Measure what matters: Counts of hospitalized patients are a better metric for health system capacity planning for a reopening

被引:12
作者
Kashyap, Sehj [1 ]
Gombar, Saurabh [1 ,3 ]
Yadlowsky, Steve [2 ]
Callahan, Alison [1 ]
Fries, Jason [1 ]
Pinsky, Benjamin A. [3 ]
Shah, Nigam H. [1 ]
机构
[1] Stanford Univ, Stanford Ctr Biomed Informat Res, Stanford, CA 94305 USA
[2] Stanford Univ, Dept Elect Engn, Stanford, CA 94305 USA
[3] Stanford Univ, Dept Pathol & Med, Sch Med, Stanford, CA USA
关键词
COVID-19; surge models; capacity planning; electronic health records;
D O I
10.1093/jamia/ocaa076
中图分类号
TP [自动化技术、计算机技术];
学科分类号
0812 ;
摘要
Objective: Responding to the COVID-19 pandemic requires accurate forecasting of health system capacity requirements using readily available inputs. We examined whether testing and hospitalization data could help quantify the anticipated burden on the health system given shelter-in-place (SIP) order. Materials and Methods: 16,103 SARS-CoV-2 RT-PCR tests were performed on 15,807 patients at Stanford facilities between March 2 and April 11, 2020. We analyzed the fraction of tested patients that were confirmed positive for COVID-19, the fraction of those needing hospitalization, and the fraction requiring ICU admission over the 40 days between March 2nd and April 11th 2020. Results: We find a marked slowdown in the hospitalization rate within ten days of SIP even as cases continued to rise. We also find a shift towards younger patients in the age distribution of those testing positive for COVID-19 over the four weeks of SIP. The impact of this shift is a divergence between increasing positive case confirmations and slowing new hospitalizations, both of which affects the demand on health systems. Conclusion: Without using local hospitalization rates and the age distribution of positive patients, current models are likely to overestimate the resource burden of COVID-19. It is imperative that health systems start using these data to quantify effects of SIP and aid reopening planning.
引用
收藏
页码:1026 / +
页数:6
相关论文
共 21 条
[1]  
American Enterprise Institute, NAT COR RESP ROAD MA
[2]  
[Anonymous], COVID 19 RES
[3]  
[Anonymous], ESTIMATING NUMBER IN
[4]   Characteristics and Outcomes of 21 Critically Ill Patients With COVID-19 in Washington State [J].
Arentz, Matt ;
Yim, Eric ;
Klaff, Lindy ;
Lokhandwala, Sharukh ;
Riedo, Francis X. ;
Chong, Maria ;
Lee, Melissa .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2020, 323 (16) :1612-1614
[5]  
CDC COVID-19 Response Team, 2020, MMWR-MORBID MORTAL W, V69, P343, DOI [10.15585/mmwr.mm6912e2, 10.15585/mmwr.mm6915e4]
[6]  
Ferstad JO, 2020, MODEL FORECAST REGIO
[7]  
Goh G., Epidemic Calculator
[8]   Critical Care Utilization for the COVID-19 Outbreak in Lombardy, Italy Early Experience and Forecast During an Emergency Response [J].
Grasselli, Giacomo ;
Pesenti, Antonio ;
Cecconi, Maurizio .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2020, 323 (16) :1545-1546
[9]  
Kennedy M., CALIFORNIA GOVERNOR
[10]  
Koseff Koseff A. A., SAN FRANCISCO CHRONI