贵州省不同等级医院重症医学科资源情况比较  

Comparison of critical care resources between second-class hospitals and third-class hospitals in Guizhou Province of China

作　　者：刘旭 王迪芬 熊杰 唐艳 程玉梅 陈启敏 Liu Xu;Wang Difen;Xiong Jie;Tang Yan;Cheng Yumei;Chen Qimin(Department of Critical Care Medicine,the Affiliated Hospital of Guizhou Medical University,Guiyang 550004,Guizhou,China;the Quality Control Center of Critical Care Medicine of Guizhou Province,Guiyang 550004,Guizhou,China;Department of Hematology,the Affiliated Hospital of Guizhou Medical University,Guiyang 550004,Guizhou,China)

机构地区：[1]贵州医科大学附属医院重症医学科,贵阳550004 [2]贵州省重症医学质量控制中心,贵阳550004 [3]贵州医科大学附属医院血液科,贵阳550004

出　　处：《中华危重病急救医学》2020年第2期230-234,共5页Chinese Critical Care Medicine

基　　金：国家重点研发计划项目(2018YFC2001904);国家自然科学基金(81701958,81960357);吴阶平医学基金会临床科研专项资助基金项目(320.6750.18001);国家临床重点专科建设项目(2011-170);贵州省临床重点专科建设项目(2011-52)。

摘　　要：目的:了解贵州省不同等级公立医院重症医学科的建设和发展状况,为本省重症医学质量改进及学科建设提供方向和决策依据。方法:通过表格填报和(或)现场调查的方式获取贵州省各级医院重症监护病房(ICU)资源状况,填报时间为2017年5月至2018年2月,现场调查(部分医院)于2018年3月进行。2018年贵州省医院数据从贵州省卫生健康委员会官方网站获取,该数据于2019年11月28日在线发布。对纳入的信息按ICU建设状况、主要设备配置状况和技能开展状况等方面进行归纳分析。结果:本次调查共纳入39家三级医院和77家二级医院,分别占该等级公立医院数的76.5%(39/51)和50.0%(77/154);三级、二级综合医院分别占该等级综合医院的86.8%(33/38)和50.4%(69/137)。在ICU建设状况方面:与二级医院相比,三级医院ICU成立更早〔年:2011(2008,2012)比2013(2011,2015),P<0.01〕,拥有的ICU床位数、医生和护士人数更多〔张:15(11,20)比8(6,10),名:9(8,11)比6(5,7),名:25(20,41)比15(12,19),均P<0.01〕,但ICU医生/床位比、ICU护士/床位比差异均无统计学意义。在ICU设备配置状况方面:与二级医院ICU比较,三级医院ICU有更多的呼吸机和更高的呼吸机/床位比、更多的输液泵及更高的输液泵/床位比、更多的监护仪、胃肠营养泵和单人间,有负压病房的比例更高〔呼吸机(台):14(10,18)比6(4,8),呼吸机/床位比:1.0(0.7,1.1)比0.8(0.6,1.0),输液泵(台):10(6,20)比5(3,8),输液泵/床位比:0.8(0.0,1.0)比0.0(0.0,0.4),监护仪(台):18(13,24)比9(6,12),胃肠营养泵(台):2(1,5)比1(0,3),单人间病房(间):2(1,3)比1(0,3),负压病房:53.8%(21/39)比31.5%(23/73),均P<0.05〕;此外,配备便携式呼吸机、脉搏指示连续心排血量监测仪(PiCCO)、主动脉球囊反搏泵(IABP)、体外膜肺氧合机(ECMO)、B超机、支气管镜、呼气末二氧化碳分压(P ETCO 2)监测设备、脑电图双频指数(BIS)监测仪、床旁胃镜、预防下肢深静Objective To know the critical care resources of the different class-hospitals in Guizhou Province,China,and to provide the direction and evidence for quality improvement and discipline construction of critical care medicine in Guizhou Province.Methods The resource status of the departments of intensive care unit(ICU)in Guizhou Province was obtained through form filling and/or field investigation.The forms were filled and submitted from May 2017 to February 2018,and the field investigation(some of the hospitals)was carried out in March 2018.The data of hospitals in Guizhou Province in 2018,was obtained from the official website of Health Committee of Guizhou Province,which was released online on November 28th,2019.The obtained data were summarized and analyzed according to different aspects such asthe status of ICU construction,main equipment configuration and technology implementation.Results There were 39 third-class hospitals and 77 second-class hospitals included in this study,which accounted for 76.5%(39/51)of third-class public hospitals and 50.0%(77/154)of second-class public hospitals respectively.Among them,there were 86.8%(33/38)of third-class general hospitals and 50.4%(69/137)of second-class general hospitals respectively.In terms of ICU construction,compared with the ICUs of second-class hospitals,the ICUs of third-class hospitals were established earlier[years:2011(2008,2012)vs.2013(2011,2015),P<0.01],had more ICU beds,doctors and nurses[15(11,20)vs.8(6,10),9(8,11)vs.6(5,7),25(20,41)vs.15(12,19),respectively,all P<0.01].However,there were no significant differences regarding the doctor-bed ratio and the nurse-bed ratio in ICUs between second-class hospitals and third-class hospitals.In terms of main equipment configuration,compared with the ICUs of second-class hospitals,the ICUs of third-class hospitals had more ventilators,higher ratio of ventilators to beds,more infusion pumps,higher ratio of infusion pumps to beds,more monitor,gastrointestinal nutrition pumps and single rooms,and higher proporti

关 键 词：重症医学 资源 等级医院 调查 

分 类 号：R197.32[医药卫生—卫生事业管理]