Multi-Criteria Decision Analysis to prioritize hospital admission of patients affected by COVID-19 in low-resource settings with hospital-bed shortage

• DOI: 10.1016/j.ijid.2020.06.082
• Publication Date: 2020-06-30T19:10:48Z
• Authors: Pasquale De Nardo; Elisa Gentilotti; Fulvia Mazzaferri; Eleonora Cremonini; Paul Hansen; Herman Goossens; Evelina Tacconelli; E. Durante Mangoni; L.L. Florio; R. Zampino; F. Mele; I. Gentile; B. Pinchera; N. Coppola; M. Pisaturo; R. Luzzati; N. Petrosillo; E. Nicastri; A. Corpolongo; M.A. Cataldo; A. D’Abramo; G. Maffongelli; L. Scorzolini; C. Palazzolo; E. Boumis; A. Pan; A. D’Arminio Monf...; F. Bai; S. Antinori; F.G. De Rosa; S. Corcione; T. Lupia; S.M. Pinna; S. Scabini; F. Canta; S. Belloro; Z. Bisoffi; A. Angheben; F. Gobbi; E. Turcato; N. Ronzoni; L. Moro; S. Calabria; P. Rodari; G. Bertoli; G. Marasca; M. Puoti; A. Gori; A. Bandera; D. Mangioni; M. Rizzi; F. Castelli; A. Montineri; C.A. Coco; M. Maresca; M. Frasca; D. Aquilini; M. Vincenzi; L. Lambertenghi; M.E. De Rui; E. Razzaboni; P. Cattaneo; A. Visentin; A. Erbogasto; I. Dalla Vecchia; I. Coledan; M. Vecchi; G. Be; L. Motta; A. Zaffagnini; N. Auerbach; P. Del Bravo; A.M. Azzini; E. Righi; E. Carrara; A. Savoldi; M. Sibani; E. Lattuada; G. Carolo; M. Cordioli; F. Soldani; M.D. Pezzani; S. Avallone; R. Bruno; A. Ricciardi; M.P. Saggese; G. Malerba
• Keywords: Prioritization; Pandemic; Economic shortage; Hospital admission

ObjectiveTo use Multi-Criteria Decision Analysis (MCDA) to determine weights for eleven criteria in order prioritize COVID-19 non-critical patients admission hospital healthcare settings with limited resources.MethodsThe MCDA was applied two main steps: specification of prioritizing (and levels within each criterion); and determination the based on experts' knowledge experience managing patients, via an online survey. Criteria were selected available evidence a focus low- middle-income countries (LMICs).ResultsThe most important (mean weights, summing 100%) are: PaO2 (16.3%); peripheral O2 saturation (15.9%); chest X-ray (14.1%); Modified Early Warning Score-MEWS (11.4%); respiratory rate (9.5%); comorbidities (6.5%); living vulnerable people (6.4%); body mass index (5.6%); duration symptoms before evaluation (5.4%); CRP (5.1%); age (3.8%).ConclusionsAt beginning new pandemic, when disease predictors is or unavailable effective national contingency plans are difficult establish, prioritization model could play pivotal role improving response health systems.