Comparative analysis of the activities of emergency hospitals in the «covid» period

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Abstract

INTRODUCTION: The pandemic of a new coronavirus infection has become a serious test of our country’s health care system.
OBJECTIVE OF THE STUDY: Analysis of the dynamics of the performance of emergency hospitals during the pandemic of a new coronavirus infection.
MATERIALS AND METHODS: The material was the data of federal state statistics (sources - FSN No. 14 and 30, 2019- 2021) of 2 multidisciplinary hospitals operating in ambulance hospitals (24/7/365), which have fundamental structural and functional features related to the availability of beds for patients with COVID-19. Regulatory, statistical (analysis of averages using parametric T-test and one-way-ANOVA analysis of variance, Spearman correlation analysis) and analytical methods (analysis, synthesis, comparison) were used.
RESULTS: For a hospital with deployed beds for patients with COVID-19, there was a characteristic decrease in volumetric performance indicators: the number of patients in the admission department (by 61.7 %), non-hospitalized patients (by 82.2 %) and patient refusals from hospitalization (by 83.6 %), the number of outpatients (by 77.7 %), the number of discharged patients (by 17.7 %), carried out by patients bed-days (2.9 %), patient re-hospitalizations (96.1 %). For a hospital that was not re-profiled for COVID-19, there was a slight increase in visits (+ 1.4 %) with a decrease in the number of discharged patients (-22.8 %) and spent bed days (-12.4 %), an increase in the number of non-hospitalized patients (by 34.2 %) and the volume of care on an outpatient basis (+ 22.7 %), the number of re-hospitalized patients increased (+ 55.5 %).
In hospitals, there was an increase in the number of patients who died (by 154.8 % and 29.2 %, respectively), including those with respiratory diseases (by 433.3 % and 145.5 %, respectively).
DISCUSSION: Two multidisciplinary emergency hospitals had significant differences in the organization of their work in the period 2019-2021, due to the re-profiling of beds for receiving infectious patients (for patients with COVID-19) and the assignment of additional volumes of specialized non-infectious medical care to the non-redesigned multidisciplinary hospital.
CONCLUSION: Currently, multidisciplinary emergency hospitals require the development of new models and principles for organizing the medical and diagnostic process, providing for the deployment of inpatient emergency departments, mobile bed capacity, infectious beds, development of algorithms for admission and triage of patients, reduction of unreasonable and non-core hospitalization, increasing the availability, efficiency and quality of medical care, which will increase the readiness to work in emergency situations of such a pandemic with a new coronavirus infection (COVID-19).

About the authors

V. V. Hominets

Ministry of Health of the Ryazan region

Email: khominetsvv@yandex.ru
ORCID iD: 0000-0002-7693-3072
SPIN-code: 2085-6447

Vladimir V. Khominets – Dr. of Sci. (Med.), Deputy Minister of health of the Ryazan region 

390006, Ryazan, Svoboda street, 32

Russian Federation

S. K. Filimonov

City Clinical Emergency Hospital of the Ryazan Region

Email: filimonovsk@yandex.ru

Stanislav К. Filimonov – Dr. of Sci. (Med.), deputy chief physician for medical affairs 

390026, Ryazan, Stroykova street, 85

Russian Federation

I. M. Barsukova

St. Petersburg Scientific Research Institute of Emergency Medicine of I.I. Dzhanelidze;
I.P. Pavlov Medical University St. Petersburg

Author for correspondence.
Email: bim-64@mail.ru
ORCID iD: 0000-0002-5398-714X
SPIN-code: 4888-2447

Irina М. Barsukova - Dr. of Sci. (Med.), associate professor, Head of the department for the organization of emergency medicine and telemedicine; рrofessor of the department of public health and health with a course in economics and health management 

192242, Saint-Petersburg, Budapestskaya st., 3;
197022, St. Petersburg, Lev Tolstoy street, 6-8

Russian Federation

A. I. Makhnovskiy

St. Petersburg Scientific Research Institute of Emergency Medicine of I.I. Dzhanelidze;
Northwest state medical university of I.I. Mechnikov

Email: andreymakhnovsky@mail.ru
ORCID iD: 0000-0002-3164-1092
SPIN-code: 6382-4478

Andrey I. Makhnovskiy – Cand. of Sci. (Med.), Deputy Chief Physycian; Assistant of the Emergency Medicine Department 

192242, Saint-Petersburg, Budapestskaya st., 3;
191015, St. Petersburg, Kirochnaya st., 41

Russian Federation

I. V. Kim

Ministry of Health of the Ryazan region;
I.P. Pavlov Medical University St. Petersburg

Email: kimirishka@gmail.com

Irina V. Kim - graduate student of the department of public health and health with a course in economics and health management 

197022, St. Petersburg, Lev Tolstoy street, 6-8

Russian Federation

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