During the COVID-19 pandemic national health emergency networks have been stressed at worldwide level. The responses of each network were different according to the models of the national healthcare system and the adopted strategies. This research aims to investigate the impact of the COVID-19 pandemic in the transitional countries. Albania was selected as representative among the transitional countries for its territorial and cultural proximity of Europe. The methodology of national case study was chosen. The analysis of the country was conducted both with interviews to the top managers of National Centre for the Health Emergencies 127 and the National Institute of Insurance, and with the desk analysis of the documents received by the same. Data showed that the number of calls to 127 increased by 47% in 2020, 56% in 2021 and 31% in 2022 (compared to 2019) for COVID-19. The requests were predominantly managed by telephone medical counselling (+243% in 2020, +89% in 2021 and +25% in 2022). This resulted in a strong containment of the growth in the number of missions (+15% in 2020, +22% in 2021 and +5% in 2022). In particular, the missions were completed more on site (+21% in 2020, +30% in 2021 and +7% in 2022) that with a transport in hospital (+12% in 2020, +17% in 2021 and +3% in 2022). This led to a reduction of access to health emergency departments of -25% in 2022 and -9% in 2021. However, hospital expenditure on emergency grows only by 22% in 2020 and 22% in 2021 in the face of higher costs for the management of patients affected by COVID-19. The strategy of the Albanian Healthcare System to manage COVID-19 positive patients at home has contained the impact the outbreak on costs of hospital emergency departments.