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

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).

1. Shchelkanov M.Yu., Kolobukhina L.V., Burgasova O.A., Kruzhkova I.S., Maleev V.V. COVID-19: etiology, clinical picture, treatmen. Russian Journal of Infection and Immunity, 2020, Vol. 10, № 3, pp. 421–445 (In Russ.). doi: 10.15789/2220-7619-CEC-1473.

2. Murashko M.A. The first pandemic of the digital era: lessons for national health. National Health, 2020, № 1. рр. 4–8. (In Rus.).

3. Kursumovich E. Lennane S., Cook T. Deaths in healthcare workers due to COVID-19: the need for robust data and analysis. Anaesthesia. 2020. № 75. pp. 989–992.

4. Treibel T.A., Manisty C., Burton M., McKnight Á., Lambourne J., Augusto J.B., Couto-Parada X., Cutino-Moguel T., Nour-sadeghi M., Moon J.C. COVID-19: PCR screening of asymptomatic health-care workers at London hospital. Lancet. 2020, Vol. 10237, № 395, pp. 1608–1610.

5. Wang X., Liu W., Zhao J., Lu Y., Wang X., Yu C., Hu S., Shen N., Liu W., Z. Sun, W. Li Clinical characteristics of 80 hospitalized frontline medical workers infected with COVID-19 in Wuhan, China. Journal of Hospital Infection. 2020, Vol. 105, № 3, рр. 399–403.

6. Briko N.I., Kagramanyan I.N., Nikiforov V.V., Suranova T.G., Chernyavskaya O.Р., Polezhaeva N.A. Pandemic COVID-19. Prevention Measures in the Russian Federation. Epidemiology and Vaccinal Prevention. 2020, Vol. 19, № 2, pp. 4–12 (In Russ.). doi: 10.31631/2073-3046-2020-19-2-4-12

7. Sizonenko N.A. Barsukova I.M., Balyura O.V. The impact of restrictive measures on the performance of multidisciplinary hospitals in St. Petersburg to provide emergency surgical care to patients with acute surgical pathology of the abdominal organs in 2020. National projects: a new quality of life for all generations. Ulyanovsk: I.P. Petrova, 2021, Р. 70 (In Russ.).

8. Вarsukova I.M., Khominets V.V., Tyavokina E.Yu., Stepanova M.N., Kim I.V. The country’s bed fund in the era of a pandemic. VI week of education at Elizabethan Hospital. a collection of abstracts of a multidisciplinary medical forum. Moscow. 2022. Р. 4–6 (In Russ.).

9. Makhnovsky A.I., Barsukova I.M., Stozharov V.V. The structure of re-hospitalization of patients after examination and treatment in emergency beds in the context of the COVID-19 pandemic. Ambulance. 2022, Vol. 23, № 1. pp. 4–10. (In Russ.). doi: 10.24884/2072-6716-2022-23-1-4-10

10. Khominets V.V., Barsukova I.M., Lukogorskaya N.N. Features of the work of hospitals in modern conditions. Janelidzev readings - 2023: Collection of scientific works of a scientific and practical conference, St. Petersburg, March 01-03, 2023. St. Petersburg: State Budgetary Institution “St. Petersburg Research Institute of Ambulance named after I.I. Janelidze,” 2023. pp. 222–224 (In Russ.).