Does It Measure Up? A Comparison of Pollution Exposure Assessment Techniques Applied across Hospitals in England.

Weighted averages of air pollution measurements from monitoring stations are commonly assigned as air pollution exposures to specific locations. However, monitoring networks are spatially sparse and fail to adequately capture the spatial variability. This may introduce bias and exposure misclassification.

Impact of extreme temperatures on emergency hospital admissions by age and socio-economic deprivation in England.

Climate change poses an unprecedented challenge to population health and health systems' resilience, with increasing fluctuations in extreme temperatures through pressures on hospital capacity. While earlier studies have estimated morbidity attributable to hot or cold weather across cities, we provide the first large-scale, population-wide assessment of extreme temperatures on inequalities in excess emergency hospital admissions in England. We used the universe of emergency hospital admissions between 2001 and 2012 combined with meteorological data to exploit daily variation in temperature experienced by hospitals (N = 29,371,084).

Optimal national prioritization policies for hospital care during the SARS-CoV-2 pandemic.

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.

The J-IDEA Pandemic Planner: A Framework for Implementing Hospital Provision Interventions During the COVID-19 Pandemic.

Background: Planning for extreme surges in demand for hospital care of patients requiring urgent life-saving treatment for coronavirus disease 2019 (COVID-19), while retaining capacity for other emergency conditions, is one of the most challenging tasks faced by health care providers and policymakers during the pandemic. Health systems must be well-prepared to cope with large and sudden changes in demand by implementing interventions to ensure adequate access to care. We developed the first planning tool for the COVID-19 pandemic to account for how hospital provision interventions (such as cancelling elective surgery, setting up field hospitals, or hiring retired staff) will affect the capacity of hospitals to provide life-saving care.

Adapting hospital capacity to meet changing demands during the COVID-19 pandemic.

Background: To calculate hospital surge capacity, achieved via hospital provision interventions implemented for the emergency treatment of coronavirus disease 2019 (COVID-19) and other patients through March to May 2020; to evaluate the conditions for admitting patients for elective surgery under varying admission levels of COVID-19 patients.

Methods: We analysed National Health Service (NHS) datasets and literature reviews to estimate hospital care capacity before the pandemic (pre-pandemic baseline) and to quantify the impact of interventions (cancellation of elective surgery, field hospitals, use of private hospitals, deployment of former medical staff and deployment of newly qualified medical staff) for treatment of adult COVID-19 patients, focusing on general and acute (G&A) and critical care (CC) beds, staff and ventilators.

Results: NHS England would not have had sufficient capacity to treat all COVID-19 and other patients in March and April 2020 without the hospital provision interventions, which alleviated significant shortfalls in CC nurses, CC and G&A beds and CC junior doctors.

Beyond financial efficiency to support environmental sustainability in economic evaluations.

The healthcare sector is one of the largest polluters in the UK, accounting for 25% of total emissions of carbon dioxide of the public sector. Ironically, it is the healthcare sector itself that is primarily affected by any deterioration in the environment affecting individuals' health and their demand for healthcare. Therefore, the healthcare sector is a direct beneficiary of its own steps towards sustainability and is more and more viewed as the one who should lead the change.