河南省县级综合医院ICU现状调查  

Study on present status of ICU in county-level general hospitals of Henan Province

作　　者：常小婉 秦秉玉 梁新亮 胡现增 王守振 叶英军 杨永光 王月波 Chang Xiaowan;Qin Bingyu;Liang Xinliang;Hu Xianzeng;Wang Shouzhen;Ye Yingjun;Yang Yongguang;Wang Yuebo(People's Hospital of Henan Province,Zhengzhou University People's Hospital,Henan University People's Hospital,Zhengzhou 450003,Henan,China;Ruzhou First People's Hospital,Ruzhou 467500,Henan,China;Dengzhou Central Hospital,Dengzhou 474100,Henan,China;Ye County People's Hospital,Pingdingshan 467200,Henan,China)

机构地区：[1]河南省人民医院,郑州大学人民医院,河南大学人民医院,郑州450003 [2]汝州市第一人民医院,河南汝州467500 [3]邓州市中心医院,河南邓州474100 [4]叶县人民医院,河南平顶山467200

出　　处：《中华危重病急救医学》2020年第12期1511-1516,共6页Chinese Critical Care Medicine

基　　金：河南省软科学研究计划项目(132400410123,182400410172);河南科技智库调研课题(HNKJZK-2020-57C)。

摘　　要：目的调查河南省县级综合医院重症医学科的建设现状,为提高重症医学科建设水平和医疗资源合理配置提供依据。方法依据原卫生部印发的《重症医学科建设与管理指南(试行)》(下文简称"指南"),采用自行设计的医院重症医学科现状调查问卷,对河南省93家县级综合医院2018年重症监护病房(ICU)运行现状进行横断面调查,调查内容包括ICU基本情况(成立时间、组织管理模式、专科ICU开展情况、重点学科建设)、ICU规模及人员配置和人才培养、ICU设备及技术开展情况。结果ICU基本情况方面:首先是ICU成立时间,河南省县级综合医院ICU起步较晚,被调查的93家医院均设置了ICU,其中成立最早的是1989年浚县人民医院ICU,2000年之前成立ICU的县级综合医院仅有4家,2009年前有34家;其次是ICU组织管理模式,本次调查显示,河南省县级综合医院ICU实行封闭管理的比例为68.82%(64/93),半开放管理的比例为18.28%(17/93),仍有12.90%(12/93)的医院采取开放管理模式;再次是专科ICU开展与重点学科建设,本次调查显示,86家医院开放了综合ICU,专科ICU开放比例较高的是新生儿ICU、急诊ICU和冠心病监护室(CCU);8家医院ICU是河南省卫生健康委员会(卫健委)重点学科,9家医院ICU是地级市卫健委重点学科。ICU规模及人员配置方面:本次调查的93家县级综合医院共开放ICU床位2189张,ICU床位使用率和ICU每床位使用面积达标率较高,分别为76.34%、80.64%,而ICU医师数/ICU床位数、ICU护士数/ICU床位数达标率低,分别为8.60%和7.52%,说明医护配备不足。被调查医院包含三级医院1家、二级甲等医院76家、二级乙等医院16家,二级甲等医院总床位数(张:922.22±285.99比636.75±258.84)、ICU床位数(张:25.28±21.15比14.63±6.89)均明显多于二级乙等医院(均P<0.01),床位使用达标率明显高于二级乙等医院〔81.6%(62/76)比50.0%(8/16),P<0.01〕;人员配置上,ICU医生�Objective To investigate the present status of intensive care unit(ICU)in the county-level general hospitals of Henan Province and provide basis for improving the construction level and rational allocation of medical resources of ICU.Methods According to The guidelines for the construction and management of critical care medicine(trial implementation)issued by National Health Commission(NHC)(hereinafter referred as the guidelines),a cross-sectional survey was conducted on the present status of ICU in 93 county-level general hospitals in Henan Province in 2018 by using a self-designed questionnaire concerning this topic.The survey included the basic information of ICU(establishment time,organization and management mode,development of special departments in ICU,construction of key disciplines),scale and staffing allocation and training,and the equipment and technology development situation in ICU.Results The basic aspects of ICU situation were as follows:firstly,the establishment time:the ICU of county-level general hospitals in Henan Province started relatively late.The survey showed that all the 93 hospitals had set up ICU,of which the earliest was the ICU of Xunxian People's Hospital in 1989,only 4 county-level general hospitals established their ICUs before 2000,and 34 before 2009.Secondly,the management mode:the proportion of ICU closely managed was accounting for 68.82%(64/93),while semi-open management was 18.28%(17/93),and 12.90%(12/93)hospitals still adopted the open management mode.Thirdly,development of specialized ICU and construction of key disciplines:comprehensive ICUs were founded in 86 hospitals,and the proportions of specialized ICUs such as neonatal ICU,emergency ICU and coronary heart disease care unit(CCU)were higher than other kinds of special department;the ICUs of 8 hospitals were the key discipline of Henan Provincial Health Commission,and the ICUs of 9 hospitals were the discipline of Municipal Health Commission.Scale and staffing of ICU:a total of 2189 ICU beds were opened in 93 county-le

关 键 词：河南省 县级医院 重症监护病房 

分 类 号：R197.323[医药卫生—卫生事业管理]