Friday, January 20, 2023
SARS-COV-2 in French Hospitals, 2021-2022 continued
In my previous summary of quarterly statistics for 2021 and 2022 (yesterday) we were left with a question: why were discharges to go home so much higher in 2022-Q1 when patient-days were not so different from those in 2021-Q1?
To get some clues, I looked at the same statistics for each of the ten age brackets commonly reported. However, I did not fetch datasets of thousands of numbers (730 days x 10 brackets per statistic), I used data I had already fetched and formatted with snapshots each Friday. The "discharged to return home" should be very close, varying from the all-patients only because my Fridays may not align perfectly with the quarter boundaries, and some (few) cases may lack age data so be missing from my figures. To get a rough estimate of duration of hospitalisations I need number of patient-days; that is where the lack of daily data may make a difference. I summed the thirteen Friday levels of each quarter and multiplied by 7, as if each level applied to every day of its week. The results are quite close to the totals in the previous post, certainly good enough for the heavily-rounded duration estimates.
discharges by age
group 2021-Q1 2022-Q1 '22 vs '21
--------- -------- -------- ---------
0-9 ans 568 9,323 +1541 %
10-19 878 4,265 + 386 %
20-29 2,805 9,478 + 238 %
30-39 4,727 12,089 + 156 %
40-49 6,959 8,490 + 22 %
50-59 12,671 12,001 - 5 %
60-69 17,398 17,734 + 2 %
70-79 21,345 23,207 + 9 %
80-89 24,166 28,175 + 17 %
90 et plus 11,262 14,620 + 30 %
Observation: much of the increase year-on-year is indeed due to more younger patients.
Does stay duration vary by age?
group 2022-Q1
-------- ---------
0-9 ans <4 days
10-19 <7 days
20-29 6 days
30-39 <7 days
40-49 11 days
50-59 16 days
60-69 20 days
70-79 22 days
80-89 22 days
90 et plus 22 days
Estimation made by dividing patient-days by number of patients discharged in the quarter.
This does change from quarter to quarter, but the progression from shortest for youngest to longest for oldest remains stable--except some slightly too-high figures for the 10-19 year old bracket during the last three quarters. That teen group is the least-present, so perhaps the longer stays are because only exceptionally ill teens are involved.
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Thursday, January 19, 2023
SARS-COV-2 Hospitalisation Activity in France, 2021-2022
As 2022 came to a close, I believe it was not generally known how much Covid-19 was (and is) still occupying French hospitals after the "crisis" was declared over from 1 August 2022. Most people, it seems, have ceased trying to prevent contagion, and contagion happens, sometimes to vulnerable people who end up in the hospital (if they are lucky).
I have been tracking a few daily statistics on number of Covid-19 hospital patients and producing a few plots so I was aware that the troughs between the peaks have been shallow --number of patients never gets very low -- since November 2021. On the other hand, ICU occupancy is lower. We'll also look at deaths and a couple of back-of-the-envelope indicators.
First, some definitions:
- hospital patient-days: for one day, the number of patients on that day; for longer periods, the sum of the patient counts. Think of it as the number of nights a hotel would invoice at a per-bed rate.
- ICU patient-days: analog for ICU patient counts.
- Number discharged to go home: a cumulative count from a fixed start date; number within a period is the difference between the count on the day before the start and the last count.
- Deaths: also a cumulative count from a fixed start date, same usage as discharges.
The data I used are from geodes.santepubliquefrance.fr.
Hospital Patient-days (quarterly)
Hospital
Patient-days
2021-Q1 2,334,547
2021-Q2 1,968,283
2021-Q3 809,762
2021-Q4 895,495
2022-Q1 2,301,857 -1,40 %
2022-Q2 1,736,947 -11,75 %
2022-Q3 1,525,883 +88,44 %
2022-Q4 1,841,350 +105,62 %
Observation: there really is a lot more Covid in the hospitals in the second half of 2022.
ICU Patient-days (quarterly)
ICU Patient-days
2021-Q1 311,976
2021-Q2 363,445
2021-Q3 145,860
2021-Q4 160,337
2022-Q1 261,587 -16,15 %
2022-Q2 112,307 -69,10 %
2022-Q3 89,380 -38,72 %
2022-Q4 101,018 -37,00 %
Observation: After the first Omicron surge in Q1, much less use of ICU, notable compared to the huge rise in the number of patients.
Deaths (in hospital)
Hospital Deaths
2021-Q1 25,156
2021-Q2 14,214
2021-Q3 5,205
2021-Q4 6,739
2022-Q1 17,174 -31.7 %
2022-Q2 6,755 -52.5 %
2022-Q3 5,251 + 0.9 %
2022-Q4 6,459 - 4.2 %
Observation: much better outcomes than in 2021 in the first half of the year, and no worse in the second half despite much higher occupancy and less use of ICU.
Discharges to go Home
Hospital Discharges
2021-Q1 102,781
2021-Q2 84,751
2021-Q3 36,390
2021-Q4 39,680
2022-Q1 139,382 +35.6 %
2022-Q2 79,362 - 7.3 %
2022-Q3 65,578 +80.2 %
2022-Q4 75,582 +90.5 %
Observation: The Q1 2022 performance needs some explaining. I suspect it is due to shorter stays, but I don't know why that would have been the case. Milder Omicron? Younger patients?
Hospital Stay Length
I know from some other tracking I do by age bracket weekly that younger patients "turn over" faster, and apparent stay duration appear to increase with age. I don't think I can readily check the age mix effect in 2022-Q1, however.
What I can propose is a rough calculation --rough because it supposes negligible changes to opening and closing counts--as follows:
- consider discharges + deaths as the number of patients whose occupancies are counted in patient-days
- divide patient-days by this number to get an average stay duration
2021-Q1 18
2021-Q2 19
2021-Q3 19
2021-Q4 19
2022-Q1 14
2022-Q2 20
2022-Q3 21
2022-Q4 22
It does not answer the question of why, what happened, it just presents it differently. I'll see what I can find and post it if I can.
Tags: :Covid-19, France, 2022, hospitals
