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医疗危机对韩国重症监护系统的影响。

Impact of medical crisis on the critical care system in South Korea.

作者信息

Chang Ye Rim, Cho Jae Hwa, Cho Joongbum, Ha Tae Sun, Kho Bo Gun, Kim Eunhye, Kim Im-Kyung, Lee Dong Hyun, Hong Suk-Kyung

机构信息

Division of Acute Care Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

出版信息

Acute Crit Care. 2025 Aug;40(3):393-401. doi: 10.4266/acc.000575. Epub 2025 Aug 21.

Abstract

BACKGROUND

The ongoing medical crisis in Korea has severely impacted the operational environment of intensive care units (ICU), posing significant challenges to quality care for critically ill patients. This study aimed to evaluate the effects of the ongoing crisis on ICUs.

METHODS

A survey was conducted in July 2024 among intensivists in charge of ICUs at institutions accredited by the Korean Society of Critical Care Medicine for critical care. The survey compared data from January 2024 (pre-crisis) and June 2024 (post-crisis) on the number ICU beds, staffing composition, work hours, and the number and roles of nurse practitioners.

RESULTS

Among the total of 71 participating ICUs, 22 experienced a reduction in the number of operational beds, with a median decrease of six beds per unit, totaling 127 beds across these ICUs. The numbers of residents and interns decreased from an average of 2.3 to 0.1 per ICU, and the average weekly working hours of intensivists increased from 62.3 to 78.8 hours. Nurse practitioners helped fill staffing gaps, with their numbers rising from 150 to 242 across ICUs, and their scope of practice expanded accordingly.

CONCLUSIONS

The medical crisis has led to major changes in the critical care system, including staffing shortages, increased workloads, and an expanded role for nurse practitioners. This is a critical moment to foster interest and engage in active discussions aimed at creating a sustainable and resilient ICU system.

摘要

背景

韩国当前的医疗危机严重影响了重症监护病房(ICU)的运营环境,给重症患者的优质护理带来了重大挑战。本研究旨在评估当前危机对ICU的影响。

方法

2024年7月,对韩国重症医学会认可的机构中负责ICU的重症医学专家进行了一项调查。该调查比较了2024年1月(危机前)和2024年6月(危机后)关于ICU床位数量、人员构成、工作时间以及执业护士数量和职责的数据。

结果

在总共71个参与调查的ICU中,有22个的运营床位数减少,每个单位中位数减少6张床,这些ICU总共减少了127张床。每个ICU的住院医师和实习医师数量从平均2.3人降至0.1人,重症医学专家的平均每周工作时间从62.3小时增加到78.8小时。执业护士帮助填补了人员缺口,各ICU的执业护士数量从150人增加到242人,其执业范围也相应扩大。

结论

医疗危机导致了重症监护系统的重大变化,包括人员短缺、工作量增加以及执业护士角色的扩大。这是一个激发兴趣并积极开展讨论以创建一个可持续且有韧性的ICU系统的关键时刻。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6a5/12408483/afa8e27f5c9c/acc-000575f1.jpg

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