Central COVID-19 Coordination Centers in Germany: Description, Economic Evaluation, and Systematic Review

Abstract

Background During the COVID-19 pandemic, Central COVID-19 Coordination Centers (CCCCs) have been established at several hospitals across Germany with the intention to assist local health care professionals in efficiently referring patients with suspected or confirmed SARS-CoV-2 infection to regional hospitals and therefore to prevent the collapse of local health system structures. In addition, these centers coordinate interhospital transfers of patients with COVID-19 and provide or arrange specialized telemedical consultations. Objective This study describes the establishment and management of a CCCC at a German university hospital. Methods We performed economic analyses (cost, cost-effectiveness, use, and utility) according to the CHEERS (Consolidated Health Economic Evaluation Reporting Standards) criteria. Additionally, we conducted a systematic review to identify publications on similar institutions worldwide. The 2 months with the highest local incidence of COVID-19 cases (December 2020 and January 2021) were considered. Results During this time, 17.3 requests per day were made to the CCCC regarding admission or transfer of patients with COVID-19. The majority of requests were made by emergency medical services (601/1068, 56.3%), patients with an average age of 71.8 (SD 17.2) years were involved, and for 737 of 1068 cases (69%), SARS-CoV-2 had already been detected by a positive polymerase chain reaction test. In 59.8% (639/1068) of the concerned patients, further treatment by a general practitioner or outpatient presentation in a hospital could be initiated after appropriate advice, 27.2% (291/1068) of patients were admitted to normal wards, and 12.9% (138/1068) were directly transmitted to an intensive care unit. The operating costs of the CCCC amounted to more than €52,000 (US $60,031) per month. Of the 334 patients with detected SARS-CoV-2 who were referred via EMS or outpatient physicians, 302 (90.4%) were triaged and announced in advance by the CCCC. No other published economic analysis of COVID-19 coordination or management institutions at hospitals could be found. Conclusions Despite the high cost of the CCCC, we were able to show that it is a beneficial concept to both the providing hospital and the public health system. However, the most important benefits of the CCCC are that it prevents hospitals from being overrun by patients and that it avoids situations in which physicians must weigh one patient’s life against another’s.

The COVID-19 Pandemic as an Impulse for the Development of Telemedicine in Primary Care in Poland

“…The benefits resulting from implementing projects and telemedicine solutions are visible in the highly developed and developing countries. Research supports the idea that telemedicine is at least as good as conventional services, in terms of effectiveness, cost, and patient outcomes [ 25 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 ]. The use of telemedicine tools as an alternative to traditional healthcare services has positively influenced the participants in the healthcare sector.…”

Burden of hospital admissions and resulting patient interhospital transports during the 2020/2021 SARS-CoV-2 pandemic in Saxony, Germany

“…In March 2020 the responsible government institution (Saxon Ministry of Social Affairs), divided Saxony into three COVID-19 coordination clusters—Chemnitz, Dresden and Leipzig 3 . One hospital (University Hospital Dresden, University Hospital Leipzig and the Hospital Chemnitz) in each cluster served as a central coordinator for SARS-CoV-2 patients and as a contact for outpatient and inpatient stakeholders in the healthcare system as well as for public health authorities 4 . Up to that point, direct data exchange and communication between hospitals were not standard.…”

An exploration of available methods and tools to improve the efficiency of systematic review production - a scoping review

“…A total of 73 studies were validity studies (n=70) [25-34, 37, 39, 43-46, 48, 49, 51, 52, 56-58, 60, 62-66, 69, 70, 75, 77-79, 81-85, 87-91, 94-97, 99, 101-103, 105-112, 114-117, 119-122, 124, 125] or usability studies (n=3) [59,67,68] assessing a single method or tool, and 30 studies performed comparative analyses of different methods or tools [12, 35, 36, 38, 40-42, 47, 50, 53-55, 61, 71-74, 76, 80, 86, 92, 93, 98, 100, 104, 108, 113, 118, 126, 127]. Few studies prospectively evaluated methods or tools in a real-world work ow (n=20) [12,27,32,35,46,50,67,68,77,78,88,90,94,98,105,108,112,114,125,127], 7 studies of those used independent testing (by a different reviewer team) with external data [12,35,46,94,98,112,127].…”

“…The majority of studies evaluated methods or tools for supporting the tasks of title and abstract screening (n=42) [32, 35, 36, 38, 43-45, 47, 48, 51, 55, 58, 59, 63, 73, 79, 82-84, 86-90, 94-96, 100, 102, 105-108, 112-114, 117-120, 125, 127] or devising the search strategy and performing the search (n=24) [28, 34, 37, 39, 42, 52, 53, 56, 60, 64-66, 72, 81, 91-93, 98, 99, 104, 110, 121, 122, 126] (see Figure 2). For several steps of the SR process, only a few studies that evaluated methods or tools were identi ed: deduplication: n=6 [30,36,54,57,71,80], additional search: n=2 [33,97], update search: n=6 [36, 50,61,77,109,111], full-text selection: n=4 [85, 113,114,125], data extraction: n=11 [31,36,46,67,69,70,74,103,112,124,125]; critical appraisal: n=9, [26, 27,36,49,62,68,75,101,115], and combination of abbreviated methods/tools: n=6 [12,25,76,78,100,116] (see Figure 2). No studies were found for some steps of the SR...…”