Study objective

One in 4 deaths from COVID-19 has been attributed to hospital crowding. We simulated how many ambulances would be required to rebalance hospital load through systematic interhospital transfers. We assessed the potential feasibility of such a strategy and explored whether transfer requirement was a helpful measure and visualization of regional hospital crowding during COVID-19 surges.

Methods

Using data from the United States hospitals reporting occupancy to the Department of Health and Human Services from July 2020 to March 2022 and road network driving times, we estimated the number of ambulances required weekly to relieve overcapacity hospitals.

Results

During the peak week, which ended on January 8, 2021, approximately 1,563 ambulances would be needed for 15,389 simulated patient transports, of which 6,530 (42%) transports involved a 1-way driving time of more than 3 hours. Transfer demands were dramatically lower during most other weeks, with the median week requiring only 134 ambulances (interquartile range, 84 to 295) and involving only 116 transports with 1-way driving times above 3 hours (interquartile range, 4 to 548). On average, receiving hospitals were larger and located in more rural areas than sending hospitals.

Conclusion

This simulation demonstrated that for most weeks during the pandemic, ambulance availability and bed capacity were unlikely to have been the main impediments to rebalancing hospital loads. Our metric provided an immediately available and much more complete measure of hospital system strain than counts of hospital admissions alone.

中文翻译：

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缓解医院产能过剩所需的救护车：美国 COVID-19 大流行期间医院压力的新衡量标准

学习目标

四分之一的 COVID-19 死亡归因于医院拥挤。我们模拟了需要多少辆救护车才能通过系统的院际转运来重新平衡医院负荷。我们评估了这种策略的潜在可行性，并探讨了转移要求是否是 COVID-19 激增期间区域医院拥挤的有用衡量和可视化。

方法

我们使用美国医院向卫生与公众服务部报告的 2020 年 7 月至 2022 年 3 月占用率和道路网络行驶时间的数据，估算了每周为缓解产能过剩医院所需的救护车数量。

结果

在 2021 年 1 月 8 日结束的高峰周期间，将需要大约 1,563 辆救护车来进行 15,389 次模拟患者运输，其中 6,530 次 (42%) 的运输涉及单向行驶时间超过 3 小时。在大多数其他周内，转运需求显着降低，平均一周仅需要 134 辆救护车（四分位距，84 至 295 辆），并且仅涉及 116 辆单程行驶时间超过 3 小时的交通工具（四分位距，4 至 548 辆）。平均而言，接收医院比发送医院更大，位于更多农村地区。

结论

该模拟表明，在大流行期间的大部分时间里，救护车可用性和床位容量不太可能成为重新平衡医院负荷的主要障碍。我们的指标提供了一种立即可用且比单独的住院人数更完整的医院系统压力衡量标准。