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一种确定重症监护病房床位需求的通用方法。

A universal method for determining intensive care unit bed requirements.

作者信息

Nguyen J M, Six P, Parisot R, Antonioli D, Nicolas F, Lombrail P

机构信息

PIMESP, Hospital St. Jacques, CHU Nantes, 44093 Nantes Cedex 01, France.

出版信息

Intensive Care Med. 2003 May;29(5):849-52. doi: 10.1007/s00134-003-1725-z. Epub 2003 Mar 27.

Abstract

OBJECTIVE

Most methods used to estimate ICU bed needs rely either on simple formulas that do not consider the actual needs of the population or on simulations that are too specific to be applicable to all hospitals. We sought to develop a universally applicable nonparametric method.

DESIGN AND SETTING

For each day, the number of immediate patient transfers to other ICUs because of a full unit and the number of patients treated in the ICU were collected. The number of beds needed was selected according to the minimization of both the mean and the variance of three parameters (accessibility, safety, and efficiency). This method was applied to the ICU of a general hospital. Robustness of the model was assessed using outliers.

MAIN RESULTS

During the 5-month study period, 215 ICU stays were collected. The method selected a ten-bed model whereas length-of-stay ratio and case-mix methods selected a twelve- and height-bed models respectively. An unusual increase in admission requests had no consequence on the bed number selected, indicating that the method was robust. None of the parameters were dependent on specific ICU characteristics, establishing that this method is applicable to any type of hospital ward.

CONCLUSION

Our model is reliable for determining the number of beds needed in any type of ICU and can be used by all ICU managers. The software is available.

摘要

目的

大多数用于估算重症监护病房(ICU)床位需求的方法,要么依赖于不考虑人群实际需求的简单公式,要么基于过于特定而无法适用于所有医院的模拟。我们试图开发一种普遍适用的非参数方法。

设计与设置

每天收集因病房满员而立即转至其他ICU的患者数量以及在该ICU接受治疗的患者数量。根据三个参数(可达性、安全性和效率)的均值和方差最小化来选择所需床位数。该方法应用于一家综合医院的ICU。使用异常值评估模型的稳健性。

主要结果

在为期5个月的研究期间,共收集到215例ICU住院病例。该方法选择了一个10张床位的模型,而住院时间比法和病例组合法分别选择了12张和8张床位的模型。入院需求的异常增加对所选床位数没有影响,表明该方法具有稳健性。没有任何参数依赖于特定的ICU特征,这表明该方法适用于任何类型的医院病房。

结论

我们的模型对于确定任何类型ICU所需的床位数是可靠的,并且可供所有ICU管理人员使用。该软件可供使用。

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