[Structure of hospital care for COVID-19 patients up to July 2020 in Germany]

BACKGROUND: Hospitalized coronavirus disease 2019 (COVID-19) patients have a high morbidity and mortality and are often dependent on intensive care, especially mechanical ventilation Little is as yet known about COVID-19 patient allocation OBJECTIVES: Analysis of the structures of German hospital care for COVID-19 patients up to July 2020 in terms of number of beds and previous ventilation experience DATA AND METHODS: For the analysis of the care structures, only completed COVID-19 cases in which the virus was detected by a PCR test were evaluated Claims data from the German Local Health Care Funds (Allgemeine Ortskrankenkassen, AOK) were analysed The sample includes 17,094 COVID-19 cases that were treated in 1082 hospitals RESULTS: A total of 77% of all hospitals participated in the treatment COVID-19 patients and 48% of all hospitals provided intensive care for these patients One half of the hospitals that treated COVID-19 cases cared for 88% of all cases Although this suggests a centralization effect of COVID-19 cases in specific hospitals, the remaining 12% of the cases were distributed among many hospitals with often very small numbers of cases Furthermore, 23% of the ventilated COVID-19 cases were treated in hospitals with below-average ventilation experience CONCLUSIONS: In the context of increasing numbers of infections, it is both necessary to improve the allocation of hospitalized, and therefore potentially ventilated, COVID-19 cases by means of clearly defined and centrally controlled pyramid-type concepts and to continue to care for patients without COVID-19 For Germany, a comprehensive pyramid-type concept with a greater concentration in the best-qualified hospitals seems reasonable for the care of these patients with complex diseases