Preventing litigation with a predictive model of COVID-19 ICUs occupancy

The COVID-19 pandemic has generated an overall slowdown in hospital activities that might lead to delays in healthcare interventions, and the scarcity of resources can raise concerns about ventilators allocation criteria. These circumstances could lead to lawsuits against hospitals and healthcare professionals: together with Regions and States, they may be vulnerable to legal actions, due to the breach of right to health, to physical integrity and right to life, to the manifestation of the informed consent in the medical field or on the basis of contractual or Aquilian obligations. In this context, predicting the litigation rate could be useful to assess the economic impact of a dispute at a local and national level, so that hospital managers and public institutions can perform multi-dimensional and cost/benefit evaluations to decide whether to invest resources to increase critical care surge capacity. In this work we present CLIP (COVID-19 LItigation Prediction), a modeling approach supported by swarm intelligence designed to forecast the occupancy of intensive care units using COVID-19 time-series. CLIP fits a logistic model of COVID-19 patients admission in order to estimate the future number of patients, and then exploits a probabilistic model to predict the number of occupied intensive care beds, whose parameters are calibrated by means of Fuzzy Self-Tuning Particle Swarm Optimization. We assume that each individual rejected from an intensive care unit due to the lack of resources should be considered a potential plaintiff. The development and the availability of such a predictive model, that could further be used within other clinical conditions and important diseases, could help policy-makers in taking decisions under conditions of uncertainty.