Nader Tavakoli, Mahnazalsadat Hoseini, Reza Jahangiri, Samaneh Sarkhosh, Reza Shirani, Saeed Bagherifaradenbeh,
Volume 6, Issue 2 (9-2021)
Abstract
Background: Admission and dispatch of patients is considered as part of the patient treatment process. The aim of this study was to investigate the status and income effects of admission and dispatch of patients in need of vascular surgery in hospitals of Iran University of Medical Sciences in 2018-2019. Methods: The present study is a descriptive cross-sectional study in which a checklist was compiled and the required information about admission and dispatch of patients in Iran University of Medical Sciences was extracted from the MCMC (Medical Care Monitoring Center) system. In order to extract the income of services related to vascular surgery service from the average income of each patient file in need of this service, university hospitals were used. The sampling method was census and 14,481 patients admitted and dispatched were examined. The data were analyzed by descriptive statistics using Excel software.
Results: The total number of registrations for dispatch of vascular surgery service was 605, 378 of which were successful. Of these, 145 were from hospitals affiliated to private hospitals and other hospitals affiliated to other medical universities, 233 were related to vascular surgery admissions, and 227 patients were related to failure to dispatch and death. The lost income due to dispatching patients is equal to 4,875,100,680 Rials. Also, the hospitals affiliated to the university have gained income equal to 7,833,782,472 Rials by admitting and not dispatching these patients.
Conclusion: The findings showed that the lost income due to dispatching patients requiring vascular surgery is 4,875,100,680 Rials. Also, the earned income resulting from the existence of medical facilities in the field of the patients’ admission to the hospitals affiliated to the university is 7,833,782,472 Rials.
Seyyed Mahdi Hosseini Sarkhosh, Mahdieh Taghvaei, Seyyed Farshad Allameh,
Volume 7, Issue 2 (9-2022)
Abstract
Background: When an epidemic occurs, resources, including hospital beds, are severely limited and not all patients can be treated; so, hospital bed rationing is inevitable. Therefore, the aim of this study is to provide a method for evaluating and prioritizing patients with COVID-19 for admission to the intensive care unit.
Methods: This was a descriptive-survey study in terms of data collection method conducted in the summer of 2021. Following the formation of an expert panel with 4 specialists, a three-stage approach to evaluating and prioritizing COVID-19 patients was adopted by combining multi-criteria decision analysis methods. In the first stage, effective criteria and sub-criteria for patients’ prioritization were identified by a panel of experts and related studies, and the hierarchy of criteria was drawn. In the second stage, the Fuzzy best-worst method was used to determine the weight of criteria and sub-criteria. Finally, in the third stage, a combined compromise solution method was performed to prioritize 10 patients in need of COVID-19 and the most critical patient was selected.
Results: According to the experts, among the 15 criteria studied, respiratory rate, PaO2/FiO2, impaired consciousness, mean arterial pressure and age were identified as 5 of the most important criteria in prioritizing COVID-19 patients for intensive care unit admission. In addition, 10 COVID-19 patients referred to Shohadaye Pakdasht Hospital were evaluated and prioritized with the proposed approach.
Conclusion: The proposed method can be used as a useful tool in the evaluation of COVID-19 patients for admission to the intensive care unit and to support the vital decisions of physicians.
