Arizona Surge Line: An emergent statewide COVID-19 transfer service with equity as an outcome
IntroductionThe Arizona Surge Line was an emergent initiative during the COVID-19 pandemic to facilitate COVID-19 patient transfers and load-level hospitals on a statewide level. It was designed and implemented by the Arizona Department of Health Services in preparation for the first hospital surge...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-01-01
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| Series: | Frontiers in Public Health |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2022.1028353/full |
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| author | Lisa Villarroel Erin Tams Luke Smith Jessica Rigler Dena Wilson Chengcheng Hu Marilyn K. Glassberg Marilyn K. Glassberg |
| author_facet | Lisa Villarroel Erin Tams Luke Smith Jessica Rigler Dena Wilson Chengcheng Hu Marilyn K. Glassberg Marilyn K. Glassberg |
| author_sort | Lisa Villarroel |
| collection | DOAJ |
| description | IntroductionThe Arizona Surge Line was an emergent initiative during the COVID-19 pandemic to facilitate COVID-19 patient transfers and load-level hospitals on a statewide level. It was designed and implemented by the Arizona Department of Health Services in preparation for the first hospital surge due to COVID-19, recognizing the disproportionate impact that hospital surge would have on rural and tribal populations.MethodsWe analyzed the Arizona Surge Line transfer data for the state's first two COVID-19 surges (4/16/2020–3/6/2021). Transfer data included transfer request characteristics, patient demographics and participating hospital characteristics. When applicable, we compared this data with Arizona census data, COVID-19 case data, and the CDC/ATSDR Social Vulnerability Index. The primary outcomes studied were the proportion of COVID-19 patient requests being successfully transferred, the median transfer time, and the proportion of vulnerable populations impacted.ResultsDuring the period of study, 160 hospitals in Arizona made 6,732 requests for transfer of COVID-19 patients. The majority of these patients (84%, 95% CI: 83–85%) were placed successfully with a median transfer time of 59 min (inter-quartile range 33–116). Of all transfer requests, 58% originated from rural hospitals, 53% were for patients of American Indian/Alaska Native ethnicity, and 73% of patients originated from highly vulnerable areas. The majority (98%) of receiving facilities were in urban areas. The Arizona Surge Line matched the number of transfers with licensed market shares during the period of study.ConclusionsThe Arizona Surge Line is an equity-enhancing initiative that disproportionately benefited vulnerable populations. This statewide transfer infrastructure could become a standard public health mechanism to manage hospital surges and enhance access to care during a health emergency. |
| first_indexed | 2024-04-10T20:29:02Z |
| format | Article |
| id | doaj.art-e3073ae857124d6a859a478256fb2d2d |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-04-10T20:29:02Z |
| publishDate | 2023-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Public Health |
| spelling | doaj.art-e3073ae857124d6a859a478256fb2d2d2023-01-25T07:41:46ZengFrontiers Media S.A.Frontiers in Public Health2296-25652023-01-011010.3389/fpubh.2022.10283531028353Arizona Surge Line: An emergent statewide COVID-19 transfer service with equity as an outcomeLisa Villarroel0Erin Tams1Luke Smith2Jessica Rigler3Dena Wilson4Chengcheng Hu5Marilyn K. Glassberg6Marilyn K. Glassberg7Division of Public Health Preparedness, Arizona Department of Health Services, Phoenix, AZ, United StatesDivision of Public Health Preparedness, Arizona Department of Health Services, Phoenix, AZ, United StatesDivision of Public Health Preparedness, Arizona Department of Health Services, Phoenix, AZ, United StatesDivision of Public Health Preparedness, Arizona Department of Health Services, Phoenix, AZ, United StatesPhoenix Area Indian Health Service, Indian Health Service, Phoenix, AZ, United StatesEpidemiology and Biostatistics, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, AZ, United StatesMedicine/Pulmonary, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, United StatesPulmonary Medicine, Critical Care and Sleep Medicine, Banner-University Medical Center Phoenix, Phoenix, AZ, United StatesIntroductionThe Arizona Surge Line was an emergent initiative during the COVID-19 pandemic to facilitate COVID-19 patient transfers and load-level hospitals on a statewide level. It was designed and implemented by the Arizona Department of Health Services in preparation for the first hospital surge due to COVID-19, recognizing the disproportionate impact that hospital surge would have on rural and tribal populations.MethodsWe analyzed the Arizona Surge Line transfer data for the state's first two COVID-19 surges (4/16/2020–3/6/2021). Transfer data included transfer request characteristics, patient demographics and participating hospital characteristics. When applicable, we compared this data with Arizona census data, COVID-19 case data, and the CDC/ATSDR Social Vulnerability Index. The primary outcomes studied were the proportion of COVID-19 patient requests being successfully transferred, the median transfer time, and the proportion of vulnerable populations impacted.ResultsDuring the period of study, 160 hospitals in Arizona made 6,732 requests for transfer of COVID-19 patients. The majority of these patients (84%, 95% CI: 83–85%) were placed successfully with a median transfer time of 59 min (inter-quartile range 33–116). Of all transfer requests, 58% originated from rural hospitals, 53% were for patients of American Indian/Alaska Native ethnicity, and 73% of patients originated from highly vulnerable areas. The majority (98%) of receiving facilities were in urban areas. The Arizona Surge Line matched the number of transfers with licensed market shares during the period of study.ConclusionsThe Arizona Surge Line is an equity-enhancing initiative that disproportionately benefited vulnerable populations. This statewide transfer infrastructure could become a standard public health mechanism to manage hospital surges and enhance access to care during a health emergency.https://www.frontiersin.org/articles/10.3389/fpubh.2022.1028353/fullsurgeCOVIDload-levelingtransfer centerequityaccess to care |
| spellingShingle | Lisa Villarroel Erin Tams Luke Smith Jessica Rigler Dena Wilson Chengcheng Hu Marilyn K. Glassberg Marilyn K. Glassberg Arizona Surge Line: An emergent statewide COVID-19 transfer service with equity as an outcome Frontiers in Public Health surge COVID load-leveling transfer center equity access to care |
| title | Arizona Surge Line: An emergent statewide COVID-19 transfer service with equity as an outcome |
| title_full | Arizona Surge Line: An emergent statewide COVID-19 transfer service with equity as an outcome |
| title_fullStr | Arizona Surge Line: An emergent statewide COVID-19 transfer service with equity as an outcome |
| title_full_unstemmed | Arizona Surge Line: An emergent statewide COVID-19 transfer service with equity as an outcome |
| title_short | Arizona Surge Line: An emergent statewide COVID-19 transfer service with equity as an outcome |
| title_sort | arizona surge line an emergent statewide covid 19 transfer service with equity as an outcome |
| topic | surge COVID load-leveling transfer center equity access to care |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2022.1028353/full |
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