DeLia Derek
Center for State Health Policy, The Institute for Health, Health Care Policy, and Aging Research, Rutgers, The State University, New Brunswick, NJ 08901-1340, USA.
Ann Emerg Med. 2006 Oct;48(4):384-8, 388.e1-2. doi: 10.1016/j.annemergmed.2006.01.024. Epub 2006 Feb 28.
I describe how annual hospital surge capacity is affected by within-year variation in patient volume and bed supply.
Surge capacity was measured as the percentage and total number of hospital beds that are not occupied by patients. Administrative data were used to calculate these bed statistics for 78 hospitals in New Jersey--statewide and by emergency planning regions--in 2003. Annual bed statistics were compared to more refined calculations for each day of the year. Calculated numbers of empty beds were compared to federal disaster planning benchmarks.
Annual bed statistics showed no major limitations on surge capacity. Statewide occupancy rates were well below 80% (ie, more than 20% of beds were empty), and the number of empty beds that were set up and staffed (ie, maintained) was well above federal disaster planning benchmarks. In contrast, daily bed statistics reveal long periods in 2003 when regional and statewide surge capacity was severely strained. Strained capacity was most likely to occur on Tuesdays through Fridays and least likely to occur on weekends. On 212 days, statewide occupancy of maintained beds met or exceeded 85%. This occupancy rate met or exceeded 90% and 95% on 88 and 4 days, respectively. On 288 days, the statewide number of empty maintained beds fell below the federal planning benchmark.
Annual bed statistics give a misleading picture of hospital surge capacity. Analysis of surge capacity should account for daily variation in patient volume and within-year variation in bed supply.
我描述了年内患者数量和床位供应的变化如何影响医院的年度应急能力。
应急能力通过未被患者占用的医院床位百分比和总数来衡量。利用行政数据计算了2003年新泽西州78家医院（全州范围以及按应急规划区域划分）的这些床位统计数据。将年度床位统计数据与一年中每一天的更精确计算结果进行比较。将计算出的空床数量与联邦灾难规划基准进行比较。
年度床位统计数据显示应急能力没有重大限制。全州的占用率远低于80%（即超过20%的床位为空），已设置并配备人员（即维持状态）的空床数量远高于联邦灾难规划基准。相比之下，每日床位统计数据显示，2003年有很长一段时间区域和全州的应急能力都受到严重压力。压力最有可能出现在周二至周五，最不可能出现在周末。在212天里，全州维持状态床位的占用率达到或超过了85%。该占用率分别在88天和4天达到或超过了90%和95%。在288天里，全州维持状态的空床数量低于联邦规划基准。
年度床位统计数据对医院应急能力给出了误导性的描述。对应急能力的分析应考虑患者数量的每日变化和床位供应的年内变化。
