Effectiveness of Intermediate Respiratory Care Units as an Alternative to Intensive Care Units during the COVID-19 Pandemic in Catalonia
Galdeano Lozano, Marina (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Alfaro Álvarez, Julio César (Hospital de Viladecans)
Parra Macías, Núria (Grup Hospitalari Quirón)
Salas Campos, Rosario (Grup Hospitalari Quirón)
Heili Frades, Sarah (Grup Hospitalari Quirón)
Montserrat Canal, José Ma (Hospital Clínic i Provincial de Barcelona)
Rosell Gratacós, Antoni (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Abad Capa, Jorge (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Parra Ordaz, Olga (Grup Hospitalari Quirón)
López Seguí, Francesc (Institut Català de la Salut)
Universitat Autònoma de Barcelona

Fecha:	2022
Resumen:	During the COVID-19 pandemic, the risk of collapse for the health system created great difficulties. We will demonstrate that intermediate respiratory care units (IRCU) provide adequate management of patients with non-invasive respiratory support, which is particularly important for patients with SARS-CoV-2 pneumonia. A prospective observational study of patients with COVID-19 admitted to the ICU of a tertiary hospital. Sociodemographic data, comorbidities, pharmacological, respiratory support, laboratory and blood gas variables were collected. The overall cost of the unit was subsequently analyzed. 991 patients were admitted, 56 to the IRCU (from a of 81 admitted to the critical care unit). Mean age was 65 years (SD 12. 8), Barthel index 75 (SD 8. 3), Charlson comorbidity index 3. 1 (SD 2. 2), HTN 27%, COPD 89% and obesity 24%. A significant relationship (p < 0. 05) with higher mortality was noted for the following parameters: fever greater than or equal to 39 °C [OR 5. 6; 95% CI (1. 2-2. 7); p = 0. 020], protocolized pharmacological treatment [OR 0. 3; 95% CI (0. 1-0. 9); p = 0. 023] and IOI [OR 3. 7; 95% CI (1. 1-12. 3); p = 0. 025]. NIMV had less of a negative impact [OR 1. 8; 95% CI (0. 4-8. 4); p = 0. 423] than IOI. The total cost of the IRCU amounted to €66,233. The cost per day of stay in the IRCU was €164 per patient. The total cost avoided was €214,865. The pandemic has highlighted the importance of IRCUs in facilitating the management of a high patient volume. The treatment carried out in IRCUs is effective and efficient, reducing both admissions to and stays in the ICU.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Cost-effectiveness ; COVID ; ICU ; Respiratory care
Publicado en:	International journal of environmental research and public health, Vol. 19 (may 2022) , ISSN 1660-4601

DOI: 10.3390/ijerph19106034
PMID: 35627571

11 p, 1.1 MB

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