Access to urban acute care services in high- vs. middle-income countries: an analysis of seven cities.
Access to urban acute care services in high- vs. middle-income countries: an analysis of seven cities.
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DOI：
10.1007/s00134-013-3174-7
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发表时间：
2014-03
影响因子：
38.9
通讯作者：
Angus, Derek C.
中科院分区：
文献类型：
--
作者：
Austin, Shamly;Murthy, Srinivas;Wunsch, Hannah;Adhikari, Neill K. J.;Karir, Veena;Rowan, Kathryn;Jacob, Shevin T.;Salluh, Jorge;Bozza, Fernando A.;Du, Bin;An, Youzhong;Lee, Bruce;Wu, Felicia;Yen-Lan Nguyen;Oppong, Chris;Venkataraman, Ramesh;Velayutham, Vimalraj;Duenas, Carmelo;Angus, Derek C.
关键词：
中等收入国家的城市正在迅速扩张，但其急性护理服务的供应尚不清楚。我们测量了不同经济背景的七个城市的急性护理服务供应。在一项横断面研究中，我们比较了两个高收入国家（美国波士顿和法国巴黎）、三个中上收入国家（哥伦比亚波哥大、巴西累西腓和中国聊城）和两个中低收入国家（印度钦奈和加纳库马西）的城市。我们收集了医院病床、重症监护病房病床和救护车的标准化数据。在可能的情况下，从地方当局收集信息。我们表示了每个人口（来自联合国）和每个急性疾病死亡（来自全球疾病负担项目）的结果。可提供静脉输液的医院床位的供应量从库马西的72.4/100，000人到波士顿的241.5/100，000人，相差四倍。重症监护病房（ICU）床位供应变化超过45倍，从库马西的0.4/10万人口到波士顿的18.8/10万人口。救护车的数量相差70倍以上。当相对于疾病负担估计供应量时，变化扩大（例如，重症监护病房床位的变化超过65倍，从库马西的0.06/100例急性疾病死亡到波哥大的4.11/100例;救护车服务的变化超过100倍）。每种疾病负担的医院床位数与国内生产总值（GDP）相关（R2 = 0.88，p = 0.01），但ICU供应量与此无关（R2 = 0.33，p = 0.18）。没有一个城市提供了所有要求的数据，只有两个城市提供了ICU数据。城市急症护理服务在各经济区域之间差异很大，部分原因是国内生产总值的差异。城市是不良的信息来源，这可能会阻碍其未来的规划。
Cities are expanding rapidly in middle-income countries, but their supply of acute care services is unknown. We measured acute care services supply in seven cities of diverse economic background. In a cross-sectional study, we compared cities from two high-income (Boston, USA and Paris, France), three upper-middle-income (Bogota, Colombia; Recife, Brazil; and Liaocheng, China), and two lower-middle-income (Chennai, India and Kumasi, Ghana) countries. We collected standardized data on hospital beds, intensive care unit beds, and ambulances. Where possible, information was collected from local authorities. We expressed results per population (from United Nations) and per acute illness deaths (from Global Burden of Disease project). Supply of hospital beds where intravenous fluids could be delivered varied fourfold from 72.4/100,000 population in Kumasi to 241.5/100,000 in Boston. Intensive care unit (ICU) bed supply varied more than 45-fold from 0.4/100,000 population in Kumasi to 18.8/100,000 in Boston. Ambulance supply varied more than 70-fold. The variation widened when supply was estimated relative to disease burden (e.g., ICU beds varied more than 65-fold from 0.06/100 deaths due to acute illnesses in Kumasi to 4.11/100 in Bogota; ambulance services varied more than 100-fold). Hospital bed per disease burden was associated with gross domestic product (GDP) (R 2 = 0.88, p = 0.01), but ICU supply was not (R 2 = 0.33, p = 0.18). No city provided all requested data, and only two had ICU data. Urban acute care services vary substantially across economic regions, only partially due to differences in GDP. Cities were poor sources of information, which may hinder their future planning.
影响因子：
8.8
作者：
Wunsch, Hannah;Angus, Derek C.;Rowan, Kathryn M.
通讯作者：
Rowan, Kathryn M.
影响因子：
168.9
作者：
Goldfrad, C;Rowan, K
通讯作者：
Rowan, K