Allocation of Scarce Resources in a Pandemic: A Systematic Review of US State Crisis Standards of Care Documents.
Disaster Med Public Health Prep
; 14(5): 677-683, 2020 10.
Article
in English
| MEDLINE | ID: covidwho-65416
ABSTRACT
The aim of this systematic review was to locate and analyze United States state crisis standards of care (CSC) documents to determine their prevalence and quality. Following PRISMA guidelines, Google search for "allocation of scarce resources" and "crisis standards of care (CSC)" for each state. We analyzed the plans based on the 2009 Institute of Medicine (IOM) report, which provided guidance for establishing CSC for use in disaster situations, as well as the 2014 CHEST consensus statement's 11 core topic areas. The search yielded 42 state documents, and we excluded 11 that were not CSC plans. Of the 31 included plans, 13 plans were written for an "all hazards" approach, while 18 were pandemic influenza specific. Eighteen had strong ethical grounding. Twenty-one plans had integrated and ongoing community and provider engagement, education, and communication. Twenty-two had assurances regarding legal authority and environment. Sixteen plans had clear indicators, triggers, and lines of responsibility. Finally, 28 had evidence-based clinical processes and operations. Five plans contained all 5 IOM elements Arizona, Colorado, Minnesota, Nevada, and Vermont. Colorado and Minnesota have all hazards documents and processes for both adult and pediatric populations and could be considered exemplars for other states.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
State Government
/
Resource Allocation
/
Pandemics
Type of study:
Observational study
/
Prognostic study
/
Reviews
/
Systematic review/Meta Analysis
Limits:
Humans
Country/Region as subject:
North America
Language:
English
Journal:
Disaster Med Public Health Prep
Journal subject:
Public Health
Year:
2020
Document Type:
Article
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