Bernardez-Pereira Sabrina, Schettino Guilherme de Paula Pinto, Marra Alexandre R, Parreira Kaue Capellato Junqueira, Racy Fabio de Castro Jorge, Miranda Rose Mara, Codeço Artur Martins, Jaures Michele, Pagliuso João Gabriel Dias, Neto Miguel Cendoroglo, Laselva Claudia Regina, Klajner Sidney, Teich Vanessa Damazio, Giliberti Danilo Nascimento, Kobayashi Takaaki, Edmond Michael B, Malheiro Daniel Tavares
Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa, IA, United States.
Front Public Health. 2025 Apr 22;13:1513709. doi: 10.3389/fpubh.2025.1513709. eCollection 2025.
INTRODUCTION: Field hospitals, following the Fangcang Shelter Hospital model, were critical during the global COVID-19 pandemic to alleviate the strain on overwhelmed healthcare systems. Despite their widespread adoption, concerns persist regarding their efficacy and cost-effectiveness. This study aimed to assess the impact of the Pacaembu Field Hospital in São Paulo, Brazil during the COVID-19 pandemic, specifically focusing on lives saved and the associated public health costs. METHODS: This retrospective cohort study was conducted April 6 to June 29. The 200-bed field hospital, a collaboration between Sociedade Beneficente Israelita Brasileira Albert Einstein and the São Paulo City Hall, São Paulo Municipal Health Departament, operated at Pacaembu Stadium and admitted. Adult patients with mild to moderate COVID-19. Electronic health records provided comprehensive data on demographics, clinical outcomes, and resource utilization. The mortality rate among field hospital patients was compared to that of two groups: I-confirmed COVID-19 cases in São Paulo, and II-severe acute respiratory syndrome patients with COVID-19 in São Paulo. RESULTS: A total of 152,928 COVID-19 cases were confirmed in São Paulo, with 20,603 patients hospitalized for ARDS and 1,499 patients admitted to the Pacaembu Field Hospital for mild to moderate disease. The median age of Pacaembu patients was 57 years (IQR 46-67), with 43.8% aged 60 or older. Lung disease was the most common comorbidity, affecting 31.0% of cases. The median length of stay was 4.2 days, and 14.2% of patients required intensive care, with 7.9% needing mechanical ventilation. The hospital had a survival rate of 99.8%. The cost per year of life saved, adjusted for gender, was R$44,243.02 (US$8,208.35). In the most favorable scenario, approximately 200 lives were saved, with a cost of R$5,640.92 (US$1,046.55) per life saved for both genders. In the least favorable scenario, around 50 lives were saved, with a cost of R$36,863.48 (US$6,839.24) per life saved for both genders, all within cost-effectiveness thresholds. CONCLUSION: The Pacaembu Field Hospital played a crucial role in saving lives during the initial COVID-19 wave, highlighting the importance of ongoing evaluation and resource optimization in field hospital strategies for an effective pandemic response.
引言：仿照方舱医院模式建立的野战医院，在全球新冠疫情期间对于缓解不堪重负的医疗系统压力至关重要。尽管其已被广泛采用，但人们对其疗效和成本效益仍存在担忧。本研究旨在评估巴西圣保罗帕卡恩布野战医院在新冠疫情期间的影响，尤其关注挽救的生命数量以及相关的公共卫生成本。 方法：本回顾性队列研究于4月6日至6月29日进行。这家拥有200张床位的野战医院由巴西以色列慈善协会阿尔伯特·爱因斯坦分会与圣保罗市政府、圣保罗市卫生局合作运营，位于帕卡恩布体育场，收治新冠轻症至中症成年患者。电子健康记录提供了有关人口统计学、临床结局和资源利用的全面数据。将野战医院患者的死亡率与两组进行比较：一是圣保罗确诊的新冠病例，二是圣保罗的新冠重症急性呼吸综合征患者。 结果：圣保罗共确诊152,928例新冠病例，其中20,603例因急性呼吸窘迫综合征住院，1,499例因轻症至中症疾病入住帕卡恩布野战医院。帕卡恩布患者的中位年龄为57岁（四分位间距46 - 67岁），60岁及以上患者占43.8%。肺部疾病是最常见的合并症，影响31.0%的病例。中位住院时间为4.2天，14.2%的患者需要重症监护，7.9%的患者需要机械通气。该医院的生存率为99.8%。经性别调整后，挽救每生命年的成本为44,243.02雷亚尔（8,208.35美元）。在最有利的情况下，大约挽救了200条生命，男女平均每挽救一条生命的成本为5,640.92雷亚尔（1,046.55美元）。在最不利的情况下，大约挽救了50条生命，男女平均每挽救一条生命的成本为36,863.48雷亚尔（6,839.24美元），均在成本效益阈值范围内。 结论：帕卡恩布野战医院在新冠疫情第一波期间对挽救生命起到了关键作用，凸显了在野战医院策略中持续评估和资源优化对于有效应对疫情的重要性。
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