ICU service in Taiwan

被引：13

作者：

Cheng K.-C. ^{[1
,2
,3
]}

Lu C.-L. ^{[4
]}

Chung Y.-C. ^{[1
]}

Huang M.-C. ^{[5
]}

Shen H.-N. ^{[6
]}

Chen H.-M. ^{[1
]}

Zhang H. ^{[7
]}

机构：

[1] Department of Internal Medicine, Chi Mei Medical Center, Tainan

[2] Department of Safety Health and Environmental Engineering, Chung Hwa University of Medical Technology, Tainan

[3] Department of Medicine, National Defense Medical Center, Taipei

[4] Department of Medical Research, Chi Mei Medical Center, Tainan

[5] Bureau of National Health Insurance Kao-Ping Branch, Kaohsiung

[6] Department of Intensive Care Medicine, Chi Mei Medical Center, Tainan

[7] The Keenan Research Centre in Biomedical Science, St. Michael's Hospital, University of Toronto, 209 Victoria Street, Toronto, M5B 1T8, ON

来源：

Journal of Intensive Care | / 2卷 / 1期

关键词：

Bed occupancy; Critical illness; ICU structure; Medical expenditure;

D O I：

10.1186/2052-0492-2-8

中图分类号：

学科分类号：

摘要：

Background: The aim of the study was to understand the current status of intensive care unit (ICU) in order to optimize the resources achieving the best possible care. Methods: The study analyzed the status of ICU settings based on the Taiwan National Health Insurance database between March 2004 and February 2009. Results: A total of 1,028,364 ICU patients were identified. The age was 65 ± 18 years, and 61% of the patients were male. The total ICU bed occupancy rate was 83.8% which went up to 87.3% during winter. The ICU bed occupancy was 94.4% in major medical centers. The ICU stay was 6.5 ± 0.5 days, and the overall ICU mortality rate was 20.2%. The hospital stay was 16.4 ± 16.8 days, and the average cost of total hospital stay was approximately US$5,186 per patient. Conclusions: The rate of ICU bed occupancy was dependent on seasonal changes, and it reached near full capacity in major medical centers in Taiwan. The ICU beds were distributed based on the categories of hospitals in order to achieve a reasonable cost efficiency. ICU faces many challenges to maintain and improve quality care because of the increasing cost of state-of-the-art technologies and dealing with aging population.

引用

共 35 条

[1]

Halpern N.A., Pastores S.M., Critical care medicine in the United States 2000-2005: an analysis of bed numbers, occupancy rates, payer mix, and costs, Crit Care Med, 38, pp. 65-71, (2010)

[2]

Halpern N.A., Pastores S.M., Greenstein R.J., Critical care medicine in the United States 1985-2000: an analysis of bed numbers, use, and costs, Crit Care Med, 32, pp. 1254-1259, (2004)

[3]

Wunsch H., Angus D.C., Harrison D.A., Collange O., Fowler R., Hoste E.A., de Keizer N.F., Kersten A., Linde-Zwirble W.T., Sandiumenge A., Rowan K.M., Variation in critical care services across North America and Western Europe, Crit Care Med, 36, pp. 2787-2793, (2008)

[4]

Kahn J.M., Angus D.C., Reducing the cost of critical care: new challenges, new solutions, Am J Respir Crit Care Med, 174, pp. 1167-1168, (2006)

[5]

Wen C.P., Tsai S.P., Chung W.S., A 10-year experience with universal health insurance in Taiwan: measuring changes in health and health disparity, Ann Intern Med, 148, pp. 258-267, (2008)

[6]

Cheng S.H., Chiang T.L., The effect of universal health insurance on health care utilization in Taiwan. Results from a natural experiment, JAMA, 278, pp. 89-93, (1997)

[7]

Lu J.F., Hsiao W.C., Does universal health insurance make health care unaffordable? Lessons from Taiwan, Health Aff, 22, pp. 77-88, (2003)

[8]

(2011)

[9]

Wennberg J.E., McPherson K., Caper P., Will payment based on diagnosisrelated groups control hospital costs?, N Engl J Med, 311, pp. 295-300, (1984)

[10]

Charlson M.E., Pompei P., Ales K.L., MacKenzie C.R., A new method of classifying prognostic comorbidity in longitudinal studies: development and validation, J Chronic Dis, 40, pp. 373-383, (1987)

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