The confrontation of COVID-19 foreshadowed a serious crisis of scarce health resources worldwide. To assist in this confrontation, the Palliative Care Scientific Technical Core of the Clinical Hospital, School of Medicine, Sao Paulo University (USP) elaborated a Triage Protocol for Palliative Care (PALI-COVID Tool) and it was possible to categorize the patients in three groups, according to the risk of death and needs of Palliative Care (PC), through the clinical evaluation of the patient that also directed them to the hospitalization resource according to their need (ward x ICU).
The patients grouped as with higher risk of death and PC needs (green group) by PALI-COVID Tool were those with a profile of end-of-life, signs of clinical deterioration and risk of death on admission and thus indicated for admission to the COVID-19 Palliative Care Inpatient Unit, however some were admitted to the ICU. Objective: to analyze the direct costs of hospitalization of COVID-19 Palliative Care patients in Palliative Care Inpatient Unit and ICU screened as green group by the COVID-19 Screening Protocol developed in the institution. Methods: observational, cross-sectional and retrospective study of the service database of patients over 18 years of age screened as the green group (PALI-COVID). The variables to be investigated are related to sociodemographic and clinical data, length of stay and hospitalization scenarios, time to call for PC, outcome and costs.
Study Type
OBSERVATIONAL
Enrollment
200
Analysis of direct costs with supplies, medications, diets, laboratory tests and imaging exams, and invasive procedures such as mechanical ventilation, dialysis, and the use of vasoactive drugs.-analysis of costs referring to working hours of physicians, nurses and physical therapists in each unit normalized for the same number of beds.- cost minimization and consequential cost analysis.
Direct costs (supplies)
costs related to supplies, medications, diets, laboratory tests, imaging exams, and invasive procedures (such as mechanical ventilation, dialysis, and the use of vasoactive drugs). The costs will be calculate for the three groups and compared between them.
Time frame: Hospitalizations between April 8th to July 31th, 2020
Direct costs (working hours)
costs referring to working hours of health professionals (physicians, nurses and physical therapists) in each unit normalized for the same number of beds. The costs will be calculate for the three groups and compared between them.
Time frame: Hospitalizations between April 8th to July 31th, 2020
Cost minimization, and consequential cost analysis
all the costs will be compared between them to do a cost-effectiveness analysis as the death rate will be probabily similar in the three groups.
Time frame: Hospitalizations between April 8th to July 31th, 2020
Sociodemographic profile
age and sex to identify and analyze the profile of the patients included in the study.
Time frame: Hospitalizations between April 8th to July 31th, 2020
Clinical profile
diagnosis, underlying disease, comorbidities to identify and analyze the profile of the patients included in the study.
Time frame: Hospitalizations between April 8th to July 31th, 2020
Length of stay and inpatient settings
length of stay at Palliative Care unit (PC), ICU and PC \& ICU to identify and analyze the profile of the patients included in the study and analyze the costs.
Time frame: Hospitalizations between April 8th to July 31th, 2020
Time to call Palliative Care group
admission to the institution, date of call of PC, first assessment of PC, indication of transfer to a COVID-19 PC unit, and date of transfer to PC unit to identify and analyze the time it took for staff to recognize the need for CP for the patients that has repercussions on the cost of hospitalization.
Time frame: Hospitalizations between April 8th to July 31th, 2020
Life-sustaining procedures
such as mechanical ventilation, dialysis, and the use of vasoactive drugs to identify and analyze the use of life-sustaining procedures in the study population and analyze the costs.
Time frame: Hospitalizations between April 8th to July 31th, 2020
Inpatient daily rates
rates for Palliative Care unit (PC), ICU and PC \& ICU to analyze the costs.
Time frame: Hospitalizations between April 8th to July 31th, 2020
Outcome of hospitalization
hospital discharge, transference, and death to identify and analyze the profile of the patients included in the study and to make a cost-effectiveness analysis with the all costs that will be analyzed.
Time frame: Hospitalizations between April 8th to July 31th, 2020
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