Intensive Care Unit Bed Capacity Research Articles

Impact of an ICU bed capacity optimisation method on the average length of stay and average cost of hospitalisation following implementation of China’s open policy with respect to COVID-19: a difference-in-differences analysis based on information management system data from a tertiary hospital in southwest China

ObjectivesFollowing the implementation of China’s open policy with respect to COVID-19 on 7 December 2022, the influx of patients with infectious diseases has surged rapidly, necessitating hospitals to adopt temporary...

Influence of ICU Surge and Capacity on COVID Mortality Across U.S. States and Regions During the COVID-19 Pandemic.

To describe the influence of COVID-19 caseload surges and overall capacity in the intensive care unit (ICU) on mortality among US population and census divisions. A retrospective analysis of the national COVID ActNow database between January 1, 2021 until March 1, 2022. The main outcome used was COVID-19 weekly mortality rates, which were calculated and incorporated into several generalized estimation of effects models with predictor variables that included ICU bed capacity, as well as ICU capacity used by COVID cases while adjusting for ratios of vaccinations in populations, case density, and percentage of the population over the age of 65. Each 1% increase in general ICU capacity is correlated with approximately 5 more weekly deaths from COVID-19 per 100,000 population and each percentage increase in the number of patients with COVID-19 admitted to the ICU resulted in approximately 10 more COVID-19 deaths per week per 100,000 population. Significant differences in ability to handle caseload surges were observed across US census divisions. A strong association was observed between COVID-19 ICU surges, overall ICU surge, and increased mortality. Further research is needed to reveal best practices and public health measures to prevent ICU overcrowding amidst future pandemics and disaster responses.

ICU-Managed Patients' Epidemiology, Characteristics, and Outcomes: A Retrospective Single-Center Study.

Resources are limited, and it is exceedingly difficult to provide intensive care in developing nations. In Somalia, intensive care unit (ICU) care was introduced only a few years ago. In this study, we aimed to determine the epidemiology, characteristics, and outcome of ICU-managed patients in a tertiary hospital in Mogadishu. We retrospectively evaluated the files of 1082 patients admitted to our ICU during the year 2021. The majority (39.7%) of the patients were adults (aged between 20 and 39 years), and 67.8% were male patients. The median ICU length of stay was three days (IQR = 5 days), and nonsurvivors had shorter stays, one day. The mortality rate was 45.1%. The demand for critical care services in low-income countries is high. The country has a very low ICU bed capacity. Critical care remains a neglected area of health service delivery in this setting, with large numbers of patients with potentially treatable conditions not having access to such services.

Impact of the COVID-19 pandemic on critical care utilization in Japan: a nationwide inpatient database study

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic has disrupted critical care services worldwide. Examining how critical care systems responded to the COVID-19 pandemic on a national level will be useful in setting future critical care plans. The present study aimed to describe the utilization of critical care services before and during the COVID-19 pandemic using a nationwide Japanese inpatient administrative database.MethodsAll patients admitted to an intensive care unit (ICU) or a high-dependency care unit (HDU) from February 9, 2019, to February 8, 2021, in the Japanese Diagnosis Procedure Combination inpatient database were included. February 9, 2020, was used as the breakpoint separating the periods before and during COVID-19 pandemic. Hospital and patient characteristics were compared before and during the COVID-19 pandemic. Change in ICU and HDU bed occupancy before and during the COVID-19 pandemic was evaluated using interrupted time-series analysis.ResultsThe number of ICU patients before and during the COVID-19 pandemic was 297,679 and 277,799, respectively, and the number of HDU patients was 408,005 and 384,647, respectively. In the participating hospitals (383 ICU-equipped hospitals and 460 HDU-equipped hospitals), the number of hospitals which increased the ICU and HDU beds capacity were 14 (3.7%) and 33 (7.2%), respectively. Patient characteristics and outcomes in ICU and HDU were similar before and during the COVID-19 pandemic except main etiology for admission of COVID-19. The mean ICU bed occupancy before and during the COVID-19 pandemic was 51.5% and 47.5%, respectively. The interrupted time-series analysis showed a downward level change in ICU bed occupancy during the COVID-19 pandemic (− 4.29%, 95% confidence intervals − 5.69 to − 2.88%), and HDU bed occupancy showed similar trends. Of 383 hospitals with ICUs, 232 (60.6%) treated COVID-19 patients in their ICUs. Their annual hospital case volume of COVID-19 ICU patients varied greatly, with a median of 10 (interquartile range 3–25, min 1, max 444).ConclusionsThe ICU and HDU bed capacity did not increase while their bed occupancy decreased during the COVID-19 pandemic in Japan. There was no change in clinicians’ decision-making to forego ICU/HDU care for selected patients, and there was no progress in the centralization of critically ill COVID-19 patients.

