Department of Family Medicine, School of Nursing and Public Health, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
S Afr Med J. 2013 Sep 3;103(10):751-3. doi: 10.7196/samj.6415.
To determine the national distribution of intensive care unit (ICU)/high care (HC) beds and the implications for ICU bed availability in the envisaged national health insurance (NHI) scheme.
A descriptive, non-interventional, observational study design was used. A desk-top audit of all public and private sector ICUs, including ICU/HC beds, in South Africa was undertaken for the period 2008 - 2009. For this study, both categories were analysed and referred to as ICU beds, as they reflect the critical care component of the health service in South Africa.
In 2008 - 2009, there were 4 719 ICU beds in the private and public sectors in South Africa, with 75% (3 533) in the former and 25% (1 186) in the latter. The majority of ICU beds in the two sectors were located in three provinces: Gauteng (49%), KwaZulu-Natal (14%) and Western Cape (15%), representing 78% of ICU beds (3 703/4 719) and catering for 54% of the country's population. Eastern Cape had fewer than 300 beds, North West and Mpumalanga had fewer than 150 beds, and Limpopo and Northern Cape had 66 and 47 beds respectively. With the proposed NHI scheme, the number of ICU beds available would be 4 719, which would translate into a bed:population ratio of approximately 1:10 000. However, there are large variations across the provinces, which makes the availability of this level of care in some provinces non-existent.
While increasing the number of ICU beds in the public sector will open critical care services to more users, the NHI scheme would not solve the huge discrepancies of access to ICUs, and availability of critical care staff, across the provinces.
确定重症监护病房（ICU）/高护病房（HC）床位在全国的分布情况，以及这些床位对拟议中的全民健康保险（NHI）计划中 ICU 床位可用性的影响。
本研究采用描述性、非干预性、观察性研究设计。对南非所有公立和私立部门的 ICU 进行了桌面审查，包括 ICU/HC 床位，审查时间为 2008-2009 年。在这项研究中，这两个类别都进行了分析，并被称为 ICU 床位，因为它们反映了南非卫生服务的重症护理部分。
2008-2009 年，南非私立和公立部门共有 4719 张 ICU 床位，其中 75%（3533 张）在前者，25%（1186 张）在后者。两个部门的大多数 ICU 床位都位于三个省份：豪登省（49%）、夸祖鲁-纳塔尔省（14%）和西开普省（15%），占 ICU 床位的 78%（3703/4719），为全国 54%的人口提供服务。东开普省的床位不足 300 张，西北省和姆普马兰加省的床位不足 150 张，林波波省和北开普省分别有 66 张和 47 张。按照拟议中的 NHI 计划，可用的 ICU 床位将达到 4719 张，这将转化为每 10000 人约 1 张床位的比例。然而，各省之间存在很大差异，使得一些省份根本无法提供这种级别的护理。
虽然增加公立部门的 ICU 床位数量将使更多的患者能够获得重症护理服务，但 NHI 计划并不能解决各省之间 ICU 获得率和重症护理人员可用性方面的巨大差异。
