Department for Orthopedics, Trauma Surgery and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany.
Medical Controlling, University Hospital Leipzig, Leipzig, Germany.
JMIR Public Health Surveill. 2021 Nov 18;7(11):e33509. doi: 10.2196/33509.
During the COVID-19 pandemic, Central COVID-19 Coordination Centers (CCCCs) have been established at several hospitals across Germany with the intention to assist local health care professionals in efficiently referring patients with suspected or confirmed SARS-CoV-2 infection to regional hospitals and therefore to prevent the collapse of local health system structures. In addition, these centers coordinate interhospital transfers of patients with COVID-19 and provide or arrange specialized telemedical consultations.
This study describes the establishment and management of a CCCC at a German university hospital.
We performed economic analyses (cost, cost-effectiveness, use, and utility) according to the CHEERS (Consolidated Health Economic Evaluation Reporting Standards) criteria. Additionally, we conducted a systematic review to identify publications on similar institutions worldwide. The 2 months with the highest local incidence of COVID-19 cases (December 2020 and January 2021) were considered.
During this time, 17.3 requests per day were made to the CCCC regarding admission or transfer of patients with COVID-19. The majority of requests were made by emergency medical services (601/1068, 56.3%), patients with an average age of 71.8 (SD 17.2) years were involved, and for 737 of 1068 cases (69%), SARS-CoV-2 had already been detected by a positive polymerase chain reaction test. In 59.8% (639/1068) of the concerned patients, further treatment by a general practitioner or outpatient presentation in a hospital could be initiated after appropriate advice, 27.2% (291/1068) of patients were admitted to normal wards, and 12.9% (138/1068) were directly transmitted to an intensive care unit. The operating costs of the CCCC amounted to more than €52,000 (US $60,031) per month. Of the 334 patients with detected SARS-CoV-2 who were referred via EMS or outpatient physicians, 302 (90.4%) were triaged and announced in advance by the CCCC. No other published economic analysis of COVID-19 coordination or management institutions at hospitals could be found.
Despite the high cost of the CCCC, we were able to show that it is a beneficial concept to both the providing hospital and the public health system. However, the most important benefits of the CCCC are that it prevents hospitals from being overrun by patients and that it avoids situations in which physicians must weigh one patient's life against another's.
在 COVID-19 大流行期间，德国的几家医院设立了中央 COVID-19 协调中心（CCCC），旨在协助当地医疗保健专业人员有效地将疑似或确诊 SARS-CoV-2 感染的患者转诊至地区医院，从而防止当地卫生系统结构崩溃。此外，这些中心协调 COVID-19 患者的医院间转院，并提供或安排专门的远程医疗咨询。
本研究描述了一家德国大学医院 CCCC 的建立和管理。
我们根据 CHEERS（综合健康经济评估报告标准）标准进行了经济分析（成本、成本效益、使用和效用）。此外，我们进行了系统评价，以确定全球类似机构的出版物。考虑了当地 COVID-19 病例发生率最高的 2 个月（2020 年 12 月和 2021 年 1 月）。
在此期间，CCC 每天接到 17.3 个关于 COVID-19 患者入院或转院的请求。大多数请求来自紧急医疗服务（601/1068，56.3%），涉及的患者平均年龄为 71.8（SD 17.2）岁，其中 1068 例中有 737 例（69%）通过聚合酶链反应检测到 SARS-CoV-2 呈阳性。在 1068 例患者中，639 例（59.8%）经适当建议后可由全科医生进一步治疗或在医院门诊就诊，291 例（27.2%）患者被收治至普通病房，138 例（12.9%）直接转至重症监护病房。CCC 的运营成本超过每月 52,000 欧元（60,311 美元）。在通过紧急医疗服务或门诊医生转诊的 334 例检测到 SARS-CoV-2 的患者中，有 302 例（90.4%）由 CCCC 进行了分诊和预先通知。未找到其他关于医院 COVID-19 协调或管理机构的经济分析。
尽管 CCC 成本高昂，但我们能够证明它对提供医院和公共卫生系统都具有有益的概念。然而，CCC 最重要的好处是，它可以防止医院被患者淹没，并避免医生必须权衡一个患者的生命与另一个患者的生命。
