Patient flow dynamics in hospital systems during times of COVID-19: Cox proportional hazard regression analysis
Objectives: The present study is aimed at estimating patient flow dynamical parameters and requirement of hospital beds. Secondly, the effects of age and gender on parameters were evaluated. Patients and Methods: In this retrospective cohort study, 987 COVID-19 patients were enrolled from SMS Medical College, Jaipur (Rajasthan, India). The survival analysis was carried out from 29 Feb to 19 May 2020 for two hazards – 'Hazard 1' was hospital discharge and 'Hazard 2' was hospital death. The
... al death. The starting point for survival analysis of the two hazards was considered to be hospital admission . The survival curves were estimated and additional effects of age and gender were evaluated using Cox proportional hazard regression analysis. Results: The Kaplan Meier estimates of lengths of hospital stay (Median =10 days, IQR =10 days) and median survival rate ( more than 60 days due to large amount of censored data) were obtained. The Cox Model for 'Hazard 1' showed no significant effect of age and gender on duration of hospital stay. Similarly, the Cox Model 2 showed no significant difference of gender on survival rate. The case fatality rate 8.1 % , recovery rate 78.8% , mortality rate 0.10 per 100 person--days and hospital admission rate 0.35 per 105 person-days were estimated.Conclusion : The study estimates hospital bed requirement based on patient flow dynamic parameters. Furthermore, study concludes that average length of hospital stay were similar for patients of both genders and all age groups.