在 COVID-19 大流行期间,一座大型临时医院的医疗实施实践及其医疗效果评价:中国上海应对公共卫生突发事件的创新性模式反应。

Medical implementation practice and its medical performance evaluation of a giant makeshift hospital during the COVID-19 pandemic: An innovative model response to a public health emergency in Shanghai, China.

机构信息

Department of Outpatient and Emergency Management, Renji Hospital, School of Medicine in Shanghai Jiao Tong University, Shanghai, China.

Department of Neurosurgery, Renji Hospital, School of Medicine in Shanghai Jiao Tong University, Shanghai, China.

出版信息

Front Public Health. 2023 Jan 6;10:1019073. doi: 10.3389/fpubh.2022.1019073. eCollection 2022.

Abstract

INTRODUCTION

In confronting the sudden COVID-19 epidemic, China and other countries have been under great pressure to block virus transmission and reduce fatalities. Converting large-scale public venues into makeshift hospitals is a popular response. This addresses the outbreak and can maintain smooth operation of a country or region's healthcare system during a pandemic. However, large makeshift hospitals, such as the Shanghai New International Expo Center (SNIEC) makeshift hospital, which was one of the largest makeshift hospitals in the world, face two major problems: Effective and precise transfer of patients and heterogeneity of the medical care teams.

METHODS

To solve these problems, this study presents the medical practices of the SNIEC makeshift hospital in Shanghai, China. The experiences include constructing two groups, developing a medical management protocol, implementing a multi-dimensional management mode to screen patients, transferring them effectively, and achieving homogeneous quality of medical care. To evaluate the medical practice performance of the SNIEC makeshift hospital, 41,941 infected patients were retrospectively reviewed from March 31 to May 23, 2022. Multivariate logistic regression method and a tree-augmented naive (TAN) Bayesian network mode were used.

RESULTS

We identified that the three most important variables were chronic disease, age, and type of cabin, with importance values of 0.63, 0.15, and 0.11, respectively. The constructed TAN Bayesian network model had good predictive values; the overall correct rates of the model-training dataset partition and test dataset partition were 99.19 and 99.05%, respectively, and the respective values for the area under the receiver operating characteristic curve were 0.939 and 0.957.

CONCLUSION

The medical practice in the SNIEC makeshift hospital was implemented well, had good medical care performance, and could be copied worldwide as a practical intervention to fight the epidemic in China and other developing countries.

摘要

简介

在应对 COVID-19 疫情时,中国和其他国家面临着阻断病毒传播和降低死亡率的巨大压力。将大型公共场所改建成临时医院是一种常见的应对方式。这可以应对疫情爆发,并在大流行期间维持一个国家或地区的医疗系统的平稳运行。然而,像上海新国际博览中心(SNIEC)这样的大型临时医院,面临着两个主要问题:有效和准确地转移患者以及医疗团队的异质性。

方法

为了解决这些问题,本研究提出了中国上海 SNIEC 临时医院的医疗实践。这些经验包括构建两个组、制定医疗管理协议、实施多维管理模式来筛选患者、有效转移患者,并实现同质的医疗质量。为了评估 SNIEC 临时医院的医疗实践表现,我们回顾性地分析了 2022 年 3 月 31 日至 5 月 23 日期间的 41941 例感染患者。采用多变量逻辑回归方法和树增强朴素贝叶斯网络(TAN)模型。

结果

我们确定了三个最重要的变量,分别是慢性病、年龄和舱型,重要性值分别为 0.63、0.15 和 0.11。构建的 TAN 贝叶斯网络模型具有良好的预测值;模型训练数据集分区和测试数据集分区的总正确率分别为 99.19%和 99.05%,相应的受试者工作特征曲线下面积分别为 0.939 和 0.957。

结论

SNIEC 临时医院的医疗实践实施良好,具有良好的医疗效果,可以作为一种实用的干预措施在全球范围内复制,以应对中国和其他发展中国家的疫情。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cfdd/9853970/e35e9cfe5c54/fpubh-10-1019073-g0001.jpg

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