The health care services offered by the public authorities and/or private providers play an important role in reducing the individual risk of serious illness or death. Through these functions, medical and health care service providers (general hospitals) protect the community social capital against losses of human life, severe sickness and disability. They also increase social capital by offering preventive and elative somatic treatments facilitating recoveries.
COVID-19 has shown that in several countries, hospital capacities were exhausted, admission of new patients ceased, people were left to die. Also, people suffering from other illnesses did not receive necessary treatment because the capacity was reserved for the Covid-19 emergency patients (many people suffering from cardiac arrest have died because hospital ICU capacities and ambulance transport were depleted). Nursing-home patients have been treated very poorly and suffered from high mortality. Particularly, shortcomings of intensive care units (ICUs) has shown the most fatal.
Against this backstage, the case study from the US examines how the hospital units that have ICU capacity, a broad stock of medical specialists and other health care services might collaborate to increase the pool of medical treatment resources from exchange of patients, medical staff, and specialist procedure facilities, and thus increase the number of patients admitted above the capacity threshold.
This innovation in the form of institutional cooperation during crisis, is especially relevant when hospitals operate as independent financial entities as in the United States. However, it might also be applicable to European member states where hospitals are organized under the same public authority, but still cater to the institution-specific performance requirements within an administrative region. Such constraints make hospitals work independently as stand-alone-health provision units and not as a network of medical treatment providers to broader public. The case study examines how institutional capacity can be increased by pooling and cross-utilizing available resources among a group of hospitals which serve more communities by greater volume of healthcare services delivered without additional investments or emergency funding.
More precisely: this US case study presents details of, and findings from, systematically designed numerical experiments conducted using a whole-hospital, resource-constrained, patient-based, stochastic, discrete-event simulation methodology for modeling a generic 200-bed urban U.S. tertiary hospital that is simultaneously caring for pandemic and routine emergency patients. Results of the experiments provide generalizable insights into how hospital functionality may be affected by the care of pandemic patients along specially designated care paths under changing pandemic situations. These situations may range from periods in which a hospital is getting ready, providing care during the initial onset, coping with an outbreak or turning all of its resources to pandemic care in a hot spot location. Performance of key hospital units associated with emergency care of both pandemic (COVID-19, or Coronavirus, caused by severe acute respiratory syndrome (SARS) or SARS-CoV-2 infection) and routine emergency patients is investigated under a variety of capacity enhancing strategies and given new discoveries in treatments. With such estimates, hospitals can, in advance, repurpose space, modify operations, implement crisis standards of care, prepare to collaborate with other health care facilities, or request external support (e.g. tents and personnel), increasing the likelihood that all arriving patients will find the care they need. An approach to forecasting the timing when capacity enhancement strategies might be implemented or withdrawn as pandemic surge demand ebbs and flows is also proposed. Outcomes of this investigation have broader policy implications for ongoing and future infectious outbreaks and approaches to hospital modeling. It could also be used to monetize the statistical values of lives saved and enlargement of social capital as gross community benefits. By so doing it creates a tangible innovation to be adopted by many health care providers world-wide.
A coordination between several medical service institutions more people might recover sooner as compared to no inter-hospital collaboration (and no reduction in pandemic vulnerability). As result, the vertical network linkages between the government's provision of healthcare and the public in need of health care services will be strengthened and solidify the cooperating communities’ social capital.
Contributors: Elise Miller Hooks (George Mason University) and Ronny Klæboe (Institute for Transport Economics)