The efficiency in the ordinary hospital bed management in Italy: an in-depth analysis of intensive care unit in the areas affected by COVID-19 before the outbreak

Fabrizio Pecoraro; Fabrizio Clemente; Daniela Luzi

is the (which was not peer-reviewed) The copyright holder for this preprint . https://doi.org/10.1101/2020.04.06.20055848 doi: medRxiv preprint A focus on the reduction of the hospital beds in the different wards is reported in Table 3 highlighting the disciplines that cover the 90% of the hospitalization complexity in terms of the average length of stay. As reported in the Table only oncology and intensive care unit wards have had an increase in the number of beds in Italy, while in other clinical specializations the reduction was even more than 20%, among which surgery, paediatrics and otolaryngology. This indicates that, among the wards that manage complex hospital cases, the availability of hospital beds was not affected by the funding cuts to public health. However, these crude differences may take into account that, in the last years, many European countries have adopted policies to strongly shift the organization and provision of health and social services from formal institutional facilities (e.g. hospitals) to home care [17] . Moreover, recently the provision of different scheduled procedures (e.g. diagnostic test, clinical examinations, treatments) are mainly provided in a day hospital, reducing the number of beds needed to treat the patients. Other differences that can be detected analysing the availability of hospital beds refers to their distribution in the 21 regions and autonomous provinces. Figure 3 reports the number of beds per 100.000 inhabitants both considering all disciplines (A) and focusing on the intensive care unit departments (B). The proportions vary across the country spanning from Molise that counts the highest values for both categories to Calabria that displays the lowest proportions. In this overall picture, while, generally, the south of Italy suffers the lack of hospital beds, lays in the middle of the rank with 279 beds in total and 8 intensive care unit beds per 100000 inhabitants. 2. The second group of regions (Calabria, Campania, Bolzano e Puglia) has similar results compared to the above cluster, with hospitalizations efficiently managed with high performances. Differently from the above-mentioned group, these regions tend to manage cases that are less complex.