Radtke J S, Götz J, Gielen S, Fischer F
Fakultät für Gesundheitswissenschaften, Universität Bielefeld, Universitätsstraße 25, 33615, Bielefeld, Deutschland.
Klinikum Lippe-Detmold, Detmold, Deutschland.
Med Klin Intensivmed Notfmed. 2021 May;116(4):322-331. doi: 10.1007/s00063-020-00663-6. Epub 2020 Feb 18.
The increasing number of elderly individuals in the population and the simultaneous increase of the intensive care demand emphasizes the relevance of an efficient bed capacity analysis. Particularly, cardiovascular diseases represent a frequently occurring disease in the population group over 65 years of age. The objective of the following paper is the analysis of the retrospective and prospective intensive care demand by patients over 65 years with 6 selected (cardiovascular) codes of the International Statistical Classification of Diseases and Related Health Problems (ICD-10).
For the retrospective analysis, data from 2015-2017 were analyzed applying descriptive and bivariate methods. The analysis of the intensive care bed demand was based on the queuing theory.
The monthly capacity utilization rates were constantly higher than the target capacity utilization rate of a maximum of 80% and in some cases even higher than 100%. In particular, the demand of patients with I50.14 was very high throughout the entire hospital. The bed demand analysis shows an increase from 9 needed beds in 2017 to 11 beds by 2030 for the 6 diagnosis groups. Regarding the 5 diagnosis groups without I50.14, only approximately half of the required beds were needed, retrospectively and in future.
The effect of demographic change on the intensive care demand already exists, and a continuing, prospective increase of the demand is expected. The results underline the need of effective and demand-oriented intensive care capacity planning. However, prior to expanding bed capacities, the analysis of admission criteria of intensive care unit patients is necessary to reserve capacities primarily for patients with real intensive care needs.
人口中老年人口数量的增加以及重症监护需求的同步增长凸显了有效床位容量分析的重要性。特别是，心血管疾病是65岁以上人群中常见的疾病。本文的目的是分析65岁以上患者使用国际疾病和相关健康问题统计分类（ICD - 10）的6个选定（心血管）编码的回顾性和前瞻性重症监护需求。
对于回顾性分析，采用描述性和双变量方法分析2015 - 2017年的数据。重症监护床位需求分析基于排队论。
每月的床位利用率一直高于最高80%的目标床位利用率，在某些情况下甚至高于100%。特别是，I50.14患者在整个医院的需求都非常高。床位需求分析显示，这6个诊断组所需床位从2017年的9张增加到2030年的11张。对于没有I50.14的5个诊断组，回顾性和未来所需床位仅约为所需床位的一半。
人口结构变化对重症监护需求的影响已经存在，预计需求将持续、前瞻性地增加。结果强调了有效且以需求为导向的重症监护容量规划的必要性。然而，在扩大床位容量之前，有必要分析重症监护病房患者的入院标准，以便主要为有实际重症监护需求的患者保留床位。