PREPARING THE INTENSIVE CARE UNIT (ICU) FOR THE COVID-19 PANDEMIC: WITH PRACTICAL AND STRATEGIC CONSIDERATIONS

Coronavirus Disease 2019 (COVID-19) has developed into a global pandemic. The coronavirus disease outbreak of 2019 (COVID-19) has posed significant challenges for healthcare systems worldwide. The establishment of an intensive care unit (ICU) is a critical component of any pandemic response. We discuss the critical principles and strategies for ICU readiness in this review. Additionally, we describe the early stages of our outbreak and discuss some of the difficulties encountered. To ensure the sustainability of intensive care unit services, we propose the following: 1) develop and implement rapid identification and isolation protocols, as well as increase ICU bed capacity; (2) provide a sustainable workforce with an infection control focus; (3) ensure adequate supplies to equip ICUs and protect health workers; and (4) maintain clinical quality of management and effective communication.

Dynamics of indicators of bed fund of offices of anesthesiology and resuscitation in the Russian Federation

Introduction. Efficient bed fund management is one of the most important conditions for an appropriate management of healthcare provision. The aim of the study is to analyze the trend in anesthesiologic and intensive care unit bed capacity in federal districts (FD) and subjects of the Russian Federation for 2014-2018. Material and methods. We analyzed the indicators of intensive care beds use (availability of beds to population, hospitalization rate, duration of patient’s stay in intensive care bed, occupancy, bed turnover, mortality) according to federal statistical observation - forms No. 14 and No. 30. Results. In Russia, the provision of beds in the health care sector has been decreasing over the last decade. At the same time, resuscitation beds were not affected by such changes, and from 2014 to 2018 the number of resuscitation beds tended to increase by 80.8%, which is associated, among other things, with the changes in the methodology of formation of the annual reporting form №30. The following changes in indicators of intensive care beds use were revealed in the trend in the Russian Federation as a whole for 2014-2018: the hospitalization rate slightly increased by 28.6% (from 0.5 to 0.7); provision of the population with intensive care beds (per 10,000 population) tends to increase by 45.8% population) tends to increase by 45.1% (from 1.1 to 2.0); length of stay of the patient on average increased by 23.9% (from 7.0 to 9.2 days); average occupancy (bed work) tends to decrease from 254 to 247 days; bed turnover tends to decrease from 36.1 to 26.9; mortality rate increases from 30.2 to 46.9%. Limitations. The results of the study of the dynamics of anesthesiologic and intensive care unit bed capacity are only valid for the Federal districts and Federal subjects of the Russian Federation. Conclusions. Additional studies are needed to further objectivize the assessment of ICU bed utilization efficiency.

Impact of hospital strain on excess deaths during the COVID-19 pandemic—United States, july 2020–july 2021

This article describes the excess deaths observed when hospitals are strained by COVID-19 admissions, as defined by intensive care unit bed occupancy. Specifically, when intensive care unit bed occupancy reaches 75% of capacity, there are an estimated 12,000 additional excess deaths; when hospitals exceed 100% of their intensive care unit bed capacity, approximately 80,000 excess deaths are expected in the following 2 weeks nationally. This report suggests that all patient populations, including transplant candidates and recipients, will experience additional excess deaths when there is increased strain on hospitals due to COVID-19 surges.

Infrastructure Availability for the Care of Congenital Heart Disease Patients and Its Influence on Case Volume, Complexity and Access Among Healthcare Institutions in 17 Middle-Income Countries.

