Turkiye Klinikleri Journal of Health Sciences

.: ORIGINAL RESEARCH
Country Differences in Lenght of Stay in Intensive-Care Unit of Severe COVID-19 Patients During the Pandemic: A Retrospective Descriptive Research
COVID-19 Pandemisinde, Ağır Hastaların Yoğun Bakımda Kalma Sürelerinin Ülkeler Arasındaki Farklılıkları: Retrospektif Tanımlayıcı Araştırma
Hakan DEMİRGİLa, Oğuzhan YÜKSELb, Ramazan ERDEMc
aDepartment of Econometrics, Süleyman Demirel University Faculty of Economics and Administrative Sciences, Isparta, Türkiye
bProgram of Health Institutions Management, Isparta University of Applied Sciences Senirkent Vocational School, Isparta, Türkiye
cDepartment of Healthcare Management, Süleyman Demirel University Faculty of Economics and Administrative Sciences, Isparta, Türkiye
Turkiye Klinikleri J Health Sci. 2022;7(4):1157-65
doi: 10.5336/healthsci.2022-89228
Article Language: EN
Full Text
ABSTRACT
 Objective: Health systems of countries face various challenges during epidemics and pandemics. Countries differ in hospital admission of coronavirus disease-2019 (COVID-19) patients and the treatment procedures followed. The aim of this study is to reveal the relation between the number of critical COVID-19 patients (CP) and the mortality rate [death number (DN)] as well as the country differences in patients' length of stay in intensive-care unit (ICU). Material and Methods: The research is a retrospective type, analyzed with a time series model. The 7 countries with the highest number of ICU beds (Türkiye, USA, UK, France, Spain, Italy and Germany) were included in the study. The 6-month period (1 August 2020-31 January 2021) has been analyzed. Koyck model has been used to measure the lagged impact of CP on DN. Results: The country with the highest positive correlation rate between the number of CP and DN is Spain. Almost all of the COVID-19 deaths in Türkiye are among severe COVID-19 patients who stayed in ICU. Results display that there is a strong relation between CP and DN in Türkiye, Spain and Italy. The death rate per million people, Türkiye has the lowest DN. It has also been seen that the period needed for the changes in the number of CP to have a dramatic effect on DN is the shortest in the UK and longest in Türkiye. Conclusion: Although CoV infects a small part of billions of people, there will be many critically ill patients in need of ICU, so countries must already take precautions against possible future waves of the pandemic and prepare their health systems in advance.

Keywords: COVID-19; intensive care unit; death
ÖZET
 Amaç: Ülkelerin sağlık sistemleri, salgın hastalıklar sırasında çeşitli zorluklarla karşı karşıyadır. Koronavirüs hastalığı-2019 [coronavirus disease-2019 (COVID-19)] hastalarının hastaneler tarafından kabulü ve uygulanan tedavi prosedürleri ülkeler arasında farklılıklar göstermektedir. Araştırmanın amacı, COVID-19 pandemi sürecinde ağır hasta [critical patient (CP)] sayıları ile vefat sayıları [death number (DN)] arasındaki ilişkiyi ve değişik ülkelerdeki hastaların yoğun bakım ünitesine [intensive-care unit (ICU)] bağlı geçen sürelerindeki farklılıkları ortaya koymaktır. Gereç ve Yöntemler: Araştırma retrospektif tipte, zaman serisi analizi yapılmış bir çalışmadır. ICU yatak sayısı en yüksek olan 7 ülke (Türkiye, ABD, İngiltere, Fransa, İspanya, İtalya ve Almanya) araştırmaya dâhil edilmiştir. Altı aylık dönem (1 Ağustos 2020- 31 Ocak 2021) analiz edilmiştir. Koyck modeli, CP'nin DN üzerindeki gecikmeli etkisini ölçmek için kullanılmıştır. Bulgular: CP sayısının, ölüm oranları üzerindeki pozitif etkisinin en yüksek olduğu ülke İspanya'dır. Türkiye'de COVID-19'a bağlı ölümlerin neredeyse tamamı ICU hastalarından kaynaklanmaktadır. Sonuçlar; Türkiye, İspanya ve İtalya'da CP ve DN arasında güçlü bir ilişki olduğunu göstermektedir. Milyon kişi başına ölüm oranlarında, Türkiye en düşük ölüm oranlarına sahiptir. CP sayılarında meydana gelen değişimin, DN'leri önemli ölçüde etkilemesi (dramatically effect) için geçmesi gereken sürenin en kısa olduğu ülke İngiltere ve en uzun olduğu ülke Türkiye olarak tespit edilmiştir. Sonuç: CoV milyarlarca insandan az bir kısmını enfekte etse de ICU'ya muhtaç durumda birçok kritik hasta olacağından, ülkeler sağlık sistemlerinde pandemilerin muhtemel diğer dalgalarına karşı gerekli önlemleri şimdiden almalı ve kendilerini hazırlamalıdırlar.

Anahtar Kelimeler: COVID-19; yoğun bakım ünitesi; ölüm
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