COVID-19 - 巴西在大流行开始时的 ICU 床位供应情况。
COVID-19 - The Availability of ICU Beds in Brazil during the Onset of Pandemic.
机构信息
Laboratory of Cell and Molecular Tumor Biology and Bioactive Compounds, São Francisco University, Bragança Paulista, São Paulo, BR.
Laboratory of Human and Medical Genetics, São Francisco University, Bragança Paulista, São Paulo, BR.
出版信息
Ann Glob Health. 2020 Aug 13;86(1):100. doi: 10.5334/aogh.3025.
BACKGROUND
Brazil faces some challenges in the battle against the COVID-19 pandemic, including: the risks for cross-infection (community infection) increase in densely populated areas; low access to health services in areas where the number of beds in intensive care units (ICUs) is scarce and poorly distributed, mainly in states with low population density.
OBJECTIVE
To describe and intercorrelate epidemiology and geographic data from Brazil about the number of intensive care unit (ICU) beds at the onset of COVID-19 pandemic.
METHODS
The epidemiology and geographic data were correlated with the distribution of ICU beds (public and private health systems) and the number of beneficiaries of private health insurance using Pearson's Correlation Coefficient. The same data were correlated using partial correlation controlled by gross domestic product (GDP) and number of beneficiaries of private health insurance.
FINDINGS
Brazil has a large geographical area and diverse demographic and economic aspects. This diversity is also present in the states and the Federal District regarding the number of COVID-19 cases, deaths and case fatality rate. The effective management of severe COVID-19 patients requires ICU services, and the scenario was also dissimilar as for ICU beds and ICU beds/10,000 inhabitants for the public (SUS) and private health systems mainly at the onset of COVID-19 pandemic. The distribution of ICUs was uneven between public and private services, and most patients rely on SUS, which had the lowest number of ICU beds. In only a few states, the number of ICU beds at SUS was above 1 to 3 by 10,000 inhabitants, which is the number recommended by the World Health Organization (WHO).
CONCLUSIONS
Brazil needed to improve the number of ICU beds units to deal with COVID-19 pandemic, mainly for the SUS showing a late involvement of government and health authorities to deal with the COVID-19 pandemic.
背景
巴西在抗击 COVID-19 大流行的过程中面临一些挑战，包括：人口稠密地区的交叉感染（社区感染）风险增加；在重症监护病房（ICU）床位数量稀少且分布不均的卫生服务获取率低的地区，主要是在人口密度较低的州。
目的
描述和相互关联巴西 COVID-19 大流行开始时 ICU 床位的流行病学和地理数据。
方法
使用 Pearson 相关系数将流行病学和地理数据与 ICU 床位（公共和私人卫生系统）的分布以及私人医疗保险受益人数相关联。使用 GDP 和私人医疗保险受益人数控制的偏相关对相同数据进行了关联。
结果
巴西地域辽阔，人口、经济等方面的差异也很大。在 COVID-19 病例、死亡人数和病死率方面，各州和联邦区也存在差异。重症 COVID-19 患者的有效管理需要 ICU 服务，因此 ICU 床位和 ICU 床位/每 10000 居民数量在公共（SUS）和私人卫生系统中的情况也大不相同，这主要是在 COVID-19 大流行开始时。公共和私人服务之间 ICU 的分布不均，大多数患者依赖 SUS，而 SUS 的 ICU 床位数量最少。在只有少数几个州，SUS 的 ICU 床位数量超过每 10000 居民 1 到 3 个，这是世界卫生组织（WHO）推荐的数量。
结论
巴西需要增加 ICU 床位数量来应对 COVID-19 大流行，主要是为了 SUS，这表明政府和卫生当局在应对 COVID-19 大流行方面的参与较晚。
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