Badenhorst C H
S Afr Med J. 1986 Nov 22;70(11):674-8.
From 1981 to 1984, 1,720 patients requiring critical care were admitted to two multidisciplinary intensive care units (MDICUs) run by a department of critical care at the University of the Orange Free State, Bloemfontein. The majority (61%) were referred from outside the metropolitan area. The most important referring specialties were surgery (25%), medicine (19%), orthopaedics (14%), paediatrics (10%) and obstetrics and gynaecology (9%). Almost 50 of patients stayed in unit for 1-4 days while 12% remained for more than 14 days. Average in-unit mortality (IUM) over the 4 years was 27%. The highest annual rate was 38%, but without measurement of severity of illness yearly and unit IUM figures cannot be compared. IUM for patients who remained in the unit for 1 day only (66%) was higher than that for patients remaining for more than 2 weeks (28%). Consultant and resident cover over the 4-year period was problematic and sometimes inadequate. Care by the referring doctor was impractical and limited numbers of patients in each discipline make independent 'level-1' units (ICU doctor in unit at all times) undesirable. The cost of care of the 1,720 patients over 4 years was approximately R5 700,000. Demand for MDICU care increased by 40% from 1981 to 1984.
1981年至1984年期间，奥兰治自由邦大学布隆方丹重症监护科运营的两个多学科重症监护病房（MDICU）收治了1720名需要重症监护的患者。大多数患者（61%）是从大都市区以外转诊而来。最重要的转诊专科是外科（25%）、内科（19%）、骨科（14%）、儿科（10%）以及妇产科（9%）。近50%的患者在病房停留1至4天，而12%的患者停留时间超过14天。4年期间的平均病房死亡率（IUM）为27%。最高年死亡率为38%，但由于未逐年测量疾病严重程度，各病房的IUM数据无法进行比较。仅在病房停留1天的患者的IUM（66%）高于停留超过2周的患者（28%）。在这4年期间，顾问医生和住院医生的轮值存在问题，有时人手不足。转诊医生进行护理不切实际，而且每个学科的患者数量有限，因此设立独立的“一级”病房（始终有ICU医生在病房）并不理想。1720名患者4年的护理费用约为570万兰特。从1981年到1984年，对MDICU护理的需求增长了40%。
