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Burden of COVID-19 on Italian Internal Medicine Wards: Delphi, SWOT, and Performance Analysis after Two Pandemic Waves in the Local Health Authority “Roma 6” Hospital Structures

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  • Filomena Pietrantonio

    (Internal Medicine Unit, Castelli Hospital, Azienda Sanitaria Locale Roma 6, 00072 Ariccia, Italy
    Department of Health Economics, St. Camillus University Health and Medical Sciences, 00131 Rome, Italy)

  • Francesco Rosiello

    (Internal Medicine Unit, Castelli Hospital, Azienda Sanitaria Locale Roma 6, 00072 Ariccia, Italy
    Department of Public Health and Infectious Disease, Sapienza University of Rome, 00185 Rome, Italy)

  • Elena Alessi

    (Internal Medicine Unit, Castelli Hospital, Azienda Sanitaria Locale Roma 6, 00072 Ariccia, Italy)

  • Matteo Pascucci

    (Internal Medicine Unit, Castelli Hospital, Azienda Sanitaria Locale Roma 6, 00072 Ariccia, Italy)

  • Marianna Rainone

    (Internal Medicine Unit, Castelli Hospital, Azienda Sanitaria Locale Roma 6, 00072 Ariccia, Italy)

  • Enrica Cipriano

    (Internal Medicine Unit, Castelli Hospital, Azienda Sanitaria Locale Roma 6, 00072 Ariccia, Italy)

  • Alessandra Di Berardino

    (Internal Medicine Unit, Castelli Hospital, Azienda Sanitaria Locale Roma 6, 00072 Ariccia, Italy)

  • Antonio Vinci

    (School of Specialization in Hygiene and Preventive Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy)

  • Matteo Ruggeri

    (Department of Health Economics, St. Camillus University Health and Medical Sciences, 00131 Rome, Italy
    National Centre for HTA, National Institute for Health, 00161 Rome, Italy)

  • Serafino Ricci

    (Department of Anatomical, Hystological Sciences and Legal Medicine, Sapienza University of Rome, 00185 Rome, Italy)

Abstract

Background : COVID-19 causes major changes in day-to-day hospital activity due to its epidemiological characteristics and the clinical challenges it poses, especially in internal medicine wards. Therefore, it is necessary to understand and manage all of the implicated factors in order to maintain a high standard of care, even in sub-par circumstances. Methods : This was a three-phase, mixed-design study. Initially, the Delphi method allowed us to analyze the causes of poor outcomes in a cohort of an aggregate of Italian COVID-19 wards via an Ishikawa diagram. Then, for each retrieved item, a score was assigned according to a pros/cons, opportunities/threats system. Scores were also assigned according to potential value/perceived risk. Finally, the performances of MCs (Medicine-COVID-19 wards) and MCFs (Medicine-COVID-19-free: Internal Medicine wards) units were represented via a Barber’s nomogram. Results : MCFs hospitalized 790 patients (−23.90% compared to 2019 Internal Medicine admissions). The main risk factors for mortality were patients admitted from local facilities (+7%) and the presence of comorbidities (>3: 100%, ≥5: 24.7%). A total of 197 (25%) patients were treated with non-invasive ventilation (NIV). The most deaths (57.14%) occurred in patients admitted from local facilities. Conclusions : Medicine-COVID-19 wards show higher complexity and demand compared to non-COVID-19 ones and they are comparable to sub-intensive therapy wards. It is necessary to promote the use of NIV in such settings.

Suggested Citation

  • Filomena Pietrantonio & Francesco Rosiello & Elena Alessi & Matteo Pascucci & Marianna Rainone & Enrica Cipriano & Alessandra Di Berardino & Antonio Vinci & Matteo Ruggeri & Serafino Ricci, 2021. "Burden of COVID-19 on Italian Internal Medicine Wards: Delphi, SWOT, and Performance Analysis after Two Pandemic Waves in the Local Health Authority “Roma 6” Hospital Structures," IJERPH, MDPI, vol. 18(11), pages 1-11, June.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:11:p:5999-:d:568094
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    1. Valentina Alfonsi & Serena Scarpelli & Maurizio Gorgoni & Alessandro Couyoumdjian & Francesco Rosiello & Cinzia Sandroni & Roberto Corsi & Filomena Pietrantonio & Luigi De Gennaro, 2023. "Healthcare Workers after Two Years of COVID-19: The Consequences of the Pandemic on Psychological Health and Sleep among Nurses and Physicians," IJERPH, MDPI, vol. 20(2), pages 1-15, January.
    2. Antonio Vinci & Amina Pasquarella & Maria Paola Corradi & Pelagia Chatzichristou & Gianluca D’Agostino & Stefania Iannazzo & Nicoletta Trani & Maria Annunziata Parafati & Leonardo Palombi & Domenico A, 2022. "Emergency Medical Services Calls Analysis for Trend Prediction during Epidemic Outbreaks: Interrupted Time Series Analysis on 2020–2021 COVID-19 Epidemic in Lazio, Italy," IJERPH, MDPI, vol. 19(10), pages 1-15, May.
    3. Filomena Pietrantonio & Antonio Vinci & Francesco Rosiello & Elena Alessi & Matteo Pascucci & Marianna Rainone & Michela Delli Castelli & Angela Ciamei & Fabrizio Montagnese & Roberto D’Amico & Antone, 2021. "Green Line Hospital-Territory Study: A Single-Blind Randomized Clinical Trial for Evaluation of Technological Challenges of Continuous Wireless Monitoring in Internal Medicine, Preliminary Results," IJERPH, MDPI, vol. 18(19), pages 1-12, September.
    4. Stefano Barone & Alexander Chakhunashvili, 2023. "Pandemetrics: systematically assessing, monitoring, and controlling the evolution of a pandemic," Quality & Quantity: International Journal of Methodology, Springer, vol. 57(2), pages 1701-1723, April.
    5. Filomena Pietrantonio & Angela Ciamei & Antonio Vinci & Tiziana Ciarambino & Elena Alessi & Matteo Pascucci & Michela Delli Castelli & Silvia Zito & Simona Sanguedolce & Marianna Rainone & Jacopo Di L, 2023. "Polypharmacy Management in a Gender Perspective: At the Heart of the Problem: Analysis of Major Cardiac Diseases, SARS-CoV-2 Affection and Gender Distribution in a Cohort of Patients in Internal Medic," IJERPH, MDPI, vol. 20(9), pages 1-11, May.

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