The care for patients with congenital heart disease (CHD) is multi-disciplinary and resource intensive. There is limited information about the infrastructure available among programs that care for CHD patients in low and middle-income countries (LMIC). A survey covering the entire care-pathway for CHD, from initial assessment to inpatient care and outpatient follow-up, was administered to institutions participating in the International Quality Improvement Collaborative for Congenital Heart Disease (IQIC). Surgical case complexity-mix was collected from the IQIC registry and estimated surgical capacity requirement was based on population data. The statistical association of selected infrastructure with case volume, case-complexity and percentage of estimated case-burden actually treated, was analyzed. Thirty-seven healthcare institutions in seventeen countries with median annual surgical volume of 361 (41–3503) operations completed the survey. There was a median of two (1–16) operating room/s (OR), nine (2–80) intensive care unit (ICU) beds, three (1–20) cardiac surgeons, five (3–30) OR nurses, four (2–35) anesthesiologists, four (1–25) perfusionists, 28 (5–194) ICU nurses, six (0–30) cardiologists and three (1–15) interventional cardiologists. Higher surgical volume was associated with higher OR availability (p = 0.007), number of surgeons (p = 0.002), OR nurses (0.008), anesthesiologists (p = 0.04), perfusionists (p = 0.001), ICU nurses (p < 0.001), years of experience of the most senior surgeon (p = 0.03) or cardiologist (p = 0.05), and ICU bed capacity (p = 0.001). Location in an upper-middle income country (P = 0.04), OR availability (p = 0.02), and number of cardiologists (p = 0.004) were associated with performing a higher percentage of complex cases. This study demonstrates an overall deficit in the infrastructure available for the care of CHD patients among the participating institutions. While there is considerable variation across institutions surveyed, deficits in infrastructure that requires long-term investment like operating rooms, intensive care capacity, and availability of trained staff, are associated with reduced surgical capacity and access to CHD care.

Pressure on the Health-Care System and Intensive Care Utilization During the COVID-19 Outbreak in the Lombardy Region of Italy: A Retrospective Observational Study in 43,538 Hospitalized Patients.

During the spring of 2020, the COVID-19 epidemic caused an unprecedented demand for intensive care resources in Lombardy, Italy. Using data on 43,538 hospitalized patients admitted between February 21 and July 12, 2020, we evaluated variations in intensive care unit (ICU) admissions and mortality over three periods: the early phase (February 20-March 13), the period of highest pressure on healthcare (March 14-April 25, when COVID-19 patients exceeded the ICU pre-pandemic bed capacity), and the declining phase (April 26-July 12).Compared to the early phase, patients above 70 years of age were admitted less often to an ICU during highest pressure on healthcare (odds ratio OR 0.47, 95%CI: 0.41-0.54) with longer delays (incidence rate ratio IRR 1.82, 95%CI: 1.52-2.18), and lower chances of death in ICU (OR 0.47, 95%CI: 0.34-0.64). Patients under 56 years of age reported more limited changes in the probability (OR 0.65, 95%CI: 0.56-0.76) and delay to ICU admission (IRR 1.16, 95%CI: 0.95-1.42) and an increased mortality (OR 1.43, 95%CI: 1.00-2.07). In the declining phase, all quantities decreased for all age groups.These patterns may suggest that limited healthcare resources during the peak epidemic phase in Lombardy forced a shift in ICU admission criteria to prioritize patients with higher chances of survival.

Applying crisis standards of care to critically ill patients during the COVID-19 pandemic: Does race/ethnicity affect triage scoring?

ObjectiveGiven the variability in crisis standards of care (CSC) guidelines during the COVID‐19 pandemic, we investigated the racial and ethnic differences in prioritization between 3 different CSC triage policies (New York, Massachusetts, USA), as well as a first come, first served (FCFS) approach, using a single patient population.MethodsWe performed a retrospective cohort study of patients with intensive care unit (ICU) needs at a tertiary hospital on its peak COVID‐19 ICU census day. We used medical record data to calculate a CSC score under 3 criteria: New York, Massachusetts with full comorbidity list (Massachusetts1), and MA with a modified comorbidity list (Massachusetts2). The CSC scores, as well as FCFS, determined which patients were eligible to receive critical care under 2 scarcity scenarios: 50 versus 100 ICU bed capacity. We assessed the association between race/ethnicity and eligibility for critical care with logistic regression.ResultsOf 211 patients, 139 (66%) were male, 95 (45%) were Hispanic, 23 (11%) were non‐Hispanic Black, and 69 (33%) were non‐Hispanic White. Hispanic patients had the fewest comorbidities. Assuming a 50 ICU bed capacity, Hispanic patients had significantly higher odds of receiving critical care services across all CSC guidelines, except FCFS. However, assuming a 100 ICU bed capacity, Hispanic patients had greater odds of receiving critical care services under only the Massachusetts2 guidelines (odds ratio, 2.05; 95% CI, 1.09 to 3.85).ConclusionVarying CSC guidelines differentially affect racial and ethnic minority groups with regard to risk stratification. The equity implications of CSC guidelines require thorough investigation before CSC guidelines are implemented.

