Measures and Impact of Caseload Surge During the COVID-19 Pandemic: A Systematic Review*
Critical Care Medicine,
Год журнала:
2024,
Номер
52(7), С. 1097 - 1112
Опубликована: Март 22, 2024
COVID-19
pandemic
surges
strained
hospitals
globally.
We
performed
a
systematic
review
to
examine
measures
of
caseload
surge
and
its
impact
on
mortality
hospitalized
patients.
Язык: Английский
Clinical evaluation of a machine learning–based early warning system for patient deterioration
Canadian Medical Association Journal,
Год журнала:
2024,
Номер
196(30), С. E1027 - E1037
Опубликована: Сен. 15, 2024
The
implementation
and
clinical
impact
of
machine
learning-based
early
warning
systems
for
patient
deterioration
in
hospitals
have
not
been
well
described.
We
sought
to
describe
the
evaluation
a
multifaceted,
real-time,
system
used
general
internal
medicine
(GIM)
unit
an
academic
medical
centre.
Язык: Английский
Mortality for Time-Sensitive Conditions at Urban vs Rural Hospitals During the COVID-19 Pandemic
JAMA Network Open,
Год журнала:
2024,
Номер
7(3), С. e241838 - e241838
Опубликована: Март 12, 2024
Importance
COVID-19
pandemic-related
disruptions
to
the
health
care
system
may
have
resulted
in
increased
mortality
for
patients
with
time-sensitive
conditions.
Objective
To
examine
whether
in-hospital
hospitalizations
not
related
(non–COVID-19
stays)
conditions
changed
during
pandemic
and
how
it
varied
by
hospital
urban
vs
rural
location.
Design,
Setting,
Participants
This
cohort
study
was
an
interrupted
time-series
analysis
assess
(March
8,
2020,
December
31,
2021)
compared
prepandemic
period
(January
1,
2017,
March
7,
2020)
overall,
month,
community
transmission
level
adult
discharges
from
3813
US
hospitals
State
Inpatient
Databases
Healthcare
Cost
Utilization
Project.
Exposure
The
pandemic.
Main
Outcomes
Measures
main
outcome
measure
among
non–COVID-19
stays
6
medical
conditions:
acute
myocardial
infarction,
hip
fracture,
gastrointestinal
hemorrhage,
pneumonia,
sepsis,
stroke.
Entropy
weights
were
used
align
patient
characteristics
2
time
periods
age,
sex,
comorbidities.
Results
There
18
601
925
hospitalizations;
50.3%
of
male,
38.5%
aged
64
years,
45.0%
65
84
16.4%
85
years
or
older
selected
2017
through
2021.
odds
sepsis
27%
at
(odds
ratio
[OR],
1.27;
95%
CI,
1.25-1.29)
35%
(OR,
1.35;
1.30-1.40).
In-hospital
pneumonia
had
similar
increases
1.48;
1.42-1.54)
1.46;
1.36-1.57)
hospitals.
Increases
these
showed
a
dose-response
association
(low
high
burden)
both
(sepsis:
22%
54%;
pneumonia:
30%
66%)
16%
28%;
34%
61%)
infarction
9%
1.09;
1.06-1.12)
responsive
level.
significant
fracture
1.32;
1.14-1.53)
hemorrhage
1.15;
1.09-1.21).
No
change
found
stroke
overall.
Conclusions
Relevance
In
this
study,
Mobilizing
strategies
tailored
different
needs
help
reduce
likelihood
excess
deaths
future
public
crises.
Язык: Английский
Direct Health Care Costs Associated with Asthma Hospitalizations Before and During the Covid-19 Pandemic in the United States: A Nationwide Inpatient Sample Analysis.
medRxiv (Cold Spring Harbor Laboratory),
Год журнала:
2025,
Номер
unknown
Опубликована: Янв. 10, 2025
Abstract
Background
Asthma,
a
chronic
inflammatory
airway
disorder,
can
increase
the
risk
of
hospitalizations
in
individuals
with
viral
infections
such
as
COVID-19.
The
impact
COVID-19
pandemic
on
asthma-related
United
States
remains
unknown.
Objective
We
hypothesized
that
led
to
an
economic
burden
society
and
decrease
hospitalization
rates
for
asthma.
Methods
analyzed
weighted
data
from
National
Inpatient
Sample
(NIS)
between
January
1,
2018,
December
31,
2020.
outcomes
were
asthma
rates,
length
stay
(LOS),
in-hospital
mortality
hospital
admission
costs.
Results
More
people
admitted
primary
diagnosis
2018
2019
compared
2020
(hospitalization
rate
per
100,000:
2018:
38.6
versus
(vs)
2019:37.0
vs
2020:
21.4;
P
<0.001).
Hospital
costs
increased
(2018:
median
[IQR]
5,251
[
3,426,
8,278];
2019:5,677
[3,725,
8.969];
5,881
[3,920-9,216];
Additionally,
in-patient
slightly
2020,
rising
0.44%,
0.20%
0.30%
(P
When
comparing
geographic
divisions,
mid-Atlantic
division
had
highest
Pacific
2018-2020
<0.05).
Conclusion
Asthma
decreased
previous
years.
Those
during
higher
significantly
This
investigation
provides
valuable
insights
policy
makers
about
shifts
healthcare
utilization
pandemic.
Язык: Английский
Reducing Hospitalisations With a Skin and Soft Tissue Infection Clinic
Tarek Abdelhalim,
Naudea Mair,
Sherele McGhie
и другие.
