scholarly journals Modeling Hospital Resource Management during the COVID-19 Pandemic: An Experimental Validation

Econometrics ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 38
Author(s):  
J. M. Calabuig ◽  
E. Jiménez-Fernández ◽  
E. A. Sánchez-Pérez ◽  
S. Manzanares
Keyword(s):  
Experimental Validation ◽  
Bed Occupancy ◽  
Hospital Resource ◽  
Average Deviation ◽  
Efficient Management ◽  
Kaplan Meier ◽  
Hospital Beds ◽  
Healthcare Crisis ◽  
Future Hospital ◽  
Hospital Occupancy

One of the main challenges posed by the healthcare crisis generated by COVID-19 is to avoid hospital collapse. The occupation of hospital beds by patients diagnosed by COVID-19 implies the diversion or suspension of their use for other specialities. Therefore, it is useful to have information that allows efficient management of future hospital occupancy. This article presents a robust and simple model to show certain characteristics of the evolution of the dynamic process of bed occupancy by patients with COVID-19 in a hospital by means of an adaptation of Kaplan-Meier survival curves. To check this model, the evolution of the COVID-19 hospitalization process of two hospitals between 11 March and 15 June 2020 is analyzed. The information provided by the Kaplan-Meier curves allows forecasts of hospital occupancy in subsequent periods. The results shows an average deviation of 2.45 patients between predictions and actual occupancy in the period analyzed.

Novel indicator for the assessment of hospital bed occupancy

2011 ◽  
Vol 152 (20) ◽  
pp. 797-801 ◽  
Author(s):  
Miklós Gresz
Keyword(s):  
Patient Needs ◽  
Bed Occupancy ◽  
The Past ◽  
Hospital Beds ◽  
Hospital Bed ◽  
Bed Capacity ◽  
Statistical Indicators

In the past decades the bed occupancy of hospitals in Hungary has been calculated from the average of in-patient days and the number of beds during a given period of time. This is the only measure being currently looked at when evaluating the performance of hospitals and changing their bed capacity. The author outlines how limited is the use of this indicator and what other statistical indicators may characterize the occupancy of hospital beds. Since adjustment of capacity to patient needs becomes increasingly important, it is essential to find indicator(s) that can be easily applied in practice and can assist medical personal and funders who do not work with statistics. Author recommends the use of daily bed occupancy as a base for all these statistical indicators. Orv. Hetil., 2011, 152, 797–801.

BED FUND OF THE RUSSIAN FEDERATION: DYNAMICS OF ITS MAIN INDICATORS

2020 ◽  
Vol 5 (4) ◽  
pp. 50-56
Author(s):  
M. Bant'eva ◽  
E. Manoshkina ◽  
Yuriy Mel'nikov
Keyword(s):  
Russian Federation ◽  
Day Care ◽  
Treatment Duration ◽  
Extreme Values ◽  
Bed Occupancy ◽  
Functional Optimization ◽  
Average Treatment ◽  
Hospital Beds ◽  
Hospital Bed ◽  
The Russian Federation

