Sandmann F G, Jit M, Robotham J V, Deeny S R
Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK; Modelling and Economics Unit, Public Health England, London, UK.
Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK; Modelling and Economics Unit, Public Health England, London, UK.
J Hosp Infect. 2017 Sep;97(1):79-85. doi: 10.1016/j.jhin.2017.05.015. Epub 2017 May 25.
Bed closures due to acute gastroenteritis put hospitals under pressure each winter. In England, the National Health Service (NHS) has monitored the winter situation for all acute trusts since 2010/11.
To estimate the burden, duration and costs of hospital bed closures due to acute gastroenteritis in winter.
A retrospective analysis of routinely collected time-series data of bed closures due to diarrhoea and vomiting was conducted for the winters 2010/11 to 2015/16. Two key issues were addressed by imputing non-randomly missing values at provider level, and filtering observations to a range of dates recorded in all six winters. The lowest and highest values imputed were taken to represent the best- and worst-case scenarios. Bed-days were costed using NHS reference costs, and potential staff absence costs were based on previous studies.
In the best-to-worst case, a median of 88,000-113,000 beds were closed due to gastroenteritis each winter. Of these, 19.6-20.4% were unoccupied. On average, 80% of providers were affected, and had closed beds for a median of 15-21 days each winter. Hospital costs of closed beds were £5.7-£7.5 million, which increased to £6.9-£10.0 million when including staff absence costs due to illness.
The median number of hospital beds closed due to acute gastroenteritis per winter was equivalent to all general and acute hospital beds in England being unavailable for a median of 0.88-1.12 days. Costs for hospitals are high but vary with closures each winter.
每年冬天，因急性肠胃炎导致的病床关闭给医院带来压力。在英格兰，自2010/11年度以来，国民医疗服务体系（NHS）一直在监测所有急性信托机构的冬季情况。
估计冬季因急性肠胃炎导致的医院病床关闭的负担、持续时间和成本。
对2010/11年度至2015/16年度冬季因腹泻和呕吐导致的病床关闭的常规收集时间序列数据进行回顾性分析。通过在提供者层面非随机插补缺失值以及将观察值过滤到所有六个冬季记录的一系列日期，解决了两个关键问题。插补的最低值和最高值分别代表最佳和最坏情况。使用NHS参考成本计算病床日成本，潜在的员工缺勤成本基于先前的研究。
在最佳至最坏情况下，每年冬天因肠胃炎关闭的病床中位数为88,000 - 113,000张。其中，19.6 - 20.4%为空床。平均而言，80%的提供者受到影响，每个冬天关闭病床的中位数为15 - 21天。关闭病床的医院成本为570万 - 750万英镑，包括因病导致的员工缺勤成本后增至690万 - 1000万英镑。
每年冬天因急性肠胃炎关闭的医院病床中位数相当于英格兰所有综合和急性医院病床中位数有0.88 - 1.12天无法使用。医院成本很高，但每年冬天会因关闭情况而有所不同。
