Burden of COVID-19 on Italian Internal Medicine Wards: Delphi, SWOT, and Performance Analysis after Two Pandemic Waves in the Local Health Authority “Roma 6” Hospital Structures

Filomena Pietrantonio, Francesco Rosiello, Elena Alessi, Matteo Pascucci, Marianna Rainone, Enrica Cipriano, Alessandra Di Berardino, Antonio Vinci, Matteo Ruggeri and Serafino Ricci
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Filomena Pietrantonio: Internal Medicine Unit, Castelli Hospital, Azienda Sanitaria Locale Roma 6, 00072 Ariccia, Italy
Francesco Rosiello: Internal Medicine Unit, Castelli Hospital, Azienda Sanitaria Locale Roma 6, 00072 Ariccia, Italy
Elena Alessi: Internal Medicine Unit, Castelli Hospital, Azienda Sanitaria Locale Roma 6, 00072 Ariccia, Italy
Matteo Pascucci: Internal Medicine Unit, Castelli Hospital, Azienda Sanitaria Locale Roma 6, 00072 Ariccia, Italy
Marianna Rainone: Internal Medicine Unit, Castelli Hospital, Azienda Sanitaria Locale Roma 6, 00072 Ariccia, Italy
Enrica Cipriano: Internal Medicine Unit, Castelli Hospital, Azienda Sanitaria Locale Roma 6, 00072 Ariccia, Italy
Alessandra Di Berardino: Internal Medicine Unit, Castelli Hospital, Azienda Sanitaria Locale Roma 6, 00072 Ariccia, Italy
Antonio Vinci: School of Specialization in Hygiene and Preventive Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy
Matteo Ruggeri: Department of Health Economics, St. Camillus University Health and Medical Sciences, 00131 Rome, Italy
Serafino Ricci: Department of Anatomical, Hystological Sciences and Legal Medicine, Sapienza University of Rome, 00185 Rome, Italy

IJERPH, 2021, vol. 18, issue 11, 1-11

Abstract: Background : COVID-19 causes major changes in day-to-day hospital activity due to its epidemiological characteristics and the clinical challenges it poses, especially in internal medicine wards. Therefore, it is necessary to understand and manage all of the implicated factors in order to maintain a high standard of care, even in sub-par circumstances. Methods : This was a three-phase, mixed-design study. Initially, the Delphi method allowed us to analyze the causes of poor outcomes in a cohort of an aggregate of Italian COVID-19 wards via an Ishikawa diagram. Then, for each retrieved item, a score was assigned according to a pros/cons, opportunities/threats system. Scores were also assigned according to potential value/perceived risk. Finally, the performances of MCs (Medicine-COVID-19 wards) and MCFs (Medicine-COVID-19-free: Internal Medicine wards) units were represented via a Barber’s nomogram. Results : MCFs hospitalized 790 patients (?23.90% compared to 2019 Internal Medicine admissions). The main risk factors for mortality were patients admitted from local facilities (+7%) and the presence of comorbidities (>3: 100%, ?5: 24.7%). A total of 197 (25%) patients were treated with non-invasive ventilation (NIV). The most deaths (57.14%) occurred in patients admitted from local facilities. Conclusions : Medicine-COVID-19 wards show higher complexity and demand compared to non-COVID-19 ones and they are comparable to sub-intensive therapy wards. It is necessary to promote the use of NIV in such settings.

Keywords: COVID-19; Internal Medicine ward; territorial medicine (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (5)

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