{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T03:23:43Z","timestamp":1790220223486,"version":"4.1.0"},"reference-count":31,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2021,10,1]],"date-time":"2021-10-01T00:00:00Z","timestamp":1633046400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Health Security"],"published-print":{"date-parts":[[2021,10,1]]},"abstract":"<jats:p>Before the predicted March 2020 surge of COVID-19, US healthcare organizations were charged with developing resource allocation policies. We assessed policy preparedness and substantive triage criteria within existing policies using a cross-sectional survey distributed to public health personnel and healthcare providers between March 23 and April 23, 2020. Personnel and providers from 68 organizations from 34 US states responded. While half of the organizations did not yet have formal allocation policies, all but 4 were in the process of developing policies. Using manual abstraction and natural language processing, we summarize the origins and features of the policies. Most policies included objective triage criteria, specified inapplicable criteria, separated triage and clinical decision making, detailed reassessment plans, offered an appeals process, and addressed palliative care. All but 1 policy referenced a sequential organ failure assessment score as a triage criterion, and 10 policies categorically excluded patients. Six policies were almost identical, tracing their origins to influenza planning. This sample of policies reflects organizational strategies of exemplar-based policy development and the use of objective criteria in triage decisions, either before or instead of clinical judgment, to support ethical distribution of resources. Future guidance is warranted on how to adapt policies across disease type, choose objective criteria, and specify processes that rely on clinical judgments.<\/jats:p>","DOI":"10.1089\/hs.2020.0166","type":"journal-article","created":{"date-parts":[[2021,6,9]],"date-time":"2021-06-09T20:11:41Z","timestamp":1623269501000},"page":"459-467","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":12,"title":["US Ventilator Allocation and Patient Triage Policies in Anticipation of the COVID-19 Surge"],"prefix":"10.1177","volume":"19","author":[{"given":"Julia S. C.","family":"Chelen","sequence":"first","affiliation":[{"name":"Julia S. C. Chelen, PhD, is a Research Associate; Amanda N. Perry, CCRP is a Research Project Specialist; Maia L. Crawford, MS, is Research Project Manager; and Amber E. Barnato, MD, MPH, MS, FACPM, is a Professor and Director, Health Policy &amp; Clinical Practice; all at The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH. Amber E. Barnato is also Professor of Medicine, Section of Palliative Care, Department of Medicine, Geisel School of Medicine at Dartmouth and Dartmouth-Hitchcock Medical Center, Lebanon, NH. Douglas B. White, MD, MAS, is Vice Chair and Professor of Critical Care Medicine and Director, Program on Ethics and Decision Making in Critical Illness, Department of Critical Care, University of Pittsburgh School of Medicine, Pittsburgh, PA. Stephanie Zaza, MD, MPH, is President, Board of Regents, American College of Preventive Medicine, Washington, DC. Deborah S. Feifer is a Presidential Scholar, Dartmouth College, Hanover, NH. Th..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas B.","family":"White","sequence":"additional","affiliation":[{"name":"Julia S. C. Chelen, PhD, is a Research Associate; Amanda N. Perry, CCRP is a Research Project Specialist; Maia L. Crawford, MS, is Research Project Manager; and Amber E. Barnato, MD, MPH, MS, FACPM, is a Professor and Director, Health Policy &amp; Clinical Practice; all at The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH. Amber E. Barnato is also Professor of Medicine, Section of Palliative Care, Department of Medicine, Geisel School of Medicine at Dartmouth and Dartmouth-Hitchcock Medical Center, Lebanon, NH. Douglas B. White, MD, MAS, is Vice Chair and Professor of Critical Care Medicine and Director, Program on Ethics and Decision Making in Critical Illness, Department of Critical Care, University of Pittsburgh School of Medicine, Pittsburgh, PA. Stephanie Zaza, MD, MPH, is President, Board of Regents, American College of Preventive Medicine, Washington, DC. Deborah S. Feifer is a Presidential Scholar, Dartmouth College, Hanover, NH. Th..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Zaza","sequence":"additional","affiliation":[{"name":"Julia S. C. Chelen, PhD, is a Research Associate; Amanda N. Perry, CCRP is a Research Project Specialist; Maia L. Crawford, MS, is Research Project Manager; and Amber E. Barnato, MD, MPH, MS, FACPM, is a Professor and Director, Health Policy &amp; Clinical Practice; all at The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH. Amber E. Barnato is also Professor of Medicine, Section of Palliative Care, Department of Medicine, Geisel School of Medicine at Dartmouth and Dartmouth-Hitchcock Medical Center, Lebanon, NH. Douglas B. White, MD, MAS, is Vice Chair and Professor of Critical Care Medicine and Director, Program on Ethics and Decision Making in Critical Illness, Department of Critical Care, University of Pittsburgh School of Medicine, Pittsburgh, PA. Stephanie Zaza, MD, MPH, is President, Board of Regents, American College of Preventive Medicine, Washington, DC. Deborah S. Feifer is a Presidential Scholar, Dartmouth College, Hanover, NH. Th..