SPECIAL ARTICLE   Open access

Italian Journal of Emergency Medicine 2022 August;11(2):72-82

DOI: 10.23736/S2532-1285.22.00144-6

Copyright © 2022 THE AUTHORS

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language: English

The impact of the province of Lodi containment measures and hospital network reconfiguration on the reduction of mortality in 2020 COVID-19 pandemic outbreak

Stefano PAGLIA ¹, Erminia MASTROSIMONE ², Pietro BISAGNI ³, Mirko DI CAPUA ¹, Sara FORLANI ⁴, Mariano SCOZZAFAVA ⁵, Giulia ACQUISTAPACE ¹, Gianluca RUSSO ⁶, Federico CASTELLONE ⁷, Paolo BERNOCCHI ⁸, Marco ESPOSTI ², Davide RANDAZZO ², Davide GIUSTIVI ¹ ✉

¹ Emergency Department, ASST Lodi, Lodi, Italy; ² Unit of Data Control, ASST Lodi, Lodi, Italy; ³ Department of Surgery, ASST Lodi, Lodi, Italy;4 Unit of Respiratory Rehabilitation, ASST Lodi, Lodi, Italy; ⁵ Unit of Respiratory High Dependency, ASST Lodi, Lodi, Italy; ⁶ Intensive Care Unit, ASST Lodi, Lodi, Italy; ⁷ Unit of Nurse Management, ASST Lodi, Lodi, Italy; ⁸ Unit of Health Management, ASST Lodi, Lodi, Italy

The COVID-19 emergency generated heavy effects on the health systems of countries around the world. The Azienda Socio Sanitaria Territoriale of Lodi (ASST Lodi), including the hospitals of Codogno, Lodi, Casalpusterlengo, and Sant’Angelo Lodigiano, was the first health structure and one of the most involved in a historical phase of absolute uncertainty and lack of regulatory, organizational and scientific references. This led to the need to develop a rapid clinical, managerial and organizational model in all ASST Lodi hospital units that will be called Lodi Model, this has resulted in changes, structural, organizational, and clinical. These changes can be divided into: 1) Emergency Department reorganization; 2) Hospital ward reorganization; 3) structural reorganization; 4) functional clinical workflow; 5) direct connection with the political authorities. In 2020, 79,105 swabs were performed in the whole Lodi area with an 18% of positivity rate. The containment measures carried out in the Lodi area during the first months of 2020, coordinated with the health management, contributed to reversing the mortality trend compared to the rest of the Region as early as March 2020, sooner than elsewhere, and the mortality rate decreased over the entire year of 2020, resulting from the minimum value for the whole region. The new configuration of the Hospital Units and the Emergency Department of the ASST Lodi, together with the early containment measures carried by authorities, determined important results in terms of outcome. In fact, despite the increase of admissions to the Lodi Emergency Department registered in the second half of 2020 is one of the most significant in the Lombardy Region, data show a reduction in hospitalization rate and ED death (13% and 56%, respectively), making Lodi one of the best ASSTs in Lombardy for a reduction in the mortality rate overall.

KEY WORDS: COVID-19; Emergency service, hospital; Mortality