The confrontation of COVID-19 foreshadowed a serious crisis of scarce health resourcesworldwide. To assist in this confrontation, the Palliative Care Scientific Technical Coreof the Clinical Hospital, School of Medicine, Sao Paulo University (USP) elaborated aTriage Protocol for Palliative Care (PALI-COVID Tool) and it was possible to categorizethe patients in three groups, according to the risk of death and needs of Palliative Care(PC), through the clinical evaluation of the patient that also directed them to thehospitalization resource according to their need (ward x ICU).
The patients grouped as with higher risk of death and PC needs (green group) by
PALI-COVID Tool were those with a profile of end-of-life, signs of clinical deterioration
and risk of death on admission and thus indicated for admission to the COVID-19
Palliative Care Inpatient Unit, however some were admitted to the ICU. Objective: to
analyze the direct costs of hospitalization of COVID-19 Palliative Care patients in
Palliative Care Inpatient Unit and ICU screened as green group by the COVID-19 Screening
Protocol developed in the institution. Methods: observational, cross-sectional and
retrospective study of the service database of patients over 18 years of age screened as
the green group (PALI-COVID). The variables to be investigated are related to
sociodemographic and clinical data, length of stay and hospitalization scenarios, time to
call for PC, outcome and costs.
Other: Analysis of costs with patient care during hospitalization
Analysis of direct costs with supplies, medications, diets, laboratory tests and imaging
exams, and invasive procedures such as mechanical ventilation, dialysis, and the use of
vasoactive drugs.-analysis of costs referring to working hours of physicians, nurses and
physical therapists in each unit normalized for the same number of beds.- cost
minimization and consequential cost analysis.
Inclusion Criteria:
- inpatients with severe forms of COVID-19 between April 08 and July 31, 2020
- positive reverse-transcriptase polymerase chain reaction (RT-PCR).
- patients with terminal illness and high clinical risk of death before COVID-19.
- those admitted to an ICU or palliative care unit.
Exclusion Criteria:
- absence of hospitalization cost data in the institution's electronic records
Not Provided
Maria DC Otero Rodriguez, BSc
+ 55 11 2661-2407
maria.rodriguez@hc.fm.usp.br
Ednalda M Franck, RN, MSc
+ 55 11 99814-6580
ednalda.franck@hc.fm.usp.br
Ricardo T de Carvalho, MD, PhD, Principal Investigator
University of Sao Paulo General Hospital