ABSTRACT
Objectives: to evaluate the impact of the COVID-19 on the hospital key performance indicators using the diagnosis-related groups (DRG). To compare the results of the Angiology and Vascular Surgery Department of the University Hospital of Cabuenes (HUCAB) with the database of the Ministry of Health. Material(s) and Method(s): hospital discharges from the Vascular Surgery Department of the HUCAB during the years 2019, 2020 and 2021. All patients refined (APR)-DRG system was extracted for discharge coding. The hospital key indicators studied were: number of discharges, mortality, mean stay (EM) and mean weight (PM) of the DRG. The overall results per year and according to the most prevalent DRGs were studied. The results obtained were compared with the annual data from the coding of the Minimum Basic Data Set (CMBD) of the Ministry of Health. The configured EM by adjusting the performance of the standard (EMAF) and by the casuistry (EMAC), the index of the adjusted EM (IEMA), the functional index (FI), casuistic index (CI) and the number of avoidable hospital stays were also analyzed. Result(s): number of discharges: it was 10 % inferior in 2020 compared to 2019. Discharges of the GRD 181 linked to admissions from the Emergency increased more than 50 % during 2020 and more than 100 % in 2021 compared to 2019. Mortality: there was no significant increase. EM: it decreased 20 % in 2020 and 18 % in 2021, compared to 2019. PM: it increased progressively to 7.7% on average in 2021. EMAF: it was superior to standard EM. The number of stays saved was higher than expected. Conclusion(s): the pandemic of COVID-19 influenced the hospital key performance indicators studied, reducing the number of discharges and ME and increasing the PM of the DRGs. The number of avoidable stays saved was greater than the standard.© Copyright 2023 SEACV.
ABSTRACT
Ventilation in confined spaces is essential to reduce the airborne transmission of viruses responsible for respiratory diseases such as COVID-19. Mechanical ventilation using purifiers is an interesting solution for elevator cabins to reduce the risk of infection and improve the air quality. In this work, the optimal position and blowing direction of these devices to maximize ventilation and minimize the residence time of the air inside two cabins (large and small) is studied. Special attention is devoted to idle periods when the cabin is not used by the passengers, in order to keep the cabin ambient safe and clean, avoiding that the trapped air in the cabin (after its use) could suppose a reservoir for contaminants. CFD numerical models of two typical cabin geometries, including the discretization of small slots and grilles for infiltration, have been developed. A full 3D URANS approach with a k-epsilon RNG turbulence model and a non-reactive scalar to compute the mean age of air (MAA) was employed. The CFD results have been also validated with experimental measurements from a home-made 1:4 small-scale mock-up. The optimal position of the purifier is on the larger sidewall of the cabins for a downward blowing direction (case 1 of the database). Flow rates in the range of 0.4–0.6 m3/min, depending on the size of the cabin, are sufficient to assure a correct ventilation. Upward blowing may be preferable only if interaction of the jet core with the ceiling or other flow deflecting elements are found. In general, the contribution of infiltrations (reaching values of up to 10%), and how these secondary flows interact with the main flow pattern driven by the purifier, is relevant and not considered previously in the literature. Though an optimal position can improve ventilation considerably, it has been proven that a good choice of the purification flow rate is more critical to ensure an adequate air renewal. © 2022 The Authors