Investigation on the current situation of the development of intensive care units in Inner Mongolia Autonomous Region in 2022.

Chendong MA; Lihua Zhou; Fei Yang; Bin LI; Caixia LI; Aili YU; Liankui WU; Haibo Yin; Junyan Wang; Lixia Geng; Xiulian Wang; Jun Zhang; Na Zhuo; Kaiquan Wang; Yun SU; Fei Wang; Yujun LI; Lipeng Zhang

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Investigation on the current situation of the development of intensive care units in Inner Mongolia Autonomous Region in 2022.

Author: Chendong MA ¹ ; Lihua ZHOU ¹ ; Fei YANG ² ; Bin LI ³ ; Caixia LI ⁴ ; Aili YU ⁵ ; Liankui WU ⁶ ; Haibo YIN ⁷ ; Junyan WANG ⁸ ; Lixia GENG ⁹ ; Xiulian WANG ¹⁰ ; Jun ZHANG ¹¹ ; Na ZHUO ¹² ; Kaiquan WANG ¹³ ; Yun SU ¹⁴ ; Fei WANG ¹⁵ ; Yujun LI ¹⁶ ; Lipeng ZHANG ¹
Author Information

1. Department of Critical Care Medicine, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, Inner Mongolia Autonomous Region, China.
2. Department of Critical Care Medicine, Chifeng Hospital, Chifeng 024099, Inner Mongolia Autonomous Region, China.
3. Department of Critical Care Medicine, Hohhot First Hospital, Hohhot 010031, Inner Mongolia Autonomous Region, China.
4. Department of Critical Care Medicine, People's Hospital of Inner Mongolia Autonomous Region, Hohhot 010020, China.
5. Department of Critical Care Medicine, Xing'an League People's Hospital, Xing'an League 137499, Inner Mongolia Autonomous Region, China.
6. Department of Critical Care Medicine, Affiliated Hospital of Inner Mongolia University for Nationalities, Tongliao 028050, Inner Mongolia Autonomous Region, China.
7. Department of Critical Care Medicine, Inner Mongolia Forestry General Hospital, Hulunbuir 022150, Inner Mongolia Autonomous Region, China.
8. Department of Critical Care Medicine, Baotou Central Hospital, Baotou 014040, Inner Mongolia Autonomous Region, China.
9. Department of Critical Care Medicine, the First Affiliated Hospital of Baotou Medical College, Baotou 014017, Inner Mongolia Autonomous Region, China.
10. Department of Critical Care Medicine, Second Affiliated Hospital of Baotou Medical College, Baotou 014031, Inner Mongolia Autonomous Region, China.
11. Department of Critical Care Medicine, Ulanqab Central Hospital, Ulanqab 012099, Inner Mongolia Autonomous Region, China.
12. Department of Critical Care Medicine, Xilin Gol League Central Hospital, Xilin Gol League 026099, Inner Mongolia Autonomous Region, China.
13. Department of Critical Care Medicine, Bayannaoer Hospital, Bayannaoer 015002, Inner Mongolia Autonomous Region, China.
14. Department of Critical Care Medicine, Ordos Central Hospital, Ordos 017010, Inner Mongolia Autonomous Region, China.
15. Department of Critical Care Medicine, Wuhai People's Hospital, Wuhai 016099, Inner Mongolia Autonomous Region, China.
16. Department of Critical Care Medicine, Alxa League Central Hospital, Alxa League 750306, Inner Mongolia Autonomous Region, China. Corresponding author: Zhang Lipeng, Email: zlp_boy2008@163.com.
Publication Type:Journal Article
MeSH: Humans; Intensive Care Units; Critical Care; Surveys and Questionnaires; Tertiary Care Centers; China
From: Chinese Critical Care Medicine 2023;35(9):984-990
CountryChina
Language:Chinese
Abstract: OBJECTIVE:To investigate the development present situation of the department of critical care medicine in Inner Mongolia Autonomous Region (hereinafter referred to as Inner Mongolia), in order to promote the standardized and homogeneous development of critical care medicine in Inner Mongolia, and also provide a reference for discipline construction and resource allocation.
METHODS:A survey study was conducted in comprehensive intensive care unit (ICU) of tertiary and secondary hospitals in Inner Mongolia by online questionnaire survey and telephone data verification. The questionnaire was based on the Guidelines for the Construction and Management of Intensive Care Units (Trial) (hereinafter referred to as the Guidelines) issued by the National Health Commission in 2009 and the development trend of the discipline. The questionnaire covered six aspects, including hospital basic information, ICU basic information, personnel allocation, medical quality management, technical skill and equipment configuration. The questionnaire was distributed in September 2022, and it was filled out by the discipline leaders or department heads of each hospital.
