Optimal national prioritization policies for hospital care during the SARS-CoV-2 pandemic

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作者
Josh C. D’Aeth
Shubhechyya Ghosal
Fiona Grimm
David Haw
Esma Koca
Krystal Lau
Stefano Moret
Dheeya Rizmie
Sarah R. Deeny
Pablo N. Perez-Guzman
Neil Ferguson
Katharina Hauck
Peter C. Smith
Giovanni Forchini
Wolfram Wiesemann
Marisa Miraldo
机构
[1] Imperial College London,MRC Centre for Global Infectious Disease Analysis and WHO Collaborating Centre for Infectious Disease Modelling, School of Public Health
[2] Imperial College London,Abdul Latif Jameel Institute for Disease and Emergency Analytics (J
[3] Imperial College London,IDEA), School of Public Health
[4] The Health Foundation,Department of Analytics, Marketing and Operations, Imperial College Business School
[5] Imperial College London,Department of Economics and Public Policy, Imperial College Business School
[6] Imperial College London,Centre for Health Economics and Policy Innovation, Imperial College Business School
[7] University of York,Centre for Health Economics
[8] Umeå University,Umeå School of Business, Economics and Statistics
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摘要
In response to unprecedented surges in the demand for hospital care during the SARS-CoV-2 pandemic, health systems have prioritized patients with COVID-19 to life-saving hospital care to the detriment of other patients. In contrast to these ad hoc policies, we develop a linear programming framework to optimally schedule elective procedures and allocate hospital beds among all planned and emergency patients to minimize years of life lost. Leveraging a large dataset of administrative patient medical records, we apply our framework to the National Health Service in England and show that an extra 50,750–5,891,608 years of life can be gained compared with prioritization policies that reflect those implemented during the pandemic. Notable health gains are observed for neoplasms, diseases of the digestive system, and injuries and poisoning. Our open-source framework provides a computationally efficient approximation of a large-scale discrete optimization problem that can be applied globally to support national-level care prioritization policies.
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页码:521 / 531
页数:10
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