Zhao Mei, Hamadi Hanadi Y, Haley D Rob, Xu Jing, Dunn Ajani Aj, Spaulding Aaron
Department of Health Administration, Brooks College of Health, University of North Florida, Jacksonville, Florida. ORCID: https://orcid.org/0000-0003-4218-463X.
Department of Health Administration, Brooks College of Health, University of North Florida, Jacksonville, Florida. ORCID: https://orcid.org/0000-0001-9050-7267.
J Emerg Manag. 2023;21(7):37-48. doi: 10.5055/jem.0734.
Terrorist attacks and natural disasters such as Hurricanes Katrina and Harvey have increased focus on disaster preparedness planning. Despite the attention on planning, many studies have found that hospitals in the United States are underprepared to manage extended disasters appropriately and the surge in patient volume it might bring.
This study aims to profile and examine the availability of hospital capacity specifically related to COVID-19 patients, such as emergency department (ED) beds, intensive care unit (ICU) beds, temporary space setup, and ventilators.
A cross-sectional retrospective study design was used to examine secondary data from the 2020 American Hospital Association (AHA) Annual Survey. A series of multivariate logistic analyses were conducted to investigate the strength of association between changes in ED beds, ICU beds, staffed beds, and temporary spaces setup, and the 3,655 hospitals' characteristics.
Our results highlight that the odds of a change in ED beds are 44 percent lower for government hospitals and 54 percent for for-profit hospitals than not-for-profit hospitals. The odds of ED bed change for nonteaching hospitals were 34 percent lower compared to teaching hospitals. Small and medium hospitals have significantly lower odds (75 and 51 percent, respectively) than large hospitals. For ICU bed change, staffed bed change, and temporary spaces setup, the conclusions were consistently significant regarding the impact of hospital ownership, teaching status, and hospital size. However, temporary spaces setup differs by hospital location. The odds of change is significantly lower (OR = 0.71) in urban hospitals compared with rural hospitals, while for ED beds, the odds of change is considerably higher (OR = 1.57) in urban hospitals compared to rural hospitals.
There is a need for policymakers to consider not only resource limitations that were created from supply line disruptions during the COVID-19 pandemic but also a more global assessment of the adequacy of funding and support for insurance coverage, hospital finance, and how hospitals meet the needs of the populations they serve.
恐怖袭击以及卡特里娜飓风和哈维飓风等自然灾害，使得人们对灾难准备规划的关注度日益提高。尽管对规划颇为关注，但许多研究发现，美国的医院在妥善应对长期灾难及其可能带来的患者数量激增方面准备不足。
本研究旨在剖析并考察与新冠肺炎患者相关的医院容量的可利用情况，例如急诊科床位、重症监护病房床位、临时空间设置以及呼吸机。
采用横断面回顾性研究设计，对2020年美国医院协会（AHA）年度调查的二手数据进行分析。开展了一系列多变量逻辑分析，以探究急诊科床位、重症监护病房床位、配备人员的床位以及临时空间设置的变化与3655家医院特征之间的关联强度。
我们的研究结果表明，政府医院急诊科床位发生变化的几率比非营利性医院低44%，营利性医院则低54%。非教学医院急诊科床位变化的几率比教学医院低34%。中小型医院的几率显著低于大型医院（分别为75%和51%）。对于重症监护病房床位变化、配备人员的床位变化以及临时空间设置，关于医院所有权、教学状况和医院规模的影响，结论始终具有显著性。然而，临时空间设置因医院位置而异。与农村医院相比，城市医院变化的几率显著更低（OR = 0.71），而对于急诊科床位，城市医院变化的几率相比农村医院则高得多（OR = 1.57）。
政策制定者不仅需要考虑新冠疫情期间供应链中断所造成的资源限制，还需要对资金充足性以及保险覆盖、医院财务方面的支持，以及医院如何满足其所服务人群的需求进行更全面的评估。
Zotero 插件