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda N.","family":"Perry","sequence":"additional","affiliation":[{"name":"Julia S. C. Chelen, PhD, is a Research Associate; Amanda N. Perry, CCRP is a Research Project Specialist; Maia L. Crawford, MS, is Research Project Manager; and Amber E. Barnato, MD, MPH, MS, FACPM, is a Professor and Director, Health Policy &amp; Clinical Practice; all at The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH. Amber E. Barnato is also Professor of Medicine, Section of Palliative Care, Department of Medicine, Geisel School of Medicine at Dartmouth and Dartmouth-Hitchcock Medical Center, Lebanon, NH. Douglas B. White, MD, MAS, is Vice Chair and Professor of Critical Care Medicine and Director, Program on Ethics and Decision Making in Critical Illness, Department of Critical Care, University of Pittsburgh School of Medicine, Pittsburgh, PA. Stephanie Zaza, MD, MPH, is President, Board of Regents, American College of Preventive Medicine, Washington, DC. Deborah S. Feifer is a Presidential Scholar, Dartmouth College, Hanover, NH. Th..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah S.","family":"Feifer","sequence":"additional","affiliation":[{"name":"Julia S. C. Chelen, PhD, is a Research Associate; Amanda N. Perry, CCRP is a Research Project Specialist; Maia L. Crawford, MS, is Research Project Manager; and Amber E. Barnato, MD, MPH, MS, FACPM, is a Professor and Director, Health Policy &amp; Clinical Practice; all at The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH. Amber E. Barnato is also Professor of Medicine, Section of Palliative Care, Department of Medicine, Geisel School of Medicine at Dartmouth and Dartmouth-Hitchcock Medical Center, Lebanon, NH. Douglas B. White, MD, MAS, is Vice Chair and Professor of Critical Care Medicine and Director, Program on Ethics and Decision Making in Critical Illness, Department of Critical Care, University of Pittsburgh School of Medicine, Pittsburgh, PA. Stephanie Zaza, MD, MPH, is President, Board of Regents, American College of Preventive Medicine, Washington, DC. Deborah S. Feifer is a Presidential Scholar, Dartmouth College, Hanover, NH. Th..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maia L.","family":"Crawford","sequence":"additional","affiliation":[{"name":"Julia S. C. Chelen, PhD, is a Research Associate; Amanda N. Perry, CCRP is a Research Project Specialist; Maia L. Crawford, MS, is Research Project Manager; and Amber E. Barnato, MD, MPH, MS, FACPM, is a Professor and Director, Health Policy &amp; Clinical Practice; all at The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH. Amber E. Barnato is also Professor of Medicine, Section of Palliative Care, Department of Medicine, Geisel School of Medicine at Dartmouth and Dartmouth-Hitchcock Medical Center, Lebanon, NH. Douglas B. White, MD, MAS, is Vice Chair and Professor of Critical Care Medicine and Director, Program on Ethics and Decision Making in Critical Illness, Department of Critical Care, University of Pittsburgh School of Medicine, Pittsburgh, PA. Stephanie Zaza, MD, MPH, is President, Board of Regents, American College of Preventive Medicine, Washington, DC. Deborah S. Feifer is a Presidential Scholar, Dartmouth College, Hanover, NH. Th..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amber E.","family":"Barnato","sequence":"additional","affiliation":[{"name":"Julia S. C. Chelen, PhD, is a Research Associate; Amanda N. Perry, CCRP is a Research Project Specialist; Maia L. Crawford, MS, is Research Project Manager; and Amber E. Barnato, MD, MPH, MS, FACPM, is a Professor and Director, Health Policy &amp; Clinical Practice; all at The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH. Amber E. Barnato is also Professor of Medicine, Section of Palliative Care, Department of Medicine, Geisel School of Medicine at Dartmouth and Dartmouth-Hitchcock Medical Center, Lebanon, NH. Douglas B. White, MD, MAS, is Vice Chair and Professor of Critical Care Medicine and Director, Program on Ethics and Decision Making in Critical Illness, Department of Critical Care, University of Pittsburgh School of Medicine, Pittsburgh, PA. Stephanie Zaza, MD, MPH, is President, Board of Regents, American College of Preventive Medicine, Washington, DC. Deborah S. Feifer is a Presidential Scholar, Dartmouth College, Hanover, NH. Th..."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,10,12]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1126\/science.abb5793"},{"key":"e_1_3_2_3_2","unstructured":"Fink S. Worst-case estimates for U.S. coronavirus deaths. New York Times. March 13 2020. Updated March 18 2020. Accessed April1 2020. https:\/\/www.nytimes.com\/2020\/03\/13\/us\/coronavirus-deaths-estimate.html"},{"key":"e_1_3_2_4_2","unstructured":"Barbaro M. It's like a war. The Daily. March 17 2020. 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