Model Input and Optimization: Improving the Speed and Accuracy of Our COVID-19 Hospitalization Forecasts

Background: During the COVID-19 pandemic, public-health decision makers have increasingly relied on hospitalization forecasts that are routinely provided, accurate, and based on timely input data to inform pandemic planning. In North Carolina, we adapted an existing agent-based model (ABM) to produce 30-day hospitalization forecasts of COVID-19 and non–COVID-19 hospitalizations for use by public-health decision makers. We sought to continually improve model speed and accuracy during forecasting. Methods: The geospatially explicit ABM included movement of agents (ie, patients) among 104 short-term acute-care hospitals, 10 long-term acute-care hospitals, 421 licensed nursing homes, and the community in North Carolina. Agents were based on a synthetic population of North Carolina residents (ie, &gt;10.4 million agents). We assigned SARS-CoV-2 infections to agents according to county-level susceptible, exposed, infectious, recovered (SEIR) models informed by reported COVID-19 cases by county. Agents’ COVID-19 severity and probability of hospitalization were determined using agent-specific characteristics (eg, age, comorbidities). During May 2020–December 2020, we produced weekly 30-day forecasts of intensive care unit (ICU) and non-ICU bed occupancy for COVID-19 agents and non–COVID-19 agents statewide and by region under a range of SARS-CoV-2 effective reproduction numbers. During the reporting period, we identified optimizations for faster results turnaround. We evaluated the incorporation of real-time hospital-level occupancy data at model initialization on forecast accuracy using mean absolute percent error (MAPE). Results: During May 2020–December 2020, we provided 31 weekly reports of 30-day hospitalization forecasts with a 1-day turnaround time. Reports included (1) raw and smoothed 7-day average values for 42 model output variables; (2) static visuals of ICU and non-ICU bed demand and capacity; and (3) an interactive Tableau workbook of hospital demand variables. Identifying code efficiencies reduced a single model runtime from ~100 seconds to 28 seconds. The use of cloud computing reduced simulation runtime from ~20 hours to 15 minutes. Across forecasts, the average MAPEs were 21.6% and 7.1% for ICU and non-ICU bed demand, respectively. By incorporating hospital-level occupancy data, we reduced the average MAPE to 6.5% for ICU bed demand and 3.9% for non-ICU bed demand, indicating improved accuracy. Conclusions: We adapted an ABM and continually improved it during COVID-19 forecasting by optimizing code and computing resources and including real-time hospital-level occupancy data. Planned SEIR model updates for enhanced forecasts include the addition of compartments for undocumented infections and recoveries as well as permission of reinfection from recovered compartments.Funding: NoDisclosures: None

ASHP national survey of pharmacy practice in hospital settings: Impact of COVID-19 pandemic on pharmacy operations-2020.

Results of the 2020 ASHP national survey of pharmacy practice in hospital settings pertaining to pharmacy operational changes implemented in response to the coronavirus disease 2019 (COVID-19) pandemic are presented. Pharmacy directors at 1,437 general and children's medical/surgical hospitals in the United States were surveyed using a mixed-mode method of contact by email and mail. Survey completion was online. The response rate was 18.7%. Seventy-three percent of hospitals implemented changes to hospital units, including 46% that increased intensive care unit bed capacity; 94% made changes to pharmacy supply chain acquisition, changes to products, and/or increased inventory. Staffing changes were implemented by 69% of hospitals, with the most common being staffing reductions (55%) and salary reductions (16%). Medication-use changes were implemented by 86% of hospitals, with treatment guidelines for COVID-19 treatment (79%) and opening compassionate use or investigational drug studies (55%) being the most common. Changes in sterile compounding processes were implemented by 84% of hospitals. Personal protective equipment (PPE) shortages led to 71% of hospitals modifying PPE use standards in sterile compounding. Eighty-seven percent of hospitals changed operational activities, such as changing medication return practices (56%), medication reconciliation processes (46%), intravenous medication recycling (38%), and discharge counseling (37%). Hospitals experienced shortages of many medications, including albuterol inhalers (60%), sedatives and anesthetic agents (58%), neuromuscular blockers (43%), corticosteroids (34%), cardiovascular agents (24%), investigational agents (24%), and dialysis solutions (6%). The pharmacy profession responded to myriad threats to operations and patient care during the COVID-19 pandemic in 2020.

