Hospital capacity and admission rate may be a factor of importance to mortality in COVID-19

Martínez, José Joaquín Alfaro; Pozo, Julián Solís García del; Oliveira, Cristina Lamas; Mellinas, Gema Paterna; García-Castillo, Sergio; Cifuentes, María Molina; Corrales, Pedro Pinés

doi:10.1080/23744235.2021.2001565

Cited by 5 publications

(4 citation statements)

References 7 publications

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“…One reason for the low admission rate is potentially due to the mass vaccination rollout as this has been shown to significantly reduce risk of hospital admission 10 . Previous studies have shown that there is an increase in hospital mortality with floods of patients indicating the need for streamlined pathways for admission 11 . Studies have also shown that the COVID‐19 pandemic has decreased hospital presentations, for example in three hospitals in America showing reduced psychiatric presentations and hospitalisations 12 .…”

Section: Discussionmentioning

confidence: 99%

“… 10 Previous studies have shown that there is an increase in hospital mortality with floods of patients indicating the need for streamlined pathways for admission. 11 Studies have also shown that the COVID‐19 pandemic has decreased hospital presentations, for example in three hospitals in America showing reduced psychiatric presentations and hospitalisations. 12 There was also a decreased in presentations of Chronic Obstructive Pulmonary Disease exacerbations due to physical and behavioural measures taken to limit COVID‐19 transmission.…”

Section: Discussionmentioning

confidence: 99%

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COVID‐19 (Omicron strain) hospital admissions from a virtual ward – who required further care?

Mackay

France

McAuley

et al. 2023

Influenza Resp Viruses

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Background: The COVID-19 virtual ward was created to provide care for people at home with COVID-19. Given this was a new model of care, little was known about the clinical characteristics and outcomes of patients requiring admission to hospital from the virtual ward platform.The aims were to characterise hospital admission volume, patient epidemiology, clinical characteristics, and outcome from a virtual ward in the setting of an Omicron (BA.1, BA.2) outbreak.Methods: A retrospective observational study was performed for all virtual ward patients admitted from 1st January 2022 to 25th March 2022 (over 16 years old).Epidemiological, clinical and laboratory data was reviewed on all patients who required hospital admission.Results: A total of 7021 patients were cared for on the virtual ward over the study period with 473 referred to hospital for assessment. Twenty-six (0.4%) patients were admitted to hospital during their care on the ward. Twenty-two (84.6%) admissions were COVID-19 related. Fifty three percent of the hospitalised patients were fully vaccinated and 11 had received prior therapeutics for COVID-19. Shortness of breath was the most common reason for escalation to hospital. Chest pain was the second most common reason and the most common diagnosis after investigation was non-cardiac chest pain.Conclusions: Few patients required admission from the virtual ward in the setting of the Omicron variant (BA.1, BA.2) as a direct result of COVID-19 disease and virtual ward care. Shortness of breath and chest pain were the most common symptoms driving further clinical care.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

COVID‐19 (Omicron strain) hospital admissions from a virtual ward – who required further care?

Mackay

France

McAuley

et al. 2023

Influenza Resp Viruses

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“…In Phases 1C and 1D, 10 and 12.5% of the acute beds and 50–60% of the ICU capacity must be kept available for patients with infectious diseases, respectively. The current hospital surge capacity plan tries to avoid opening additional hospitals or ICU beds since past experiences have shown that the opening of additional hospitalization capacity was linked to an increase in mortality ( 67 , 68 ).…”

Section: Interaction Between Free Hospital Capacity and Remote Care: ...mentioning

confidence: 99%

Large-scale real-life implementation of technology-enabled care to maximize hospitals' medical surge preparedness during future infectious disease outbreaks and winter seasons: a viewpoint

