Vladescu Cristian, Ciutan Marius, Rafila Alexandru
Prof. Dr., MD, PhD, National School of Public Health Management and Professional Development, No. 31 Vaselor Street, Bucharest, Romania and University Titu Maiorescu Bucharest, Romania.
Dr. Marius Ciutan, National School of Public Health Management and Professional Development Bucharest, No. 31 Vaselor Street, Bucharest, Romania.
Germs. 2022 Jun 30;12(2):169-179. doi: 10.18683/germs.2022.1320. eCollection 2022 Jun.
The COVID-19 pandemic context led to a relevant burden on essential sectors of society; hospital sector capacity is tested in this period.
A cross-sectional study of admissions in hospitals reporting DRG data for 2018-2020. Trend analysis of admissions and deaths in hospitals was carried out for identifying annual patterns and deviations from the 2010-2020 trend. Data aggregated by year, month, diagnosis, death in hospital. Graph analysis for time and diagnosis comparisons and correlation identifying associations.
There is an annual change in admission and death patterns recorded in Romanian hospitals. An important contraction in number of acute hospital admissions was recording during the COVID-19 pandemic; patients' hesitancy to seek healthcare and limited capacity to treat patients other than COVID-19 patients due to legal regulations limiting the admissions number could explain this pattern of admission only for serious condition or emergency surgery. In Romania excess deaths in second half 2020 was generally greater than COVID-19 deaths. Overall, excess mortality between March and December 2020 was more than double than reported COVID-19 deaths. The same mortality pattern persists, but with significant decreases for some diagnoses.
The Romanian healthcare system has been challenged due to COVID-19 pandemic, leading to temporary reorganization of hospitals with consequences on all acute care diagnostics and therapeutic pathways. It is a challenge to identify causes of reduced inpatient treatment rates and to provide evidence on hospital activity for understanding future optimal management of patients with COVID-19, but also with other acute and chronic conditions.
新冠疫情给社会关键部门带来了巨大负担；在此期间，医院部门的能力受到了考验。
对报告2018 - 2020年疾病诊断相关分组（DRG）数据的医院入院情况进行横断面研究。对医院的入院和死亡情况进行趋势分析，以确定年度模式以及与2010 - 2020年趋势的偏差。数据按年份、月份、诊断、院内死亡进行汇总。进行时间和诊断比较的图表分析以及相关性分析以识别关联。
罗马尼亚医院记录到入院和死亡模式存在年度变化。在新冠疫情期间，急性医院入院人数出现了显著减少；患者就医意愿降低以及由于法律法规限制入院人数导致医院除新冠患者外治疗其他患者的能力有限，这只能解释严重病情或急诊手术的入院模式。在罗马尼亚，2020年下半年的超额死亡人数总体上大于新冠死亡人数。总体而言，2020年3月至12月的超额死亡率比报告的新冠死亡人数高出一倍多。相同的死亡模式持续存在，但某些诊断的死亡率显著下降。
由于新冠疫情，罗马尼亚医疗系统受到了挑战，导致医院进行了临时重组，对所有急性护理诊断和治疗途径都产生了影响。确定住院治疗率降低的原因并提供医院活动的证据，以了解未来对新冠患者以及其他急性和慢性疾病患者的最佳管理，是一项挑战。