Despite the fact that the process of structural and functional optimization of the hospital bed fund is currently underway, the basis for the provision of medical care remains the assistance provided in around the clock and day time hospitals, which is the most costly because it requires the constant involvement of a large amount of staff, material, technical, financial and other types of resources. The main indicators of the bed fund in around the clock and daily stay hospitals in the Russian Federation, Federal District and regions in dynamics for 2010-2018, as well as mortality in around the clock hospitals, are analyzed using descriptive statistics. In the Russian Federation from 2010 to 2018 the absolute number of hospitals decreased from 5705 to 4323 (by 24.2%), both due to the reduction in the number of hospital beds and in connection with the unification of medical organizations. At the same time, the number of round-the-clock beds decreased from 1250120 to 1044875 (by 16.4%); provision with hospital beds decreased (from 87.5 to 71.1 per 10,000 population - by 18.7%), the average treatment duration (from 12.6 days to 10.7 - by 15.1%) and, unfortunately, average bed occupancy per year (from 325 to 313 days - by 3.7%). In 2018, the extreme values of the indicator of hospitalization rate for 24-hour hospital beds in the regions of the Russian Federation differ 1.8 times, provision with hospital beds - 2.9 times, average bed occupancy per year - 1.2 times, average treatment duration - 1 8 times. The established differences may indicate an imbalance in the ongoing structural transformations. The overall mortality rate in the Russian Federation increased: from 1.5% in 2010 to 1.9% in 2018 (by 28.4%), a similar trend was observed in all regions. The provision of beds in day care hospitals increased from 15.4 per 10,000 in 2010 to 17.0 in 2018 (10.7%). Multidirectional tendencies are noted, both towards increasing and decreasing the number of places in day hospitals, both in the Federal Districts as a whole and in individual regions. The extreme values of the indicator of the provision of places for day care hospitals in the regions of the Russian Federation differ by 30 times, what reflects the disproportionate organization of a network of day care hospitals in the country's regions. During the observation period in the Russian Federation, the level of hospitalization in round-the-clock hospitals decreased from 222.0 to 203.5 per 1000 population (by 8.3%), while the level of hospitalizations in day care hospitals steadily increased from 26.4 to 35.0 per 1,000 (32.8%), what indicates the implementation of the expected hospital-replacing function of day care in the country as a whole. The issue of further structural and functional optimization of the hospital bed fund of the country remains relevant.

scholarly journals Patients with acute stroke are less likely to be admitted directly to a stroke unit when hospital beds are scarce: A Swedish multicenter register study

2017 ◽  
Vol 2 (2) ◽  
pp. 178-186 ◽  
Author(s):  
David Darehed ◽  
Bo Norrving ◽  
Birgitta Stegmayr ◽  
Karin Zingmark ◽  
Mathias C. Blom
Keyword(s):  
Emergency Department ◽  
Confidence Interval ◽  
Acute Stroke ◽  
Odds Ratio ◽  
Stroke Unit ◽  
Register Study ◽  
Bed Occupancy ◽  
Hospital Beds ◽  
Hospital Bed ◽  
Direct Admission

Introduction It is well established that managing patients with acute stroke in dedicated stroke units is associated with improved functioning and survival. The objectives of this study are to investigate whether patients with acute stroke are less likely to be directly admitted to a stroke unit from the Emergency Department when hospital beds are scarce and to measure variation across hospitals in terms of this outcome. Patients and methods This register study comprised data on patients with acute stroke admitted to 14 out of 72 Swedish hospitals in 2011–2014. Data from the Swedish stroke register were linked to administrative daily data on hospital bed occupancy (measured at 6 a.m.). Logistic regression analysis was used to analyse the association between bed occupancy and direct stroke unit admission. Results A total of 13,955 hospital admissions were included; 79.6% were directly admitted to a stroke unit from the Emergency Department. Each percentage increase in hospital bed occupancy was associated with a 1.5% decrease in odds of direct admission to a stroke unit (odds ratio = 0.985, 95% confidence interval = 0.978–0.992). The best-performing hospital exhibited an odds ratio of 3.8 (95% confidence interval = 2.6–5.5) for direct admission to a stroke unit versus the reference hospital. Discussion and conclusion We found an association between hospital crowding and reduced quality of care in acute stroke, portrayed by a lower likelihood of patients being directly admitted to a stroke unit from the Emergency Department. The magnitude of the effect varied considerably across hospitals.

scholarly journals ANALYSIS OF STRUCTURE AND FUNCTIONING OF HOSPITAL BEDS OF EMERGENCY DEPARTMENT IN THE RUSSIAN FEDERATION

