Kojin Hiroyuki, Inoue Osamu, Kinouchi Hiroyuki
Department of Quality and Patient Safety, Graduate Faculty of Interdisciplinary Research, Faculty of Medicine, University of Yamanashi, Chuo, Japan.
Department of Infection Control, Graduate Faculty of Interdisciplinary Research, Faculty of Medicine, University of Yamanashi, Chuo, Japan.
JMA J. 2021 Jan 29;4(1):24-31. doi: 10.31662/jmaj.2020-0034. Epub 2021 Jan 14.
Whether healthcare providers can secure the number of beds that may be required during the coronavirus disease 2019 (COVID-19) pandemic remains unclear. This study aimed to determine the sufficiency of the hospital beds available to the healthcare system of Yamanashi, Japan, in accommodating hospitalized and severely ill patients during the COVID-19 pandemic.
In total, 60 hospitals, with > 20 beds each, were included in this study ( = 10,684). However, beds in the psychiatric and tuberculosis wards ( = 2,295), nonoperational beds ( = 376), and beds for patients in the recovery and chronic phases ( = 3,494) were excluded. The projected occupancy rate was calculated based on the estimated number of patients, including severely ill patients requiring hospitalization during the COVID-19 pandemic. Based on the number of hospitalized patients, we created an adjusted model to calculate the mean occupancy rate of beds for each medical area in the prefecture (Model 1), which is free of areal occupancy rate biases. Moreover, we created an adjusted model that places severely ill patients in the two advanced acute hospitals in Yamanashi, thereby calculating the bed occupancy rates in other hospitals with > 200 beds (Model 2).
A total of 4,519 beds were analyzed. Although the existing infectious disease beds may not be able to accommodate the projected number of severely ill patients, the existing capacity can accommodate all patients projected to require hospitalization during the pandemic. In Model 1, the mean bed occupancy rate was 50%. Conversely, in Model 2, advanced acute hospital beds were insufficient for the projected number of severely ill patients, and the mean bed occupancy rate was 72.5%.
Adjustment of patients across the medical area borders enables the existing hospital beds to accommodate the estimated number of patients requiring hospitalization or those who are severely ill.
在2019冠状病毒病（COVID-19）大流行期间，医疗服务提供者能否确保所需的床位数量仍不明确。本研究旨在确定日本山梨县医疗系统中可用于收治COVID-19大流行期间住院患者和重症患者的现有医院床位是否充足。
本研究共纳入60家每家床位超过20张的医院（n = 10,684）。然而，精神科和结核病病房的床位（n = 2,295）、非运营床位（n = 376）以及康复期和慢性期患者的床位（n = 3,494）被排除在外。根据包括COVID-19大流行期间需要住院治疗的重症患者在内的估计患者数量计算预计占用率。基于住院患者数量，我们创建了一个调整模型来计算该县每个医疗区域床位的平均占用率（模型1），该模型不存在区域占用率偏差。此外，我们创建了一个调整模型，将重症患者安置在山梨县的两家高级急症医院，从而计算其他床位超过200张的医院的床位占用率（模型2）。
共分析了4,519张床位。虽然现有的传染病床位可能无法容纳预计的重症患者数量，但现有床位容量可以容纳大流行期间预计需要住院治疗的所有患者。在模型1中，平均床位占用率为50%。相反，在模型2中，高级急症医院的床位不足以容纳预计的重症患者数量，平均床位占用率为72.5%。
跨医疗区域边界调整患者，可使现有医院床位容纳预计需要住院治疗的患者或重症患者数量。