RESULTS:As of October 24, 2022, a total of 101 questionnaires had been distributed, 85 questionnaires had been recovered, and the questionnaire recovery rate had reached 84.16%, of which 71 valid questionnaires had been collected in a total of 71 comprehensive ICU. (1) There were noticeable regional differences in the distribution of comprehensive ICU in Inner Mongolia, with a relatively weak distribution in the east and west, and the overall distribution was uneven. The development of critical care medicine in Inner Mongolia was still lacking. (2) Basic information of hospitals: the population and economy restricted the development of ICU. The average number of comprehensive ICU beds in the western region was only half of that in the central region (beds: 39.0 vs. 86.0), and the average number of ICU beds in the eastern region was in the middle (83.6 beds), which was relatively uneven. (3) Basic information of ICU: among the 71 comprehensive ICU surveyed, there were 44 tertiary hospitals and 27 secondary hospitals. The ratio of ICU beds to total beds in tertiary hospitals was significantly lower than that in secondary hospitals [(1.59±0.81)% vs. (2.11±1.07)%, P < 0.05], which were significantly lower than the requirements of the Guidelines of 2%-8%. The utilization rate of ICU in tertiary and secondary hospitals [(63.63±22.40)% and (44.65±20.66)%, P < 0.01] were both lower than the bed utilization rate required by the Guidelines (75% should be appropriate). (4) Staffing of ICU: there were 376 doctors and 1 117 nurses in tertiary hospitals, while secondary hospitals had 122 doctors and 331 nurses. There were significant differences in the composition ratio of the titles of doctors, the degree of doctors, and the titles of nurses between tertiary and secondary hospitals (all P < 0.05). Most of the doctors in tertiary hospitals had intermediate titles (attending physicians accounted for 41.49%), while most of the doctors in secondary hospitals had junior titles (resident physicians accounted for 43.44%). The education level of doctors in tertiary hospitals was generally higher than that in secondary hospitals (doctors: 2.13% vs. 0, masters: 37.24% vs. 8.20%). The proportion of nurses in tertiary hospitals was significantly lower than that in secondary hospitals (17.01% vs. 24.47%). The ratio of ICU doctors/ICU beds [(0.64±0.27)%, (0.59±0.34)%] and ICU nurses/ICU beds [(1.76±0.56)%, (1.51±0.48)%] in tertiary and secondary hospitals all failed to meet the requirements above 0.8 : 1 and 3 : 1 of the Guidelines. (5) Medical quality management of ICU: compared with secondary hospitals, the proportion of one-to-one drug-resistant bacteria care in tertiary hospitals (65.91% vs. 40.74%), multimodal analgesia and sedation (90.91% vs. 66.67%), and personal digital assistant (PDA) barcode scanning (43.18% vs. 14.81%) were significantly higher (all P < 0.05). (6) Technical skills of ICU: in terms of technical skills, the proportion of bronchoscopy, blood purification, jejunal nutrition tube placement and bedside ultrasound projects carried out in tertiary hospitals were higher than those in secondary hospitals (84.09% vs. 48.15%, 88.64% vs. 48.15%, 61.36% vs. 55.56%, 88.64% vs. 70.37%, all P < 0.05). Among them, the placement of jejunal nutrition tube, bedside ultrasound and extracorporeal membrane oxygenation were mainly completed independently in tertiary hospitals, while those in secondary hospitals tended to be completed in cooperation. (7) Equipment configuration of ICU: in terms of basic equipment, the ratio of the total number of ventilators/ICU beds in tertiary and secondary hospitals [0.77% (0.53%, 1.07%), 0.88% (0.63%, 1.38%)], and the ratio of injection pump/ICU beds [1.70% (1.00%, 2.56%), 1.25% (0.75%, 1.88%)] didn't meet the requirements of the Guidelines. The equipment ratio was insuffcient, which means that the basic needs of development had not been met yet.
CONCLUSIONS:The development of comprehensive ICU in Inner Mongolia has tended to mature, but there is still a certain gap in the development scale, personnel ratio and instruments and equipment compared with the Guidelines. Moreover, the comprehensive ICU appears the characteristics of relatively weak eastern and western regions, and the overall distribution is uneven. Therefore, it is necessary to increase efforts to invest in the construction of the department of critical care medicine.