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http://conacyt.repositorioinstitucional.mx/jspui/handle/1000/2874| COVID-19 scenario modelling for the mitigation of capacity-dependent deaths in intensive care: computer simulation study | |
| Wood Richard M. McWilliams Christopher J. Thomas Matthew J. Bourdeaux Christopher P. Vasilakis Christos. | |
| Acceso Abierto | |
| Atribución-NoComercial-SinDerivadas | |
| 10.1101/2020.04.02.20050898 | |
| Background Managing healthcare demand and capacity is especially difficult in the context of the COVID-19 pandemic, where limited intensive care resources can be overwhelmed by a large number of cases requiring admission in a short space of time. If patients are unable to access this specialist resource, then death is a likely outcome. The aim of this study is to estimate the extent to which such capacity-dependent deaths can be mitigated through demand-side initiatives involving non-pharmaceutical interventions and supply-side measures to increase surge capacity or reduce length of stay. Methods A stochastic discrete event simulation model is developed to represent the key dynamics of the intensive care admissions process for COVID-19 patients. Model inputs are aligned to levers available to planners with key outputs including duration of time at maximum capacity (to inform workforce requirements), peak daily deaths (for mortuary planning), and total deaths (as an ultimate marker of intervention efficacy). The model - freely available - is applied to the COVID-19 response at a large hospital in England for which the effect of a number of possible interventions are simulated. Results Capacity-dependent deaths are closely associated with both the nature and effectiveness of non-pharmaceutical interventions and availability of intensive care beds. For the hospital considered, results suggest that capacity-dependent deaths can be reduced five-fold through a combination of isolation policies, a doubling of bed capacity, and 25% reduced length of stay. Conclusions Without treatment or vaccination there is little that can be done to reduce deaths occurring when patients have otherwise been treated in the most appropriate hospital setting. Healthcare planners should therefore focus on minimising the capacity-dependent deaths that are within their influence. | |
| www.medrxiv.org | |
| 2020 | |
| Artículo | |
| https://www.medrxiv.org/content/medrxiv/early/2020/04/06/2020.04.02.20050898.full.pdf | |
| Inglés | |
| VIRUS RESPIRATORIOS | |
| Aparece en las colecciones: | Artículos científicos |
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| Fichero | Tamaño | Formato | |
|---|---|---|---|
| 1102875.pdf | 1.12 MB | Adobe PDF | Visualizar/Abrir |