Construction of a demand and capacity model for intensive care and hospital ward beds, and mortality from COVID-19

BackgroundThis paper describes a model for estimating COVID-19 related excess deaths that are a direct consequence of insufficient hospital ward bed and intensive care unit (ICU) capacity.MethodsCompartmental models were used to estimate deaths under different combinations of ICU and ward care required and received in England up to late April 2021. Model parameters were sourced from publicly available government information and organisations collating COVID-19 data. A sub-model was used to estimate the mortality scalars that represent increased mortality due to insufficient ICU or general ward bed capacity. Three illustrative scenarios for admissions numbers, ‘Optimistic’, ‘Middling’ and ‘Pessimistic’, were modelled and compared with the subsequent observations to the 3rd February.ResultsThe key output was the demand and capacity model described. There were no excess deaths from a lack of capacity in the ‘Optimistic’ scenario. Several of the ‘Middling’ scenario applications resulted in excess deaths—up to 597 deaths (0.6% increase) with a 20% reduction compared to best estimate ICU capacity. All the ‘Pessimistic’ scenario applications resulted in excess deaths, ranging from 49,178 (17.0% increase) for a 20% increase in ward bed availability, to 103,735 (35.8% increase) for a 20% shortfall in ward bed availability. These scenarios took no account of the emergence of the new, more transmissible, variant of concern (b.1.1.7).ConclusionsMortality is increased when hospital demand exceeds available capacity. No excess deaths from breaching capacity would be expected under the ‘Optimistic’ scenario. The ‘Middling’ scenario could result in some excess deaths—up to a 0.7% increase relative to the total number of deaths. The ‘Pessimistic’ scenario would have resulted in significant excess deaths. Our sensitivity analysis indicated a range between 49,178 (17% increase) and 103,735 (35.8% increase). Given the new variant, the pessimistic scenario appeared increasingly likely and could have resulted in a substantial increase in the number of COVID-19 deaths. In the event, it would appear that capacity was not breached at any stage at a national level with no excess deaths. it will remain unclear if minor local capacity breaches resulted in any small number of excess deaths.

Development of a Prone Team and Exploration of Staff Perceptions During COVID-19.

As intensive care unit bed capacity doubled because of COVID-19 cases, nursing leaders created a prone team to support labor-intensive prone positioning of patients with COVID-related acute respiratory distress syndrome. The goal of the prone team was to reduce workload on intensive care teams, standardize the proning process, mitigate pressure injuries and turning-related adverse events, and ensure prone team safety. Staff were trained using a hybrid learning model focused on prone-positioning techniques, pressure injury prevention, and turning-related adverse events. No adverse events occurred to patients or members of the prone team. The prone team mitigated pressure injuries using prevention strategies. The prone team and intensive care unit staff were highly satisfied with their experience. The prone team provided support for critically ill patients, and team members reported feeling supported and empowered. Intensive care unit staff were highly satisfied with the prone team.

Successful treatment of intubation-induced severe neurogenic post-extubation dysphagia using pharyngeal electrical stimulation in a COVID-19 survivor: a case report

BackgroundA significant portion of critically ill patients with coronavirus disease 2019 (COVID-19) are at high risk of developing intensive care unit (ICU)-acquired swallowing dysfunction (neurogenic dysphagia) as a consequence of requiring prolonged mechanical ventilation. Pharyngeal electrical stimulation (PES) is a simple and safe treatment for neurogenic dysphagia. It has been shown that PES can restore safe swallowing in orally intubated or tracheotomized ICU patients with neurogenic dysphagia following severe stroke. We report the case of a patient with severe neurogenic post-extubation dysphagia (PED) due to prolonged intubation and severe general muscle weakness related to COVID-19, which was successfully treated using PES.Case presentationA 71-year-old Caucasian female patient with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection developed neurogenic dysphagia following prolonged intubation in the ICU. To avoid aerosol-generating procedures, her swallowing function was evaluated non-instrumentally as recommended by recently published international guidelines in response to the COVID-19 pandemic. Her swallowing function was markedly impaired and PES therapy was recommended. PES led to a rapid improvement of the PED, as evaluated by bedside swallowing assessments using the Gugging Swallowing Screen (GUSS) and Dysphagia Severity Rating Scale (DSRS), and diet screening using the Functional Oral Intake Scale (FOIS). The improved swallowing, as reflected by these measures, allowed this patient to transfer from the ICU to a non-intensive medical department 5 days after completing PES treatment.ConclusionsPES treatment contributed to the restoration of a safe swallowing function in this critically ill patient with COVID-19 and ICU-acquired swallowing dysfunction. Early clinical bedside swallowing assessment and dysphagia intervention in COVID-19 patients is crucial to optimize their full recovery. PES may contribute to a safe and earlier ICU discharge of patients with ICU-acquired swallowing dysfunction. Earlier ICU discharge and reduced rates of re-intubation following PES can help alleviate some of the pressure on ICU bed capacity, which is critical in times of a health emergency such as the ongoing COVID-19 pandemic.

