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纽约市一家大型学术医疗中心在 COVID-19 大流行期间内科住院医师的缺勤情况。

Internal Medicine Resident Work Absence During the COVID-19 Pandemic at a Large Academic Medical Center in New York City.

机构信息

Chief Resident, Moses/Weiler Internal Medicine Residency, Albert Einstein College of Medicine and Montefiore Medical Center.

Instructor, Department of Ecology, Evolution, and Natural Resources, Rutgers University.

出版信息

J Grad Med Educ. 2020 Dec;12(6):682-685. doi: 10.4300/JGME-D-20-00657.1. Epub 2020 Oct 20.

Abstract

BACKGROUND

Montefiore Medical Center (MMC) is a large tertiary care center in the Bronx, New York City, with 245 internal medicine residents. Beginning on February 29, 2020, residents became ill with COVID-19-like illness (CLI), which required absence from work. There was initially a shortage of personal protective equipment and delays in SARS-CoV-2 testing, which gradually improved during March and April 2020.

OBJECTIVE

We evaluated the relationship between CLI-related work absence rates of internal medicine residents and MMC's COVID-19 hospital census over time.

METHODS

Data on resident work absence between February 29 and May 22 were reviewed along with MMC's COVID-19 hospital census data. To determine the effect of patient exposure on resident CLI incidence, we compared the mean incidence of CLI per patient exposure days (PED = daily hospital census × days pre- or post-peak) before and after peak COVID-19 hospital census.

RESULTS

Forty-two percent (103 of 245) of internal medicine residents were absent from work, resulting in 875 missed workdays. At the peak of resident work absence, 16% (38 of 245) were out sick. Residents were absent for a median of 7 days (IQR 6-9.5 days). Mean resident CLI incidence per PED (CLI/PED) was 13.9-fold lower post-peak compared to pre-peak ( = .003).

CONCLUSIONS

At the beginning of the COVID-19 pandemic in New York City, a large portion of internal medicine residents at this single center became ill. However, the incidence of CLI decreased over time, despite ongoing exposure to patients with COVID-19.

摘要

背景

蒙特菲奥雷医疗中心(MMC)是纽约市布朗克斯区的一家大型三级保健中心,拥有 245 名内科住院医师。从 2020 年 2 月 29 日开始,住院医师出现了类似 COVID-19 的疾病(CLI),需要缺勤。最初个人防护设备短缺,SARS-CoV-2 检测延迟,这些情况在 2020 年 3 月和 4 月逐渐得到改善。

目的

我们评估了内科住院医师 CLI 相关缺勤率与 MMC 新冠肺炎住院患者人数随时间的变化关系。

方法

我们查阅了 2 月 29 日至 5 月 22 日期间住院医师缺勤数据以及 MMC 的新冠肺炎住院患者人数数据。为了确定患者接触对住院医师 CLI 发病率的影响,我们比较了 COVID-19 住院患者人数达到高峰前后,每单位患者接触日(PED=每日住院患者人数×高峰前后的日数)的 CLI 平均发病率。

结果

245 名内科住院医师中有 42%(103 人)缺勤,导致 875 个工作日缺勤。在住院医师缺勤的高峰期,有 16%(38 人)因病缺勤。住院医师的平均缺勤时间为 7 天(IQR 6-9.5 天)。与高峰前相比,高峰后每单位 PED 的住院医师 CLI 发病率(CLI/PED)降低了 13.9 倍( =.003)。

结论

在纽约市 COVID-19 大流行开始时,该中心的大量内科住院医师患病。然而,尽管持续接触 COVID-19 患者,CLI 的发病率随着时间的推移呈下降趋势。

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