2019 ◽  
Vol 20 (3) ◽  
pp. 4-9
Author(s):  
S. F. Bagnenko ◽  
A. G. Miroshnichenko ◽  
R. R. Alimov ◽  
N. V. Razumnyj ◽  
I. A. Turov
Keyword(s):  
Emergency Department ◽  
Russian Federation ◽  
Occupancy Rate ◽  
Short Stay ◽  
Bed Occupancy ◽  
Hospital Beds ◽  
Discharged Patients ◽  
Bed Capacity ◽  
The Russian Federation ◽  
Population Ratio

29 emergency departments (ED) with hospital beds were functioning in 2018 in the Russian Federation (RF). Within the period 2014–2018 the bed capacity has been increased from 415 to 737, which portion is increased from 0,036% to 0,071% (in 2018 the portion of daily bed was 27,3%, the portion of the bed of short stay department was 72,7%). The number of discharged patients has been increased from 94545 to 306757. Therewith the portion of patients referred from ED to specialized units has been decreased from 19,0% to 11,1%. The average annual bed occupancy rate is 276,6 and 274,1. The bed turnover has been increased from 262,6 to 447,2. The lethal index is decreased from 0,18% to 0,13%. Bed population ratio keeps at the low level (5.0 bed per 1 million people which is rated as 4,5% from recommended values). Additional introduction of hospital departments of emergency medicine in 56 federal subjects of the RF al­lows quicker to achieve the goals of the National Project «Health care».  

scholarly journals Menghadapi Ancaman Pandemi: Analisis Sumber Daya Rumah Sakit Rujukan Avian Influenza di Jakarta

2009 ◽  
Vol 4 (2) ◽  
pp. 84
Author(s):  
Wiku Adisasmito ◽  
Mega Purba Sari ◽  
Amir Su’udi ◽  
Yusi Narulita
Keyword(s):  
Avian Influenza ◽  
Normal Saline ◽  
Influenza Pandemic ◽  
Scenario Planning ◽  
Referral Hospital ◽  
Hospital Resource ◽  
Cross Sectional ◽  
Hospital Beds ◽  
Referral Hospitals ◽  
Resource Capacity

Hingga kini, di Indonesia, pandemi Avian Influenza (AI) masih menjadi ancaman yang dapat menimbulkan banyak korban manusia dan kerugian ekonomi yang besar. Untuk mengantisipasi hal tersebut perlu persiapan dari rumah sakit rujukan AI secara matang khususnya di Jakarta yang merupakan provinsi dengan jumlah kasus AI terbesar. Tujuan dari penelitian ini adalah untuk mengetahui kemampuan sumber daya yang dimiliki rumah sakit rujukan AI RSPI Dr.Sulianti Saroso, RSUP Persahabatan dan RSPAD Gatot Soebroto dalam menghadapi ancaman pandemi AI. Penelitian ini menggunakan disain cross sectional, mengamati sumber daya rumah sakit meliputi fasilitas tempat tidur, peralatan, alat proteksi diri, dan obat-obatan. Metode perhitungan estimasi kebutuhan sumber daya menggunakan formula Radonovich LJ, et al. Hasil penelitian menunjukkan masih terbatasnya ketersediaan tempat tidur baik ICU maupunnon ICU, APD, serta oseltamivir, amoxicillin dan cairan Intravena di rumah sakit rujukan khusus AI apabila terjadi pandemi AI di DKI Jakarta. Dalam rangka siap siaga menghadapi pandemik influenza, disarankan menambahkan rumah sakit rujukan AI di DKI Jakarta dengan mempertimbangkan hasil penelitian ini dan menggunakan pendekatan scenario planning.Kata kunci: Avian influenza , pandemi, sumber daya, RS rujukanAbstractAvian Influenza (AI) pandemic has been threatening Indonesia people and may cause human fatality as well as huge economic lost. To anticipate any loss, a careful hospital preparation needs to be measured. The objective of this research was to explore the AI referral hospital resource capacity in Jakarta to cope with AI pandemic. The hospitals involved in this resource capacity study were Dr. Sulianti Saroso Infectious Hospital, Persahabatan Hospital, and GatotSoebroto Hospital. This cross sectional research aimed at measuring the capacity of the hospital beds, ICU, equipments, personal protective equipments (PPE) and drugs. The Radonovich formula was used in the calculation. The results showed that the resource capacity of the AI referral hospitals in Jakarta was limi-ted, especially in the number of ICU and non ICU beds, PPE, oseltamivir antiviral, amoxicillin and normal saline if AI pandemic occurred in Jakarta. In orderto increase the capacity of Jakarta for pandemic influenza preparedness, it is suggested to assign more hospitals for AI in Jakarta to consider the data of this research and the scenario planning approach.Key words: Avian influenza, pandemic, resources, referral hospital

