We extracted 190 source-linked observations. Frequency estimates included 175 observations from 34 sources after excluding 15 potentially overlapping rows from an interim cross-country PHEPA synthesis. Evidence was coded using nonexclusive policy (P), mechanism (M), operational functionality (O), completed exercise (E) and real-world use (R) attributes, without deriving a readiness score. Results: Policy commitments and established mechanisms were documented more often than completed exercise testing or real-world use. Explicitly documented gaps occurred in 62 of 175 observations (35.4%), concerning formalisation and activation, interoperability and situational visibility, scalability and sustainability, exercise and event evidence, learning and corrective-action closure, and cross-sector or cross-border integration. Gap frequencies differed by source type, particularly between PHEPA reports and other documents, and do not indicate comparative readiness. Most observations did not specify hazard interaction; none met the revised strict thresholds for a hybrid campaign, compound crisis or cascading disruption. Conclusions: This study provides a traceable map of public evidence linking preparedness structures to reported operationalisation. Its findings identify documentary patterns and implementation challenges, not direct measures of capability, effectiveness or performance in complex crises.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Security Studies, Polish Air Force University, 08-521 Dęblin, Poland.",
    "Civil-Military Centre of Expertise for Trauma Care, Central Military Hospital, Ministry of Defence, 3584 EZ Utrecht, The Netherlands.",
    "Civil-Military Centre of Expertise for Trauma Care, Traumacenter, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands.",
    "Crisis and Disaster Management Unit, Heidelberg University Hospital, Heidelberg University, Im Neuenheimer Feld 430, 69120 Heidelberg, Germany.",
    "Center for Virtual Patients, Medical Faculty, University of Heidelberg, 69120 Heidelberg, Germany.",
    "Pediatric Neurology and Metabolic Medicine, Center for Pediatrics and Adolescent Medicine, Heidelberg University Hospital, 69120 Heidelberg, Germany.",
    "Rhine-Neckar Public Health Service, 69115 Heidelberg, Germany.",
    "Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, 405 30 Gothenburg, Sweden.",
    "Disaster Medicine Center, University of Gothenburg, 405 30 Gothenburg, Sweden.",
    "Gothenburg Emergency Medicine Research Group (GEMREG), Sahlgrenska Academy, Gothenburg University, 405 30 Gothenburg, Sweden."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Krzysztof Goniewicz",
      "orcid": "0000-0003-4368-6850"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Henk van der Wal",
      "orcid": "0000-0001-7551-2842"
    },
    {
      "affs": [
        3,
        4,
        5,
        6
      ],
      "name": "Markus Ries",
      "orcid": "0000-0002-5054-5741"
    },
    {
      "affs": [
        7,
        8,
        9
      ],
      "name": "Amir Khorram-Manesh",
      "orcid": "0000-0002-2734-5733"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/bjzyr8ysgsh4g.bib",
  "cited_by": 0,
  "doi": "10.3390/healthcare14203529",
  "fulltext_url": "https://europepmc.org/articles/PMC13704503",
  "id": "bjzyr8ysgsh4g",
  "issns": [
    "2227-9032"
  ],
  "landing_url": "https://europepmc.org/article/MED/42940574",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "3604|Disaster Response and Management"
    ]
  ],
  "openalex": "W7216527713",
  "pdf_url": "https://europepmc.org/articles/PMC13704503?pdf=render",
  "pmcid": "PMC13704503",
  "pmid": "42940574",
  "published": "2026-10-20",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/bjzyr8ysgsh4g.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:22:12Z",
      "native_id": "MED:42940574",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42940574"
    }
  ],
  "subjects": [],
  "title": "From Preparedness to Documented Operational Readiness: Mapping Public Evidence Across the EU/EEA Health-Security Architecture.",
  "title_text": "From Preparedness to Documented Operational Readiness: Mapping Public Evidence Across the EU/EEA Health-Security Architecture.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:22:12Z",
  "url": "https://research.draconitic.com/paper/bjzyr8ysgsh4g",
  "venue": "Healthcare (Basel, Switzerland)",
  "versions": []
}