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Flexibility and Bed Margins of the Community of Madrid’s Hospitals during the First Wave of the SARS-CoV-2 Pandemic

Author

Listed:
  • Eugenio F. Sánchez-Úbeda

    (Institute for Research in Technology (IIT), ICAI School of Engineering, Comillas Pontifical University, 28015 Madrid, Spain)

  • Pedro Sánchez-Martín

    (Institute for Research in Technology (IIT), ICAI School of Engineering, Comillas Pontifical University, 28015 Madrid, Spain)

  • Macarena Torrego-Ellacuría

    (Unidad de Innovación, Hospital Clínico San Carlos, IdISSC, 28040 Madrid, Spain)

  • Ángel Del Rey-Mejías

    (Unidad de Innovación, Hospital Clínico San Carlos, IdISSC, 28040 Madrid, Spain
    Departamento de Psicobiología y Metodología en Ciencias del Comportamiento, Facultad de Psicología, Universidad Complutense, 28223 Madrid, Spain)

  • Manuel F. Morales-Contreras

    (Institute for Research in Technology (IIT), ICAI School of Engineering, Comillas Pontifical University, 28015 Madrid, Spain
    Faculty of Business Management and Economics, ICADE, Comillas Pontifical University, 28015 Madrid, Spain)

  • José-Luis Puerta

    (Consejería de Sanidad y Dirección General de Estadística, Comunidad de Madrid, 28013 Madrid, Spain)

Abstract

Background: The COVID-19 pandemic has had global effects; cases have been counted in the tens of millions, and there have been over two million deaths throughout the world. Health systems have been stressed in trying to provide a response to the increasing demand for hospital beds during the different waves. This paper analyzes the dynamic response of the hospitals of the Community of Madrid (CoM) during the first wave of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in the period between 18 March and 31 May 2020. The aim was to model the response of the CoM’s health system in terms of the number of available beds. Methods: A research design based on a case study of the CoM was developed. To model this response, we use two concepts: “bed margin” (available beds minus occupied beds, expressed as a percentage) and “flexibility” (which describes the ability to adapt to the growing demand for beds). The Linear Hinges Model allowed a robust estimation of the key performance indicators for capturing the flexibility of the available beds in hospitals. Three new flexibility indicators were defined: the Average Ramp Rate Until the Peak (ARRUP), the Ramp Duration Until the Peak (RDUP), and the Ramp Growth Until the Peak (RGUP). Results: The public and private hospitals of the CoM were able to increase the number of available beds from 18,692 on 18 March 2020 to 23,623 on 2 April 2020. At the peak of the wave, the number of available beds increased by 160 in 48 h, with an occupancy of 90.3%. Within that fifteen-day period, the number of COVID-19 inpatients increased by 200% in non-intensive care unit (non-ICU) wards and by 155% in intensive care unit (ICU) wards. The estimated ARRUP for non-ICU beds in the CoM hospital network during the first pandemic wave was 305.56 beds/day, the RDUP was 15 days, and the RGUP was 4598 beds. For the ICU beds, the ARRUP was 36.73 beds/day, the RDUP was 20 days, and the RGUP was 735 beds. This paper includes a further analysis of the response estimated for each hospital. Conclusions: This research provides insights not only for academia, but also for hospital management and practitioners. The results show that not all of the hospitals dealt with the sudden increase in bed demand in the same way, nor did they provide the same flexibility in order to increase their bed capabilities. The bed margin and the proposed indicators of flexibility summarize the dynamic response and can be included as part of a hospital’s management dashboard for monitoring its behavior during pandemic waves or other health crises as a complement to other, more steady-state indicators.

Suggested Citation

  • Eugenio F. Sánchez-Úbeda & Pedro Sánchez-Martín & Macarena Torrego-Ellacuría & Ángel Del Rey-Mejías & Manuel F. Morales-Contreras & José-Luis Puerta, 2021. "Flexibility and Bed Margins of the Community of Madrid’s Hospitals during the First Wave of the SARS-CoV-2 Pandemic," IJERPH, MDPI, vol. 18(7), pages 1-22, March.
  • Handle: RePEc:gam:jijerp:v:18:y:2021:i:7:p:3510-:d:525632
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    References listed on IDEAS

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