[Apropriateness of hospital admissions due to COVID-19 in the 2 and 5 phase of the pandemic].

Objective: The increase in the demand for healthcare caused by COVID-19 implies a lower availability of health resources and influences the appropriateness of their use. Due to the variability of demand during the pandemic, the study aimed to compare the appropriateness of hospital admissions between the 2 and 5 phases of the pandemic according to the criteria of the Hospital Emergency Service (CiHRyC). These results were compared with those obtained according to the Pneumonity Severity Index (FINE) and the Appropriateness Evaluation Protocol (AEP). As a secondary objective, the clinical and sociodemographic characteristics of the patients studied were described.

Methods: 80 patients hospitalized from the Emergency Department were randomly selected in two study periods (2 and 5 pandemic phase) obtained from the registry of hospitalizations of the Preventive Medicine service of Hospital Ramon y Cajal. Prevalences of inappropriateness were estimated according to the CiHRyC, FINE and AEP and an analysis was performed using univariate logistic regression between epidemiological variables of both periods collected through the electronical medical records.

Results: Inappropriateness of admissions were 35% and 45% in the 2 and 5 phase of the pandemic according with CiHRyC, 25% and 5/% according with FINE and 0% and 5% according with AEP. Median age was 71.4 and 50.0 years in 2 and 5 phase (p=0.02). 72.5% and 17.5% of the patients in the 2 and 5 phases had at least one risk factor for COVID-19 severe illness (p<0.01).

Conclusions: The measurement tools used identified more inappropriately cases in the 5 phase of the pandemic than in the 2 one. CiHRyC coincided with FINE and AEP in the result of their evaluation.