Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo.
Data Science Center, Jichi Medical University.
J Epidemiol. 2022 Dec 5;32(12):535-542. doi: 10.2188/jea.JE20210016. Epub 2021 Sep 17.
Detailed data on intensive care unit (ICU) occupancy in Japan are lacking. Using a nationwide inpatient database in Japan, we aimed to assess ICU bed occupancy to guide critical care utilization planning.
We identified all ICU patients admitted from January 1, 2015 to December 31, 2018 to ICU-equipped hospitals participating in the Japanese Diagnosis Procedure Combination inpatient database. We assessed the trends in daily occupancy by counting the total number of occupied ICU beds on a given day divided by the total number of licensed ICU beds in the participating hospitals. We also assessed ICU occupancy for patients with mechanical ventilation, patients with extracorporeal membrane oxygenation, and patients without life-supportive therapies.
Over the 4 study years, 1,379,618 ICU patients were admitted to 495 hospitals equipped with 5,341 ICU beds, accounting for 75% of all ICU beds in Japan. Mean ICU occupancy on any given day was 60%, with a range of 45.0% to 72.5%. Mean ICU occupancy did not change over the 4 years. Mean ICU occupancy was about 9% higher on weekdays than on weekends and about 5% higher in the coldest season than in the warmest season. For patients with mechanical ventilation, patients with extracorporeal membrane oxygenation, and patients without life-supportive therapies, mean ICU occupancy was 24%, 0.5%, and 30%, respectively.
Only one-fourth of ICU beds were occupied by mechanically ventilated patients, suggesting that the critical care system in Japan has substantial surge capacity under normal temporal variation to care for critically ill patients.
日本缺乏关于重症监护病房（ICU）入住率的详细数据。我们使用日本全国性住院患者数据库，旨在评估 ICU 床位占用率，以指导重症监护利用规划。
我们确定了所有 2015 年 1 月 1 日至 2018 年 12 月 31 日期间入住配备 ICU 的医院的 ICU 患者。我们通过计算给定日期内占用的 ICU 床位总数与参与医院的 ICU 床位总数之比，评估 ICU 床位的日常占用率。我们还评估了接受机械通气、体外膜氧合和无生命支持治疗的患者的 ICU 入住率。
在 4 年的研究期间，共有 1379618 例 ICU 患者入住 495 家配备 5341 张 ICU 床位的医院，占日本 ICU 床位总数的 75%。任何给定日期的 ICU 平均入住率为 60%，范围为 45.0%至 72.5%。4 年来 ICU 入住率没有变化。工作日 ICU 入住率比周末高约 9%，最寒冷季节比最温暖季节高约 5%。接受机械通气、体外膜氧合和无生命支持治疗的患者的 ICU 平均入住率分别为 24%、0.5%和 30%。
只有四分之一的 ICU 床位被接受机械通气的患者占用，这表明日本的重症监护系统在正常时间变化下具有相当大的扩充能力，可以照顾危重患者。