scholarly journals The Impact of COVID-19 Pandemic on Stock Market: Evidence from Romania

2021 ◽  
Vol 18 (17) ◽  
pp. 9315
Author(s):  
Mariana Hatmanu ◽  
Cristina Cautisanu
Keyword(s):  
Stock Market ◽  
Negative Impact ◽  
Positive Influence ◽  
Negative Effects ◽  
Health Crisis ◽  
Economic Context ◽  
Distributed Lag ◽  
Efficient Management ◽  
Healthcare Crisis ◽  
The Impact

The current health crisis has several socioeconomic influences that could be compared to those experienced during the 2008 economic and financial crisis. Governments around the world are making great efforts to sustain markets as there are signs showing that the health crisis will be followed by an economic crisis. In this study, we aim to investigate the impact of COVID-19 on the Romanian stock market. For this purpose, we considered the influence on the Bucharest Exchange Trading (BET) index of such variables as the number of new cases and the number of new deaths caused by COVID-19, measures taken by authorities, and the international economic context. The collected data covered the period between 11 March 2020 and 30 April 2021. The Autoregressive Distributed Lag (ARDL) Bound cointegration test was used to measure the impact of COVID-19 on the stock market. The results showed a significant long-term negative impact of the pandemic on the BET index for Romania, while the European economic context had a positive influence. Therefore, these results could be used by authorities as a good guideline for the efficient management of measures that aim to reduce the negative effects of the healthcare crisis.

Efficiency indicators of the round-the-clock hospital beds of the oncologic profile in the Russian Federation

2020 ◽  
pp. 12-18
Author(s):  
V. A. Evdakov ◽  
◽  
M. N. Banteva ◽  
E. M. Manoshkina ◽  
Y. Y. Melnikov ◽  
...  
Keyword(s):  
Health Care ◽  
Length Of Stay ◽  
Russian Federation ◽  
Average Length ◽  
Hospitalization Rate ◽  
Bed Occupancy ◽  
Average Length Of Stay ◽  
Hospital Beds ◽  
Federal Districts ◽  
The Russian Federation

The steady growth trend of oncological diseases in Russia in recent years requires a response from the health care system: development of prevention aimed at early detection of diseases; improvement of methods of diagnostics and treatment of oncopathology; improving the quality and effectiveness of medical care. A i m : to identify trends in changes of the neoplasms incidence and performance indicators of oncological beds for round-the-clock stay of the state health care system in the Russian Federation, federal districts and regions of the Russian Federation in dynamics for 2010–2019. M a t e r i a l s a n d m e t h o d s . Using the data of federal statistical observation (forms NoNo. 12, 30) by the method of descriptive statistics, the main indicators of the neoplasms incidence in the population are analyzed, as well as the work of round-the-clock oncological beds in the Russian Federation, federal districts and regions of the Russian Federation in dynamics for 2010–2019. R e s u l t s . On the background of an increase in the neoplasms incidence in the population (by 24.9%), including malignant (1.5 times), for the period 2010–2019 in the Russian Federation increased: the absolute number of oncology beds of round-the-clock stay from 30,970 to 36,186 (+ 16.8%), the provision with these beds from 2.17 to 2.47 per 10,000 population (+ 13.8%), hospitalization rate from 6.1 to 9.6 per 1000 population (+ 57.4%), and decreased: the average length of stay in an oncological bed (from 12.1 days to 8.4 – by 30.6%), as well as the average bed occupancy per year (from 345 to 330 days – by 4.3%). The extreme values of the indicators of the hospitalization rate for round-the-clock oncological beds in the regions of the Russian Federation in 2019 differ 12.8 times, the provision of these beds – 9.2 times, the average bed occupancy per year – 1.5 times, the average length of stay in a bed – 2.4 times. Mortality in oncological hospital beds increased from 0.76% in 2010 to 0.95% in 2019 (by 25%). C o n c l u s i o n . The 24-hour oncological bed capacity, against the background of the growth of oncological morbidity, has naturally increased, but at the same time it is characterized by an extreme disproportionality of development in the Federal Districts and the regions of the Russian Federation. Optimization of the bed fund should be carried out based on the objective needs of a particular region, taking into account its characteristics and with the simultaneous development of alternative medical services.

