In this work, we analyze the dynamic of patient transfers during the Covid crisis among a group of 14 hospitals that function as a network, in the South East of the Province of Buenos Aires, Argentina (Red Sudeste).

The COVID-19 pandemic placed health systems worldwide in crisis. Many pre-existing health infrastructures had to adapt to its new and changeable conditions. The lack of health personnel and supplies, and the saturation of hospital beds, were some of the effects generated at the beginning of the pandemic. The functioning of hospitals in a network is a common practice that allows the optimization of physical and human resources at critical moments, facilitating the referral of patients of medium and high complexity between the network's hospitals. Within this context, an informatic system built at the beginning of the pandemic to collect, organize, and display information on the use and availability of patient beds in the hospital network helps the Red Sudeste in managing the crisis [1][2], and besides, stored all data on the transfers within the Red Sudeste, that we have later the opportunity to analyze.

Representing the health centers as the nodes, and patient transfers as directed and temporary links between health centers, we study the network's structure change over time. At the same time, we quantify the complexity of the transfers in terms of bed type, clinical risk, and differences between the involved health centers, seeking to understand the functioning of the network at different key moments of the pandemic (first wave, intermediate, second wave and post-vaccination stages). Along the four stages, we can observe that the number of connections of each hospital decreases, from multiple hospitals to only a few for each one, showing patient transfer specification. Moreover, the number of ambulance transfers to distant facilities also reduces, which could be interpreted as increasing transfer efficiency. These could be interpreted as an adaptation of the system.

Currently, our work studies how the adaptation process leads to specification and overall resource saving in the network. A deeper understanding of the adaptation of the system as a whole could improve decision-making in preparation for future emergencies.

[1]  https://www.ic.fcen.uba.ar/institucional/herramientas/hospitales-en-red

[2]  Clinical characteristics of vulnerable populations hospitalized and diagnosed with

COVID-19 in Buenos Aires, Argentina A Yacobitti, et al. Scientific Reports volume 11, 9679 (2021).