Survival analysis of hospital length of stay of novel coronavirus (COVID-19) pneumonia patients in Sichuan, China

zhuo wang; John S. Ji; Yang Liu; Runyou Liu; Yuxin Zha; Xiaoyu Chang; Lun Zhang; Yu Zhang; Jing Zeng; Ting Dong; Xinyin Xu; Lijun Zhou; Jun He; Yin Deng; Bo Zhong; Xianping Wu

is the (which was not peer-reviewed) The copyright holder for this preprint . https://doi.org/10.1101/2020.04.07.20057299 doi: medRxiv preprint of medical resources may be one of the reasons for the excessive number of deaths. For example, many patients with mild illness may occupy many medical resources. In Sichuan Province, 78% (419 / 538) of the patients were admitted to non-provincial hospitals. Single factor analysis showed that different levels of hospitals had no effect on the length of inpatient treatment. After controlling the covariates such as patient age, clinical severity and regional medical service density, we found that the hospital level had a weak association to the length of stay, which was mainly attributed to the clinical severity of patients. And patients in areas with more than 5.5 health servicers per 1,000 population had shorter hospital stays. Massonnaud et al. assessed COVID-19 impact on healthcare resources for each French metropolitan region based on the average length of stay in hospitals of 15 days, and showed that even in the best case scenario, the French healthcare system will very soon be overwhelmed 23 This paper shows the necessity of establishing a multi-level medical system and strengthening primary medical care, which can reduce the pressure of high-level hospitals in case of public health emergencies. In recent years, China has been strengthening the construction of lower-level medical systems and the monitoring of major diseases and health hazards, which deserve further implementation. 24 In addition, this study pointed out that the interval length of time from symptoms to doctor's visit did not affect the length of stay in hospitals, while some patients may mistakenly regard the COVID-19 infection as influenza, but COVID-19 is more infectious and pathogenic, 25 and the length of stay in hospital is longer, while the mean length of stay for the treatment of influenza was less than a week. 26 We suggest that in areas with insufficient medical resources and shortage of inpatient beds, patients under 45 years old with mild illness could choose to be treated at home with quarantine under the guidance of doctors, which may avoid cross infection and crowding of medical resources, under the circumstances of access to medical security at home, and timely communication between doctors and patients. While promoting quarantine, best-practices should be considered, such as placing patients in an isolated single room with good ventilation and away from visitors. [27] [28] [29]