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Quantifying the impact of hospital catchment area definitions on hospital admissions forecasts: COVID-19 in England, September 2020 - April 2021
Sophie Meakin
Sebastian Funk
Acceso Abierto
Atribución-NoComercial-SinDerivadas
https://doi.org/10.1101/2023.07.12.23292451
https://www.medrxiv.org/content/10.1101/2023.07.12.23292451v1
Background. Defining healthcare facility catchment areas is a key step in predicting future healthcare demand in epidemic settings. Forecasts of hospitalisations can be informed by leading indicators measured at the community level. However, this relies on the definition of so-called catchment areas, or the geographies whose populations make up the patients admitted to a given hospital, and which are often not well-defined. Little work has been done to quantify the impact of hospital catchment area definitions on healthcare demand forecasting. Methods. We made forecasts of Trust-level hospital admissions using a scaled convolution of local cases (as defined by the hospital catchment area) and a delay distribution. Hospital catchment area definitions were derived from either simple heuristics (in which people are admitted to their nearest hospital or any nearby hospital) or historical admissions data (all emergency or elective admissions in 2019, or COVID-19 admissions), plus a marginal baseline definition based on the distribution of all hospital admissions. We evaluated predictive performance using each hospital catchment area definition using the Weighted Interval Score (WIS) and considered how this changed by the length of the predictive horizon, the date on which the forecast was made, and by location. We also considered the change, if any, on the relative performance of each definition in retrospective vs. real-time settings, or at different spatial scales. Results. The choice of hospital catchment area definition affected the accuracy of hospital admission forecasts. The definition based on COVID-19 admissions data resulted in the most accurate forecasts at both a 7- and 14-day horizon, and was one of the top two best-performing definitions across forecast dates and locations. The nearby heuristic also performed well, but less consistently than the COVID-19 data definition. The marginal distribution baseline, which did not include any spatial information, was the lowest-ranked definition. The relative performance of the definitions was larger when using case forecasts compared to future observed cases. All results were consistent across spatial scales of the catchment area definitions. Conclusions. Using catchment area definitions derived from context-specific data can improve local-level hospital admissions forecasts. Where context-specific data is not available, using catchment areas defined by carefully-chosen heuristics are a sufficiently-good su
bioRxiv
13-07-2023
Preimpreso
Inglés
Público en general
VIRUS RESPIRATORIOS
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