{"title":"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。","authors":"Reena Mehta, Raliat Onatade, Savvas Vlachos, Ritesh Maharaj","doi":"10.1177/17511437251350808","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":39161,"journal":{"name":"Journal of the Intensive Care Society","volume":" ","pages":"17511437251350808"},"PeriodicalIF":1.4000,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12245829/pdf/","citationCount":"0","resultStr":"{\"title\":\"Geographical disparities in adult intensive care beds in the English National Health Service: A retrospective, observational panel data study.\",\"authors\":\"Reena Mehta, Raliat Onatade, Savvas Vlachos, Ritesh Maharaj\",\"doi\":\"10.1177/17511437251350808\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":39161,\"journal\":{\"name\":\"Journal of the Intensive Care Society\",\"volume\":\" \",\"pages\":\"17511437251350808\"},\"PeriodicalIF\":1.4000,\"publicationDate\":\"2025-06-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12245829/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of the Intensive Care Society\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/17511437251350808\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CRITICAL CARE MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the Intensive Care Society","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/17511437251350808","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
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.
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''.