Prioritization of COVID-19 Patients for Admission in the Intensive Care Unit in the Context of Hospital Bed Shortages: An Integrated Multi-criteria Decision Making Approach

Seyyed Mahdi  Hosseini Sarkhosh; Mahdieh  Taghvaei; Seyyed  Farshad Allameh

doi:10.18502/mshsj.v7i2.10677

Seyyed Mahdi Hosseini Sarkhosh Assistant Professor, Department of Industrial Engineering, School of Engineering, University of Garmsar, Garmsar, Iran
Mahdieh Taghvaei Internal Medicine Specialist, Department of Internal Medicine, Shohadaye Pakdasht Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Seyyed Farshad Allameh Internal Medicine Specialist, Department of Internal Medicine, Shohadaye Pakdasht Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/mshsj.v7i2.10677

Keywords: COVID-19, Intensive Cares Unit, Pandemic, Hospital beds, Decision analysi

Abstract

Background: When an epidemic occurs, resources, including hospital beds, are severely limited and not all patients can be treated; so, hospital bed rationing is inevitable. Therefore, the aim of this study is to provide a method for evaluating and prioritizing patients with COVID-19 for admission to the intensive care unit.

Methods: This was a descriptive-survey study in terms of data collection method conducted in the summer of 2021. Following the formation of an expert panel with 4 specialists, a three-stage approach to evaluating and prioritizing COVID-19 patients was adopted by combining multi-criteria decision analysis methods. In the first stage, effective criteria and sub-criteria for patients’ prioritization were identified by a panel of experts and related studies, and the hierarchy of criteria was drawn. In the second stage, the Fuzzy best-worst method was used to determine the weight of criteria and sub-criteria. Finally, in the third stage, a combined compromise solution method was performed to prioritize 10 patients in need of COVID-19 and the most critical patient was selected.

Results: According to the experts, among the 15 criteria studied, respiratory rate, PaO2/FiO2, impaired consciousness, mean arterial pressure and age were identified as 5 of the most important criteria in prioritizing COVID-19 patients for intensive care unit admission. In addition, 10 COVID-19 patients referred to Shohadaye Pakdasht Hospital were evaluated and prioritized with the proposed approach.

Conclusion: The proposed method can be used as a useful tool in the evaluation of COVID-19 patients for admission to the intensive care unit and to support the vital decisions of physicians.