英国国家卫生服务成人重症监护病床的地理差异:一项回顾性、观察性面板数据研究。

IF 1.4 Q3 CRITICAL CARE MEDICINE
Reena Mehta, Raliat Onatade, Savvas Vlachos, Ritesh Maharaj
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引用次数: 0

摘要

背景:英国国家医疗服务体系(NHS)是一个公共资助的体系,然而在提供方面存在着显著的差距。尽管随着时间的推移,重症监护病房(ICU)床位分布的全国情况有所增加,但人们对ICU服务增长率的区域差异以及这是否与人口增长有关知之甚少。本研究的目的是描述英国ICU床位供应的国家差异,并评估随着时间的推移,提供ICU床位的地区差异是否已经缩小。方法:以人群为基础的面板分析2012-2021年10年间ICU床位供应情况。数据来自可公开获得的国家资源。总结了描述性分析并检查了趋势。计算各地区ICU床位差距。使用固定效应面板数据回归模型来查看未观察变量对特定地区与国家平均水平相比的ICU床位供应的影响。对65岁及以上的人进行亚组分析。结果:总体而言,ICU床位增加了9.9%,导致每10万人口ICU床位增加2.2%,65岁及以上人口ICU床位减少5.1%。在不同地区之间,人均ICU床位随着时间的推移而变化,东南地区减少,但所有其他地区都增加。在65岁及以上的人群中,ICU床位减少的变化更为明显,东南地区的影响最大。若要将区域ICU病床容量增加到与伦敦(人均最高的地区)相同,则需要将总人口的ICU病床数量增加29%至109%,65岁及以上人群的ICU病床数量增加104%至246%。未观察到的变量对伦敦ICU床位供应的积极影响最大,对中部地区的负面影响最大。结论:ICU床位供应在英国各地存在显著的地区差异。我们没有发现随着时间的推移,ICU床位供应的地区差异有任何显著的缩小。进一步的研究应侧重于更好地理解作为区域卫生保健供应基础的政策框架。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Geographical disparities in adult intensive care beds in the English National Health Service: A retrospective, observational panel data study.

Background: The English National Health Service (NHS) is a publicly funded system, however significant disparities in provision exist. Whereas the national picture of the distribution of Intensive Care Unit (ICU) beds has increased over time, less is understood about the regional variation in the rate of growth in ICU services and whether this is related to population growth. The aim of this study was to describe the national variation in the supply of ICU beds in England and evaluate whether there has been a narrowing of the regional disparities in providing ICU beds over time.

Methods: Population-based panel analysis of ICU bed supply over a 10-year period, 2012-2021. Data were obtained from publicly available national resources. Descriptive analyses were summarised and trends examined. Disparity gap of ICU beds were calculated for each region. A fixed-effect panel data regression model was used to see the effect of unobserved variables on ICU bed supply for a particular region compared to the country average. Sub-group analysis was done for those 65 years and over.

Results: Overall, ICU beds increased by 9.9%, resulting in a 2.2% increase in ICU beds per 100k population and a decrease by 5.1% in those aged 65 years and over. Between regions, ICU beds per capita varied over time, with a decrease in the South East but an increase in all other regions. In the population aged 65 years and over, the variation of a decrease in ICU beds was more pronounced, with the largest impact in the South East. To increase regional ICU bed capacity to the same as London, which was the region with the highest per capita, for total population, an uplift of 29% to 109% of ICU beds is required and 104% to 246% in those 65 years and over. The unobserved variables have the highest positive impact in ICU bed supply in London and the highest negative impact in the Midlands.

Conclusion: ICU bed supply showed significant regional variations across England. We did not identify any significant narrowing of the regional disparities in provision of ICU beds over time. Further research should focus on better understanding the policy framework that underlies the regional supply of healthcare.

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来源期刊
Journal of the Intensive Care Society
Journal of the Intensive Care Society Nursing-Critical Care Nursing
CiteScore
4.40
自引率
0.00%
发文量
45
期刊介绍: The Journal of the Intensive Care Society (JICS) is an international, peer-reviewed journal that strives to disseminate clinically and scientifically relevant peer-reviewed research, evaluation, experience and opinion to all staff working in the field of intensive care medicine. Our aim is to inform clinicians on the provision of best practice and provide direction for innovative scientific research in what is one of the broadest and most multi-disciplinary healthcare specialties. While original articles and systematic reviews lie at the heart of the Journal, we also value and recognise the need for opinion articles, case reports and correspondence to guide clinically and scientifically important areas in which conclusive evidence is lacking. The style of the Journal is based on its founding mission statement to ‘instruct, inform and entertain by encompassing the best aspects of both tabloid and broadsheet''.
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