Sener

Haenen²,

Smits³

et al. 2023

Front. Public Health

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Hospitals can be overburdened with large numbers of patients with severe infectious conditions during infectious disease outbreaks. Such outbreaks or epidemics put tremendous pressure on the admission capacity of care facilities in the concerned region, negatively affecting the elective program within these facilities. Such situations have been observed during the recent waves of the coronavirus disease pandemic. Owing to the imminent threat of a “tripledemic” by new variants of the coronavirus disease (such as the new Omicron XBB.1.16 strain), influenza, and respiratory syncytial virus during future winter seasons, healthcare agencies should take decisive steps to safeguard hospitals' surge capacity while continuing to provide optimal and safe care to a potentially large number of patients in their trusted home environment. Preparedness of health systems for infectious diseases will require dynamic interaction between a continuous assessment of region-wide available hospital capacity and programs for intensive home treatment of patients who can spread the disease. In this viewpoint, we describe an innovative, dynamic coupling system between hospital surge capacity and cascading activation of a nationwide system for remote patient monitoring. This approach was developed using the multi-criteria decision analysis methodology, considering previously published real-life experiences on remote patient monitoring.

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“…Importantly, overcrowding decreases the quality of care, leads to worse patient outcomes, and increases mortality. [8][9][10] Furthermore, if ICU capacity is insufficient, patients would need to be triaged for access and, the worst-case scenario, would have to be denied access to life-saving care on the ICU based on, for example, age or previous medical history. [11][12][13][14] This scenario must be avoided at all cost.…”

Section: Introductionmentioning

confidence: 99%

Managing Hospital Capacity: Achievements and Lessons from the COVID-19 Pandemic

Koning¹,

Boogers

Beeres

et al. 2022

Prehosp. Disaster med.

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Introduction: The coronavirus disease 2019 (COVID-19) pandemic challenged health care systems in an unprecedented way. Due to the enormous amount of hospital ward and intensive care unit (ICU) admissions, regular care came to a standstill, thereby overcrowding ICUs and endangering (regular and COVID-19-related) critical care. Acute care coordination centers were set up to safely manage the influx of COVID-19 patients. Furthermore, treatments requiring ICU surveillance were postponed leading to increased waiting lists. Hypothesis: A coordination center organizing patient transfers and admissions could reduce overcrowding and optimize in-hospital capacity. Methods: The acute lack of hospital capacity urged the region West-Netherlands to form a new regional system for patient triage and transfer: the Regional Capacity and Patient Transfer Service (RCPS). By combining hospital capacity data and a new method of triage and transfer, the RCPS was able to effectively select patients for transfer to other hospitals within the region or, in close collaboration with the National Capacity and Patient Transfer Service (LCPS), transfer patients to hospitals in other regions within the Netherlands. Results: From March 2020 through December 2021 (22 months), the RCPS West-Netherlands was requested to transfer 2,434 COVID-19 patients. After adequate triage, 1,720 patients with a mean age of 62 (SD = 13) years were transferred with the help of the RCPS West-Netherlands. This concerned 1,166 ward patients (68%) and 554 ICU patients (32%). Overcrowded hospitals were relieved by transferring these patients to hospitals with higher capacity. Conclusion: The health care system in the region West-Netherlands benefitted from the RCPS for both ward and ICU occupation. Due to the coordination by the RCPS, regional ICU occupation never exceeded the maximal ICU capacity, and therefore patients in need for acute direct care could always be admitted at the ICU. The presented method can be useful in reducing the waiting lists caused by the delayed care and for coordination and transfer of patients with new variants or other infectious diseases in the future.

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Hospital capacity and admission rate may be a factor of importance to mortality in COVID-19

Cited by 5 publications

References 7 publications

COVID‐19 (Omicron strain) hospital admissions from a virtual ward – who required further care?

COVID‐19 (Omicron strain) hospital admissions from a virtual ward – who required further care?

Large-scale real-life implementation of technology-enabled care to maximize hospitals' medical surge preparedness during future infectious disease outbreaks and winter seasons: a viewpoint

Managing Hospital Capacity: Achievements and Lessons from the COVID-19 Pandemic

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