Journal of Evaluation in Clinical Practice,
Год журнала:
2025,
Номер
31(3)
Опубликована: Апрель 1, 2025
ABSTRACT
Rationale
Patients
with
skin
and
soft
tissue
infection
are
often
admitted
to
hospital
despite
compelling
evidence
that
many
can
be
managed
safely
as
outpatients.
This
quality
improvement
study
reports
the
outcomes
of
an
outpatient
programme
implemented
at
academic
acute‐care
in
Toronto,
Canada.
Methods
The
intervention
was
care
pathway
for
patients
suspected
who
may
otherwise
have
required
admission
hospital.
within
existing
general
internal
medicine
clinic
primarily
involved
addition
part‐time
advanced
practice
wound
nurses.
main
outcome
number
inpatient
days
infection.
Data
were
analysed
4
years
pre‐intervention
(June
2016–May
2020)
2
post‐intervention
2020–May
2022).
Another
same
network
which
did
not
undergo
included
a
control.
Results
During
2‐year
period
there
465
visits
(mean
19/month).
median
decreased
from
224
per
month
before
148
after
(a
reduction
34%).
There
no
control
site
or
among
all
diagnoses
site.
Conclusions
implementation
associated
sustained
34%
demonstrates
benefits
enhancing
through
creation
streamlined
adding
interdisciplinary
expertise.
Язык: Английский
Policy Proposals for Mitigating Intensive Care Unit Strain: Insights from the COVID-19 Pandemic
Annals of the American Thoracic Society,
Год журнала:
2024,
Номер
21(12), С. 1633 - 1642
Опубликована: Сен. 5, 2024
Intensive
care
unit
(ICU)
strain,
characterized
by
a
discrepancy
between
perceived
or
actual
intensive
resources
and
demand,
significantly
impacts
patient
outcomes
healthcare
worker
well-being.
The
coronavirus
disease
(COVID-19)
pandemic
exacerbated
ICU
leading
to
increased
mortality
extended
hospital
stays,
affecting
both
critically
ill
patients
with
without
COVID-19.
A
systematic
review
identified
16
lagging
indicators
of
capacity
including
queuing,
premature
after-hours
discharge,
use
temporary
space,
length
stay,
burnout,
staffing
nurse-to-patient
ratio,
census,
acuity
turnover,
standardized
readmissions,
availability
critical
supplies,
ventilator
use,
surgery
cancellation.
However,
variability
in
operational
definitions
limited
evidence
regarding
the
reliability,
validity,
usability,
feasibility
limit
value
single
for
informed
strategic
planning
policy
guidance.
Regional
national
policies
programs
are
essential
enhance
real-time
monitoring
effective
management
resources,
they
mitigate
impact
facilitating
complex
interhospital
transfers
reduce
strain
ensuring
comprehensive
strategies
enhancing
resilience.
Proactive
regional
cooperation
is
advocated
formulation,
knowledge
exchange,
resource
allocation
anticipate
equitable
access
during
global
health
crises.
implications
future
preparedness
emphasize
importance
evidence-based
triage
adaptable
alongside
ethical
considerations
role
behavioral
economic
insights
optimizing
utilization
collaborative
practices.
This
multifaceted
approach
addressing
comprehensively
effectively
would
promote
equity
system
resilience
under
routine
operations
crisis
conditions.
Язык: Английский
Trends in heart failure-related mortality among middle-aged adults in the United States from 1999-2022
Current Problems in Cardiology,
Год журнала:
2024,
Номер
unknown, С. 102973 - 102973
Опубликована: Дек. 1, 2024
Язык: Английский
Strain on Scarce Intensive Care Beds Drives Reduced Patient Volumes, Patient Selection, and Worse Outcome: A National Cohort Study
Critical Care Medicine,
Год журнала:
2023,
Номер
52(4), С. 574 - 585
Опубликована: Дек. 14, 2023
OBJECTIVES:
Strain
on
ICUs
during
the
COVID-19
pandemic
required
stringent
triage
at
ICU
to
distribute
resources
appropriately.
This
could
have
resulted
in
reduced
patient
volumes,
selection,
and
worse
outcome
of
non-COVID-19
patients,
especially
peaks
when
strain
was
extreme.
We
analyzed
this
potential
impact
patients.
DESIGN:
A
national
cohort
study.
SETTING:
Data
71
Dutch
PARTICIPANTS:
total
120,393
patients
(from
March
1,
2020
February
28,
2022)
164,737
prepandemic
January
2018
December
31,
2019).
INTERVENTIONS:
None.
MEASUREMENTS
AND
MAIN
RESULTS:
Volume,
characteristics,
mortality
were
compared
between
cohort,
focusing
period
its
peaks,
with
attention
strata
specific
admission
types,
diagnoses,
severity.
The
number
admitted
were,
respectively,
26.9%
34.2%
lower
cohort.
consisted
fewer
medical
(48.1%
vs.
50.7%),
comorbidities
(36.5%
40.6%),
more
mechanical
ventilation
(45.3%
42.4%)
vasoactive
medication
(44.7%
38.4%)
Case-mix
adjusted
higher
period,
odds
ratios
1.08
(95%
CI,
1.05–1.11)
1.10
1.07–1.13).
CONCLUSIONS:
In
healthcare
has
driven
volume,
selection
comorbid
who
intensive
support,
a
modest
increase
case-mix
mortality.
Язык: Английский