Development of a Critical Care Response - Experiences from Italy During the Coronavirus Disease 2019 Pandemic.

Italy was the first western country facing an outbreak of coronavirus disease 2019 (COVID-19). The first Italian patient diagnosed with COVID-19 was admitted, on Feb. 20, 2020, to the intensive care unit (ICU) in Codogno (Lodi, Lombardy, Italy), and the number of reported positive cases increased to 36 in the next 24hours, and then exponentially for 18days. This triggered a response that resulted in a massive surge in ICU bed capacity. The COVID19 Lombardy Network organized a structured logistic response and provided scientific evidence to highlight information on COVID-19 associated respiratory failure.

New Normal Context in Health Care Settings after COVID-19 Pandemic: A Narrative Literature Review

COVID-19 is an infectious disease that rapidly developed into a pandemic status. This deemed a need for new strategies to carry out routine health care activities. The recent practices and adaptations of the system as a response to the pandemic status were called a new normal situation. The aim of the study was to describe principles for adaptation to a new normal context for health care settings in COVID-19 pandemic. This narrative review of literature was conducted based on policy documents, guidelines, and public notices issued by the government and other key policymakers from the United Kingdom, Australia, Singapore, and Canada between June 15, 2020, and July 15, 2020, available on their government websites. The study revealed several principles, namely, enhanced surveillance, phasedown strategy for restoring routine services, vulnerability, dynamics of the service demand, new principles in human resource management, infection control measures, supply and usage of personal protective equipment, demand for intensive-care unit bed capacity, coordination and collaboration internally and externally, promotion and utility of remote care, ensuring equity, pre-hospital communication and assessment before reaching service facility, enhancing clinician participation in local-level decision-making, and risk assessments within all levels of service facility. The results of this study exposed new principles that facilitated managerial decision-making to the adaptation of new strategies. This new normal context created many challenges for resource management, which needed to consider dynamics of demand of services, prevention of spreading infections, and readiness for surge of cases while safeguarding quality and safety.

Alternative cardiac intensive care unit locations during the COVID-19 pandemic at an academic medical center

Alternative cardiac intensive care unit locations during the COVID-19 pandemic at an academic medical center

A Closer Look Into Global Hospital Beds Capacity and Resource Shortages During the COVID-19 Pandemic

BackgroundAs the COVID-19 pandemic continues, there is a question of whether hospitals have adequate resources to manage patients. We aim to investigate global hospital bed (HB), acute care bed (ACB), and intensive care unit (ICU) bed capacity and determine any correlation between these hospital resources and COVID-19 mortality. MethodCross-sectional study utilizing data from the World Health Organization (WHO) and other official organizations regarding global HB, ACB, ICU bed capacity, and confirmed COVID-19 cases/mortality. Descriptive statistics and linear regression were performed. ResultsA total of 183 countries were included with a mean of 307.1 HBs, 413.9 ACBs, and 8.73 ICU beds/100,000 population. High-income regions had the highest mean number of ICU beds (12.79) and HBs (402.32) per 100,000 population whereas upper middle-income regions had the highest mean number of ACBs (424.75) per 100,000. A weakly positive significant association was discovered between the number of ICU beds/100,000 population and COVID-19 mortality. No significant associations exist between the number of HBs or ACBs per 100,000 population and COVID-19 mortality. ConclusionsGlobal COVID-19 mortality rates are likely affected by multiple factors, including hospital resources, personnel, and bed capacity. Higher income regions of the world have greater ICU, acute care, and hospital bed capacities. Mandatory reporting of ICU, acute care, and hospital bed capacity/occupancy and information relating to coronavirus should be implemented. Adopting a tiered critical care approach and targeting the expansion of space, staff, and supplies may serve to maximize the quality of care during resurgences and future disasters.

Intensive Care Unit Capacity, Cancellation of Elective Surgery, and the US Pandemic Response.

Intensive Care Unit Capacity, Cancellation of Elective Surgery, and the US Pandemic Response.