Ethics Support for the Distribution of Hospital Beds: Co-Creating a Map of Values and Norms for the Allocation Meetings

2021 ◽  
Vol 66 (Special Issue) ◽  
pp. 65-66
Author(s):  
Janine de Snoo-Trimp ◽  
◽  
Laura Hartman ◽  
Bert Molewijk ◽  
◽  
...  
Keyword(s):  
Healthcare Professionals ◽  
Bed Occupancy ◽  
Joint Development ◽  
Ethics Support ◽  
Hospital Beds ◽  
Bed Allocation ◽  
Occupancy Rates ◽  
Bed Occupancy Rates ◽  
Selection Of

"Background: Allocating admitted patients to their wards is increasingly put under pressure due to high bed occupancy rates. Consequently, allocation becomes morally challenging as it is confronted with potentially conflicting values like protecting teams’ workload, solidarity between wards and quality of care. Furthermore, there is a continuous uncertainty regarding expected intake, discharge, available beds and personnel. An integrative ethics support project was started to help to better deal with these challenges. After identifying core moral challenges, the aim of the current project was to co-create a map of values and norms for the daily allocation meetings. Methods: This qualitative study included observations of allocation meetings and 13 interviews. Subsequently, in five working group sessions a map of relevant values and norms was co-created with a selection of involved professionals. Results: Findings revealed moral challenges in three so-called ‘moral circles’: 1) one’s own team; 2) the hospital and 3) the hospital’s region. A map was developed including important and agreed upon values with 14 norms for the daily allocation meetings. Additionally, formal policies were updated and a conversation method was introduced to guide discussions when there are moral challenges. Conclusion: The joint development of the map led to a shared and practical product for both discussions and decisions regarding bed allocation. Its development already contributed to increased awareness of and openness about moral challenges. Using the map in daily allocation meetings may further stimulate moral reflection on these challenges to support these healthcare professionals in making well-considered and value-based decisions. "

Early Breast Cancer - Less Axillary Surgery?

Swiss Surgery ◽  
2000 ◽  
Vol 6 (3) ◽  
pp. 116-120 ◽  
Author(s):  
Gambazzi ◽  
Zuber ◽  
Oertli ◽  
Marti ◽  
Kocher ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Early Breast Cancer ◽  
Axillary Surgery ◽  
Kaplan Meier

