Wood R M, Pratt A C, Murch B J, Powell A L, Booton R D, Thomas D G, Twigger J, Diakou E, Coleborn S, Manning T, Davies C, Turner K M
Bristol, North Somerset and South Gloucestershire CCG, National Health Service, Bristol, UK.
School of Management, University of Bath, Bath, UK.
Health Syst (Basingstoke). 2021 Sep 6;10(4):337-347. doi: 10.1080/20476965.2021.1973348. eCollection 2021.
Without timely assessments of the number of COVID-19 cases requiring hospitalisation, healthcare providers will struggle to ensure an appropriate number of beds are made available. Too few could cause excess deaths while too many could result in additional waits for elective treatment. As well as supporting capacity considerations, reliably projecting future "waves" is important to inform the nature, timing and magnitude of any localised restrictions to reduce transmission. In making the case for locally owned and locally configurable models, this paper details the approach taken by one major healthcare system in founding a multi-disciplinary "Scenario Review Working Group", comprising commissioners, public health officials and academic epidemiologists. The role of this group, which met weekly during the pandemic, was to define and maintain an evolving library of plausible scenarios to underpin projections obtained through an SEIR-based compartmental model. Outputs have informed decision-making at the system's major incident Bronze, Silver and Gold Commands. This paper presents illustrated examples of use and offers practical considerations for other healthcare systems that may benefit from such a framework.
如果不及时评估需要住院治疗的新冠肺炎病例数量，医疗服务提供者将难以确保提供足够数量的床位。床位过少可能导致额外死亡，而床位过多则可能导致择期治疗的等待时间延长。除了支持容量考量外，可靠地预测未来的“疫情波”对于确定任何局部限制措施的性质、时间和规模以减少传播至关重要。在论证本地拥有和本地可配置模型时，本文详细介绍了一个主要医疗系统在组建一个多学科“情景审查工作组”时所采取的方法，该工作组由专员、公共卫生官员和学术流行病学家组成。该小组在疫情期间每周开会，其作用是定义并维护一个不断演变的合理情景库，以支持通过基于易感-暴露-感染-康复（SEIR）的分区模型获得的预测。其产出为该系统的重大事件青铜、白银和黄金指挥部的决策提供了依据。本文展示了使用示例，并为其他可能受益于此类框架的医疗系统提供了实际考量。
