The Department of Health (DOH) said on Monday, April 19, it would add the bed occupancy of hospitals’ emergency departments as an indicator in keeping track of the health system’s capacity to treat coronavirus patients. 

Health Undersecretary Maria Rosario Vergeire told reporters the number would form part of the figures the country would monitor when watching the healthcare utilization rate, a critical statistic government officials use when deciding whether to tighten quarantine restrictions in certain places.

“Maybe give us one to two weeks and we will be able to report this already,” Vergeire said in a virtual press briefing.

The healthcare utilization rate currently reflects the percentage of COVID-19 ward beds, isolation beds, critical care beds, and mechanical ventilators that are being used from level 1 to level 3 health facilities in a city or province at the time. It does not yet include the number of beds in emergency departments being used by patients who were waiting to be properly admitted for COVID-19. 

Vergerie added that emergency department numbers were being tracked internally for now, after the DOH had a meeting with the Philippine College of Emergency Medicine (PCEM).

Rappler earlier reported last April 12 that at least 310 COVID-19 patients needing hospital care were still waiting for beds in the emergency department of at least 14 hospitals in Metro Manila – the center of the pandemic in the country – and Cavite. 

The 14 hospitals, though just a fraction of the 159 health facilities in the region and a neighboring province, highlighted the strain under which public and private hospitals operate as infections have yet to significantly decline.

PCEM President Dr Pauline Convocar earlier told Rappler the waiting time of patients to get a bed after entering the emergency department could span anywhere from “days to weeks.” 

Why this matters

Health experts and emergency medicine specialists have been pushing for such figures to be included in the DOH’s public tracker. They pointed out that during the current surge in cases and last peak in infections the Philippines saw in July to August 2020, emergency departments were among the first to feel the wave of patients seeking care in high level facilities. 

Convocar earlier said occupancy in emergency department was a sensitive number that could also help to reflect 3 things in the state of the health system: demand of patients seeking care, supply or space in other parts of hospital where patients need to be admitted, and efficiency of referral systems among hospitals. 

Since cases quickly increased in the past few weeks, many Filipinos have flooded emergency departments while hundreds of other patients were left with no choice but wait in line, hoping to seek treatment in overcrowded hospitals. 

What the DOH is doing 

To add the new figure in its tracker, Vergeire said the DOH was studying with emergency medicine specialists how best to come up with standard reporting methods of bed occupancy in emergency departments across the Philippines. 

Among the challenges in doing this, Vergeire added, was changing “modules” the DOH used when inputting data into its system used by hospitals to report statistics and used by officials to track and share the healthcare utilization rate. 

It was also studying several factors that could affect the reporting of bed occupancy in emergency departments in different hospitals, Vergeire said.

“We need to know what [beds] are for COVID-19 and what is for non-COVID. We also need to know the base requirement – how many beds in emergency department have been declared  for covid, how many for non-covid, how many have you extended where you might have a tent for triaging and all,” she said in Filipino. 

“We need to study what will be the standard we will employ in hospitals so that we know the measurement will be comparable,” she added. 

But for now, the DOH has started to keep track of emergency department figures internally. “From the time we started talking to the emergency medicine group, we have had these internal reports coming from our hospitals,” Vergeire said. – Rappler.com