Saigal Saurabh, Sharma Jai Prakash, Pakhare Abhijit, Bhaskar Santosh, Dhanuka Sanjay, Kumar Sanjay, Sabde Yogesh, Bhattacharya Pradip, Joshi Rajnish
Department of Trauma and Emergency Medicine, AIIMS, Bhopal, Madhya Pradesh, India.
Department of Anaesthesia, AIIMS, Bhopal, Madhya Pradesh, India.
Indian J Crit Care Med. 2017 Oct;21(10):625-633. doi: 10.4103/ijccm.IJCCM_193_17.
In low- and middle-income countries such as India, where health systems are weak, the number of available Critical Care Unit (Intensive Care Unit [ICU]) beds is expected to be low. There is no study from the Indian subcontinent that has reported the characteristics and distribution of existing ICUs. We performed this study to understand the characteristics and distribution of ICUs in Madhya Pradesh (MP) state of Central India. We also aimed to develop a consensus scoring system and internally validate it to define levels of care and to improve health system planning and to strengthen referral networks in the state.
We obtained a list of potential ICU facilities from various sources and then performed a cross-sectional survey by visiting each facility and determining characteristics for each facility. We collected variables with respect to infrastructure, human resources, equipment, support services, procedures performed, training courses conducted, and in-place policies or standard operating procedure documents.
We identified a total of 123 ICUs in MP. Of 123 ICUs, 35 were level 1 facilities, 74 were level 2 facilities, and only 14 were level 3 facilities. Overall, there were 0.17 facilities per 100,000 population (95* confidence interval [CI] 0.14-0.20 per 100,000 populations). There were a total of 1816 ICU beds in the state, with an average of 2.5 beds per 100,000 population (95* CI 2.4-2.6 per 100,000 population). Of the total number of ICU beds, 250 are in level 1, 1141 are in level 2, and 425 are in level 3 facilities. This amounts to 0.34, 1.57, and 0.59 ICU beds per 100,000 population for levels 1, 2, and 3, respectively.
This study could just be an eye opener for our healthcare authorities at both state and national levels to estimate the proportion of ICU beds per lac population. Similar mapping of intensive care services from other States will generate national data that is hitherto unknown.
在印度等中低收入国家，卫生系统薄弱，可用的重症监护病房（重症加强护理病房[ICU]）床位数量预计较低。印度次大陆尚无研究报告现有ICU的特征和分布情况。我们开展这项研究，旨在了解印度中部中央邦（MP）的ICU特征和分布情况。我们还旨在制定一个共识评分系统并进行内部验证，以界定护理级别，改善卫生系统规划，并加强该邦的转诊网络。
我们从各种来源获取了潜在ICU设施的清单，然后通过走访每个设施并确定其特征进行横断面调查。我们收集了有关基础设施、人力资源、设备、支持服务、开展的程序、举办的培训课程以及现行政策或标准操作程序文件等方面的变量。
我们在MP共识别出123个ICU。在这123个ICU中，35个为1级设施，74个为2级设施，只有14个为3级设施。总体而言，每10万人口有0.17个设施（95%置信区间[CI]为每10万人口0.14 - 0.20个）。该邦共有1816张ICU床位，平均每10万人口有2.5张床位（95% CI为每10万人口2.4 - 2.6张）。在ICU床位总数中，1级设施有250张，2级设施有1141张，3级设施有425张。这分别相当于1级、2级和3级设施每10万人口有0.34张、1.57张和0.59张ICU床位。
这项研究可能会让我们邦和国家层面的卫生保健当局大开眼界，以估计每十万人口中ICU床位的比例。对其他邦的重症监护服务进行类似的摸底调查将生成迄今未知的全国数据。
