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Access to hospitalization for patients with severe COVID-19 during the first wave of the pandemic in Caracas, Venezuela
Open Forum Infectious Diseases ; 9(Supplement 2):S436, 2022.
Article in English | EMBASE | ID: covidwho-2189692
ABSTRACT
Background. The COVID-19 pandemic has overwhelmed health systems around the world, causing access problems. The patient referral system in Caracas, Venezuela has no interinstitutional coordination, patients are given a note by the referring center and thereafter seeking care relies on themselves. We studied primarily to what extent the Caracas healthcare system satisfied the demand for hospitalization of severe COVID-19 during periods of congestion, measured in proportion of patients not hospitalized;and secondly how difficult it was for patients with severe COVID-19 to meet their need of hospitalization, measured in number of days and visits made to health centers until hospitalization or desisting from further searching. Methods. This study was approved by national bioethics committee. We included all symptomatic patients who attended the University Hospital of Caracas COVID-19 testing center, whose nasopharyngeal swab PCR was positive for SARS-CoV-2, and whose SpO2 was 93% or less between 07/01/2020 and 07/24/2020, the period in which we referred patients due to unavailability of beds in our center. Results. Ninety-four patients were included, 66 (70%) were men, the mean age was 58 years (range, 25-87 years), the median number of comorbidities was 1 (range, 0-3), and the median SpO2 was 90% (range, 30%-93%). Fourty-three (46%) patients were never admitted following referral from our center. Referred patients required a median of 1 day (range, 1-15 days) and 2 visits (range, 1-41 visits) to being admitted, or a median of 2 days (range, 1-17 days) and 5 visits (range, 1-31 visits) to desisting from further searching for admission. Conclusion. These data show that the healthcare system did not meet the hospitalization needs of half of the patientswith severe COVID-19 during the peak of the first wave of the pandemic in Caracas. The data also show that referred patientsfaced a major delay in being hospitalized, and that referred patients had to perform multiple visits to healthcare centers accross the city as a consequence of insufficient system capacity, increasing their urban mobility and therefore their probabilities of transmitting SARS-CoV-2 to others.
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Full text: Available Collection: Databases of international organizations Database: EMBASE Country/Region as subject: South America / Venezuela Language: English Journal: Open Forum Infectious Diseases Year: 2022 Document Type: Article

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Full text: Available Collection: Databases of international organizations Database: EMBASE Country/Region as subject: South America / Venezuela Language: English Journal: Open Forum Infectious Diseases Year: 2022 Document Type: Article