法国重症监护医生供应不足:一项点流行率前瞻性研究。

IF 5.7 1区 医学 Q1 CRITICAL CARE MEDICINE
Sacha Sarfati, Stephan Ehrmann, Dominique Vodovar, Boris Jung, Nadia Aissaoui, Cédric Darreau, Wulfran Bougouin, Nicolas Deye, Hatem Kallel, Khaldoun Kuteifan, Charles-Edouard Luyt, Nicolas Terzi, Thierry Vanderlinden, Christophe Vinsonneau, Grégoire Muller, Christophe Guitton
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引用次数: 0

摘要

背景:COVID-19 大流行凸显了重症监护病房(ICU)及其组织在医疗保健系统中的重要性。然而,大流行过后,重症监护室的容量和可用性一直是令人担忧的问题,特别是由于人口老龄化和护理工作日益复杂。本研究旨在评估法国目前和未来的重症监护室医生短缺情况,这是在上次评估十年后进行的。2022 年 1 月,研究人员在法国的重症监护病房进行了一次全国性电子调查,以收集有关重症监护病房特征、医务人员配置、医生个人特征以及教育和培训能力的数据:结果:在所联系的 290 家重症监护室中,有 242 家做出了回应(回应率:83%),代表了 4943 张重症监护室床位。调查显示,全国共有 300 个相当于全职的 ICU 医生职位空缺。近三分之二参与调查的重症监护室报告至少有一名医生空缺,35%的重症监护室依靠出差医生顶班。受医生空缺影响最大的 ICU 是非大学附属公立医院的 ICU。预计未来五年内退休的人员约占工作人员总数的 10%。每间重症监护室的医生数量中位数为 7.0 人,相当于每张重症监护室病床有 0.36 名医生(全职)。此外,由于职位空缺和即将退休,27%的重症监护室面临严重功能障碍或关闭的风险:研究结果凸显了法国急需解决重症监护室医生短缺的问题。与 2012 年进行的类似研究相比,重症监护室医生供不应求的情况有所加剧,导致职位空缺数量增加。我们的研究表明,除其他外,增加每年接受培训的重症监护住院医师人数可能是解决这一问题的关键一步。如果不采取适当措施,可能会导致重症监护室进一步关闭,并增加该医疗系统中患者的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Inadequate intensive care physician supply in France: a point-prevalence prospective study.

Inadequate intensive care physician supply in France: a point-prevalence prospective study.

Background: The COVID-19 pandemic has highlighted the importance of intensive care units (ICUs) and their organization in healthcare systems. However, ICU capacity and availability are ongoing concerns beyond the pandemic, particularly due to an aging population and increasing complexity of care. This study aimed to assess the current and future shortage of ICU physicians in France, ten years after a previous evaluation. A national e-survey was conducted among French ICUs in January 2022 to collect data on ICU characteristics, medical staffing, individual physician characteristics, and education and training capacities.

Results: Among 290 ICUs contacted, 242 responded (response rate: 83%), representing 4943 ICU beds. The survey revealed an overall of 300 full time equivalent (FTE) ICU physician vacancies in the country. Nearly two-thirds of the participating ICUs reported at least one physician vacancy and 35% relied on traveling physicians to cover shifts. The ICUs most affected by physician vacancies were the ICUs of non-university affiliated public hospitals. The retirements expected in the next five years represented around 10% of the workforce. The median number of physicians per ICU was 7.0, corresponding to a ratio of 0.36 physician (FTE) per ICU bed. In addition, 27% of ICUs were at risk of critical dysfunction or closure due to vacancies and impending retirements.

Conclusion: The findings highlight the urgent need to address the shortage of ICU physicians in France. Compared to a similar study conducted in 2012, the inadequacy between ICU physician supply and demand has increased, resulting in a higher number of vacancies. Our study suggests that, among others, increasing the number of ICM residents trained each year could be a crucial step in addressing this issue. Failure to take appropriate measures may lead to further closures of ICUs and increased risks to patients in this healthcare system.

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来源期刊
Annals of Intensive Care
Annals of Intensive Care CRITICAL CARE MEDICINE-
CiteScore
14.20
自引率
3.70%
发文量
107
审稿时长
13 weeks
期刊介绍: Annals of Intensive Care is an online peer-reviewed journal that publishes high-quality review articles and original research papers in the field of intensive care medicine. It targets critical care providers including attending physicians, fellows, residents, nurses, and physiotherapists, who aim to enhance their knowledge and provide optimal care for their patients. The journal's articles are included in various prestigious databases such as CAS, Current contents, DOAJ, Embase, Journal Citation Reports/Science Edition, OCLC, PubMed, PubMed Central, Science Citation Index Expanded, SCOPUS, and Summon by Serial Solutions.
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