State coordination centers boost load balancing in healthcare

The formation and utilization of state capacity coordination centers across the U.S. largely ramped up as a result of the COVID-19 pandemic, but continuing their use could benefit the healthcare system, a new report published Dec. 20 in the New England Journal of Medicine found.

The purpose of the centers is to "aggregate capacity data and coordinate patient placement among multiple independent regional hospitals," according to the study authors. During the pandemic, this proved to be helpful for load balancing and improving access to acute care — particularly during surges. 

By partnering with the American Hospital Association, the authors surveyed 44 state-level hospital associations about the presence of state capacity coordination centers and found that 43.2% are currently using the centers for care coordination, and some started to as early as December 2019, before the coronavirus outbreak was declared a pandemic. 

A smaller subset of the survey focused on more comprehensive insights from 12 state coordination centers highlighted that five of the 12 — or 42% — have operated continuously since opening. But others reported only operating during surges. 

Six more notes:

  • On average, state coordination centers receive 3,614 patient placement requests. 
  • The range of placement requests is wide. The lowest number of patient placement requests was 109 for one state coordination center, and the highest had 15,000.
  • Around 63.3% of patient placement requests were successfully fulfilled.

  • Nine of the 12 responding to the more in-depth survey reported disregarding patient insurance status when determining placement. 
  • Seven of the 12 state coordination centers stated that all hospitals in their regions participate in coordination efforts, while the other five stated only some in their region do the same.

  • Two of the 12 had authority to mandate patient placement acceptance. 

"As of the date of response, all respondents with currently operating SCCCs reported intent to continue operations following the COVID-19 pandemic, suggesting that SCCCs may be used to facilitate load balancing during both public health emergencies and routine capacity challenges," the authors wrote.


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