The efficiency in the ordinary hospital bed management: A comparative analysis in four European countries before the COVID-19 outbreak

Abstract

During COVID-19 emergency the majority of health structures in Europe saturated or nearly saturated their availabilities already in the first weeks of the epidemic period especially in some regions of Italy and Spain. The aim of this study is to analyse the efficiency in the management of hospital beds before the COVID-19 outbreak at regional level in France, Germany, Italy and Spain. This analysis can indicate a reference point for future analysis on resource management in emergency periods and help hospital managers, emergency planners as well as policy makers to put in place a rapid and effective response to an emergency situation. The results of this study clearly underline that France and Germany could rely on the robust structural components of the hospital system, compared to Italy and Spain. Presumably, this might have had an impact on the efficacy in the management of the COVID-19 diffusion. In particular, the high availability of beds in the majority of the France regions paired with the low occupancy rate and high turnover interval led these regions to have a high number of available beds. Consider also that this country generally manages complex cases. A similar structural component is present in the German regions where the number of available beds is significantly higher than in the other countries. The impact of the COVID-19 was completely different in Italy and Spain that had to deal with a relevant large number of patients relying on a reduced number of both hospital beds and professionals. A further critical factor compared to France and Germany concerns the dissimilar distribution of cases across regions. Even if in these countries the hospital beds were efficiently managed, the concentration of hospitalized patients and the scarcity of beds have put pressure on the hospital systems.

First and second COVID-19 waves in Brazil: A cross-sectional study of patients’ characteristics related to hospitalization and in-hospital mortality

“…(2021) observed a lower mortality rate in Japan in their second wave even when stratifying data for age and severity of symptoms at admission, which they suggested could be due to the shorter time between disease onset and hospital admission at the second wave [28] . In this sense, the efficiency of bed management is also an important factor when dealing with the pandemic [40] . A retrospective observational cohort with patients hospitalized in Lombardy, Italy, observed an increase in mortality with the increase in the interval between the first symptoms and admission to the ICU, from six days onwards [41] .…”

Open Data Resources on COVID-19 in Six European Countries: Issues and Opportunities

“…Another important perspective concerns the lack of accompanying variables that may be useful for providing a clear picture on the structural resources available at the national and local level. For instance, considering hospitalization procedures, data on the number of beds available in the ICU and in the medical wards or the medical professionals working in a specific region should be updated and provided to the scientific community in order to provide a comprehensive view of the state of the health system and to rapidly and efficiently assign and reallocate appropriate resources [ 56 , 57 ]. Unfortunately, this aspect has been partially considered and only by a limited number of countries.…”

Determinants of Health Service Efficiency in Hospi-tal: A Systematic Review

“…Assessment of service efficiency is an assessment of managerial ability in order to process sources of funds, personnel, equipment, and technology in order to provide services to patients, so in this sense it includes the notion of managerial ability, processing sources of funds, personnel, equipment and technology, and for patient care [8] [26]. The availability of hospital beds and efficiency in the management of health resources play an important role in determining the space for maneuvering health facilities in the event of an emergency situation, this is in line with the results of the analysis of the articles conducted [9] [17]. The hospital's bed utilization performance has a positive impact on the hospital's fi-nancial success.…”

“…Efficiency is related to 3 things, namely indicators and criteria, achievement of the assessment, and determining the level of efficiency [8]. Availability of hospital beds and efficiency in the management of health resources play an important role in determining the maneuvering room for health facilities in the event of an emergency [9]. Various studies identify factors to look at efficiency, such as hospital size, own-ership, bed occupancy rate, outpatient to inpatient ratio, average income of the population, technology, financing, and hospi-tal teaching status as determinants of hospital efficiency [10].…”