April 2020 multi-principle allocation framework for scarce intensive care unit beds and ventilators
| Principle | Criterion | Point system | |||
| +1 | +2 | +3 | +4 | ||
| Promote population health outcomes | Prognosis for hospital survival (using a risk prediction score score) |
Quartile 1
lowest risk of death (ie, risk of death <25%) |
Quartile 2
(ie, risk of death 25%–49%) |
Quartile 3
(ie, risk of death 50%–75%) |
Quartile 4
highest risk of death (ie, risk of death >75%) |
| Prognosis for near-term survival (individualised clinical judgment) | – |
Death expected in
1–5 years | – |
Death expected within 1 year from end stage
condition | |
| Promote justice/equity | Priority to frontline essential workers | Subtract one point from Triage Priority Score if the patient is an essential worker in a high-risk occupation.* | |||
| Priority to those who have had the least chance to live through life’s stages | Tiebreaker: In the event that two patients have identical Triage Priority Scores, give priority to the younger patient when a significant age difference exists. | ||||
| Equal chances | Second tiebreaker: In the event that two patients have identical Triage Priority Scores and are of similar ages, use random selection to determine who receives the resource. | ||||
*This equity-focused criterion could also be operationalized as a tiebreaker.