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Hospital Capacity Pooling in Pandemics: Simulation-Based Mortality Impacts and Diversification Mechanisms
Francois Daudelin1,2, Harrison B Zeff1,2, Gregory W Characklis1,2
1Institute for Risk Management and Insurance Innovation, University of North Carolina, Chapel Hill, NC, USA.
Summary
Expanding hospital service populations by pooling resources can reduce healthcare strain and patient mortality during pandemics. This strategy dampens demand volatility and averages epidemic phases, leading to more predictable resource needs and fewer costly interventions.
Area of Science:
- Healthcare management
- Epidemiology
- Public health
Background:
- The COVID-19 pandemic caused significant healthcare strain, increasing patient mortality and necessitating costly interventions.
- Hospital service population size, expandable via patient transfer networks, is a key factor influencing healthcare system resilience.
Purpose of the Study:
- To examine how hospital service population size impacts healthcare strain through volatility dampening and epidemic phase averaging.
- To evaluate the health impacts of pooling resources via patient transfers during pandemics.
Main Methods:
- Analysis of facility-level intensive care unit (ICU) data across three COVID-19 waves.
- Evaluation of volatility dampening and epidemic phase averaging mechanisms.
- Scenario simulations of patient pooling strategies based on observed occupancy levels.
Main Results:
- Volatility dampening reduces ICU occupancy variability proportionally to the square root of population size.
- Epidemic phase averaging effectiveness depends on pathogen transmission dynamics.
- Increased service population size reduces demand spikes, enhancing predictability and lowering intervention likelihood.
- Simulations showed local hospital pools reduced COVID ICU mortality by 2%-7% in the winter 2020 wave.
Conclusions:
- Coordinated patient transfer strategies can significantly reduce mortality and healthcare costs during pandemics.
- Expanding hospital service populations through networks enhances resilience against healthcare strain.
- Diversification mechanisms like volatility dampening and phase averaging are crucial for pandemic preparedness.
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