The efficiency in the ordinary hospital bed management in Italy: An in-depth analysis of intensive care unit in the areas affected by COVID-19 before the outbreak

Abstract

Since the end of February 2020 a severe diffusion of COVID-19 has affected Italy and in particular its northern regions, resulting in a high demand of hospitalizations in particular in the intensive care units (ICUs). Hospitals are suffering the high degree of patients to be treated for respiratory diseases and the majority of the health structures, especially in the north of Italy, are or are at risk of saturation. Therefore, the question whether and to what extent the reduction of hospital beds occurred in the past years has biased the management of the emergency has come to the front in the public debate. In our opinion, to start a robust analysis it is necessary to consider the Italian health system capacity prior to the emergency. Therefore, the aim of this study is to analyse the availability of hospital beds across the country as well as to determine their management in terms of complexity and performance of cases treated at regional level. The results of this study underlines that, despite the reduction of beds for the majority of the hospital wards, ICUs availabilities did not change between 2010 and 2017. Moreover, this study confirms that the majority of the Italian regions have a routinely efficient management of their facilities allowing hospitals to treat patients without the risk of having an overabundance of patients and a scarcity of beds. In fact, this analysis shows that, in normal situations, the management of hospital and ICU beds has no critical levels.

Fig 1. Number of patients hospitalized in the Italian regions and in Lombardia by COVID-19 wards and Intensive Care Units [7].

Fig 2. Percent of routinely available beds in the Intensive Care Units occupied by COVID-19 patients by region.

Colours indicate the level of bed occupancy rate spanning from red (high % of beds occupied) and green (low % of beds occupied).

Fig 3. Number of total and intensive care unit beds per 100000 inhabitants in the different Italian regions.

Fig 4. Overall classification of each Italian region considering both the hospital bed management indicators and the complexity and performance indicators.

In both figures the colour of the marker captures the hospital bed management classification. In the Italian map, regions are coloured on the basis of the ratio between the CMI and PI.

Fig 5. Overall classification of each Italian region considering both the hospital bed management indicators and the complexity and performance indicators of intensive care units.

In both figures the colour of the marker captures the hospital bed management classification. In the Italian map, regions are coloured on the basis of the ratio between the CMI and PI.