Kleine Mammakarzinome werden häufiger entdeckt. Die nodal positiven Fälle werden seltener. Die sentinel lymph node (SLN) Technik könnte die geeignete Methode sein, unnötige Axilladissektionen zu vermeiden. Wir untersuchten ein Kollektiv von Patientinnen mit pT1 Tumoren in Bezug auf Nodalstatus (pT1a,b und c), auf Axillarezidiv sowie auf das Gesamtüberleben. Von 1983 bis 1997 wurden konsekutiv 185 Frauen mit einem Mammakarzinom </= 20mm Durchmesser behandelt. Die Überlebensdaten nach Kaplan-Meier stützten sich auf eine Kohorte aus 117 Patientinnen mit einer medianen Nachsorge von mindestens sieben Jahren. Es fanden sich sieben Patientinnen mit einem pT1a Karzinom, 30 mit einem pT1b Karzinom und 148 mit einem pT1c Karzinom. Im Mittel wurden 16 axilläre Lymphknoten vom Pathologen gezählt. Der axilläre Lymphknotenbefall zeigte eine erwartete Abhängigkeit von der Tumorgrösse: Kein Axillabefall bei nur sieben pT1a, 10% befallene Lymphknoten bei pT1b und 30% bei pT1c Karzinomen. Kein einziges Axillarezidiv wurde während der Beobachtungszeit entdeckt. Das Gesamtüberleben nach zehn Jahren betrug für Patientinnen mit einem pT1a Karzinom 100%, 91% für pT1b und noch 74% für pT1c Karzinome. Die Screening Mammographie entdeckt vermehrt kleinere Mammakarzinome. Die pN+ Stadien nehmen ab. Hier müssen Nutzen und Risiko der Axilladissektion einander kritisch gegenübergestellt werden. Eine selektive Axilladissektion ermöglicht die sentinel lymph node (SLN) Methode, welche in Verbindung mit aufwendigeren histologischen Nachweismethoden den axillären Nodalstatus realistisch wiedergibt.

Colorectal Liver Metastases - Does the Number of Lesions Determine the Sensibility of Resection?

Swiss Surgery ◽  
2000 ◽  
Vol 6 (1) ◽  
pp. 6-10
Author(s):  
Knoefel ◽  
Brunken ◽  
Neumann ◽  
Gundlach ◽  
Rogiers ◽  
...  
Keyword(s):  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Rank Test ◽  
Log Rank Test ◽  
Kaplan Meier ◽  
Chirurgische Entfernung

Die komplette chirurgische Entfernung von Lebermetastasen bietet Patienten nach kolorektalem Karzinom die einzige kurative Chance. Es gibt jedoch eine, anscheinend unbegrenzte, Anzahl an Parametern, die die Prognose dieser Patienten bestimmen und damit den Sinn dieser Therapie vorhersagen können. Zu den am häufigsten diskutierten und am einfachsten zu bestimmenden Parametern gehört die Anzahl der Metastasen. Ziel dieser Studie war es daher die Wertigkeit dieses Parameters in der Literatur zu reflektieren und unsere eigenen Patientendaten zu evaluieren. Insgesamt konnte von 302 Patienten ein komplettes Follow-up erhoben werden. Die gebildeten Patientengruppen wurden mit Hilfe einer Kaplan Meier Analyse und konsekutivem log rank Test untersucht. Die Literatur wurde bis Dezember 1998 revidiert. Die Anzahl der Metastasen bestätigte sich als ein prognostisches Kriterium. Lagen drei oder mehr Metastasen vor, so war nicht nur die Wahrscheinlichkeit einer R0 Resektion deutlich geringer (17.8% versus 67.2%) sondern auch das Überleben der Patienten nach einer R0 Resektion tendenziell unwahrscheinlicher. Das 5-Jahres Überleben betrug bei > 2 Metastasen 9% bei > 2 Metastasen 36%. Das 10-Jahres Überleben beträgt bislang bei > 2 Metastasen 0% bei > 2 Metastasen 18% (p < 0.07). Die Anzahl der Metastasen spielt in der Prognose der Patienten mit kolorektalen Lebermetastasen eine Rolle. Selbst bei mehr als vier Metastasen ist jedoch gelegentlich eine R0 Resektion möglich. In diesen Fällen kann der Patient auch langfristig von einer Operation profitieren. Das wichtigere Kriterium einer onkologisch sinnvollen Resektabilität ist die Frage ob technisch und funktionell eine R0 Resektion durchführbar ist. Ist das der Fall, so sollte auch einem Patienten mit mehreren Metastasen die einzige kurative Chance einer Resektion nicht vorenthalten bleiben.

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