Optimal national prioritization policies for hospital care during the SARS-CoV-2 pandemic
Joshua C D'Aeth, Shubhechyya Ghosal, Fiona Grimm, David Haw, Esma Koca, Krystal Lau, Stefano Moret, Dheeya Rizmie, Sarah R Deeny, Pablo N. Perez‐Guzman, Neil M. Ferguson, Katharina Hauck, Peter Smith, Giovanni Forchini, Wolfram Wiesemann, Marisa Miraldo
Abstract
In response to unprecedented surges in the demand for hospital care during the SARS-CoV-2 pandemic, health systems have prioritized patients with COVID-19 to life-saving hospital care to the detriment of other patients. In contrast to these ad hoc policies, we develop a linear programming framework to optimally schedule elective procedures and allocate hospital beds among all planned and emergency patients to minimize years of life lost. Leveraging a large dataset of administrative patient medical records, we apply our framework to the National Health Service in England and show that an extra 50,750-5,891,608 years of life can be gained compared with prioritization policies that reflect those implemented during the pandemic. Notable health gains are observed for neoplasms, diseases of the digestive system, and injuries and poisoning. Our open-source framework provides a computationally efficient approximation of a large-scale discrete optimization problem that can be applied globally to support national-level care prioritization policies.