Read Abstract: Intensive care medicine is a clinical discipline that competes with the "Grim Reaper" for time and life, and is the last line of defense for the lives of all critically ill patients. From the perspective of resource allocation, the allocation of medical resources for critical treatment in mainland China has been increasing year by year. Nowadays, the state has put forward higher requirements for the hardware capabilities of critical care medicine. The "Opinions" proposes that by the end of 2025 and the end of 2027, the number of intensive care beds in mainland China will reach 15 and 18 per 100,000 people, respectively. By the end of 2027, the mainland's intensive care medical service resources will be effectively expanded, the regional layout will be more balanced, and the capacity of specialized services will be significantly improved.
(People's Daily Health Client Reporter Zhang He, Hou Jiaxin, Yang Linsong) "This is an extraordinary night, and countless seriously ill people can't calm down for a long time. With the implementation of this document, mainland critical care medicine ushered in a new period of development. ”
On May 7, Duan Meili, director of the Department of Critical Care Medicine of Beijing Friendship Hospital, told the People's Daily health client reporter that after the test of many major public emergencies, the mainland's critical care medical treatment capacity has been continuously improved.
On May 6, the National Health Commission and other eight departments jointly issued the "Opinions on Strengthening the Capacity Building of Critical Care Medical Services", which put forward clear requirements on continuously improving the critical care medical service network, focusing on strengthening the capacity building of critical care medical specialties, effectively expanding the team of critical care medical professionals, and continuously promoting the reform of the field of critical care medical services.
After more than 40 years, mainland intensive care medicine has completed the "from scratch" advancement
"Intensive care medicine is a clinical discipline that competes with the "Grim Reaper" for time and life, and is the last line of defense for the lives of all critically ill patients. The level of critical care medicine is the embodiment of the comprehensive medical capacity of the whole hospital. Qiu Haibo, vice president of Southeast University and a well-known expert in critical care medicine, described critical care medicine as such.
Critical care medicine in mainland China started in the 80s of the 20th century, and after experiencing the challenges of major public emergencies such as the SARS epidemic and the Wenchuan earthquake, the development of critical care medicine and the improvement of critical care treatment capacity have gradually received attention.
In 2008, the Department of Critical Care Medicine was listed as a second-level discipline of clinical medicine by the State Council, and obtained a unique code: 302.58;
In 2009, critical care medicine was positioned as a first-level diagnosis and treatment subject in the clinical diagnosis and treatment subjects of medical institutions;
In 2010, the specialty of critical care medicine became an exclusive specialty in the doctor's field of practice......
"In recent years, critical care medicine has made remarkable progress driven by national policies, especially in the fight against the new crown epidemic, and the importance of critical care medicine has been further highlighted." On May 7, Peng Zhiyong, director of the Department of Critical Care Medicine at Zhongnan Hospital of Wuhan University, told the People's Daily health client reporter that at present, with the strong support of the state, the hardware conditions of most hospitals have been significantly improved.
From the perspective of resource allocation, the allocation of medical resources for critical treatment in mainland China has been increasing year by year. According to the 2007-2021 Health Statistical Yearbook, the number of intensive care unit (ICU) beds in China increased from 7,328 in 2007 to 67,153 in 2021, the percentage of hospital ICU beds in hospital beds increased from 0.27% in 2007 to 0.91%, and the number of ICU beds per 100,000 population increased from 0.57 in 2007 to 4.76 (1).
Nowadays, the state has put forward higher requirements for the hardware capabilities of critical care medicine. The "Opinions" proposes that by the end of 2025 and the end of 2027, the number of intensive care beds in mainland China will reach 15 and 18 per 100,000 people, respectively. By the end of 2027, the mainland's intensive care medical service resources will be effectively expanded, the regional layout will be more balanced, and the capacity of specialized services will be significantly improved.
On April 1, 2020, Yuan Weifang, deputy head nurse of the Department of Intensive Care Medicine of Shanghai Seventh People's Hospital, did a B-ultrasound for patients with severe COVID-19 in Wuhan. Photo by Shen Bohan of Xinhua News Agency
The talent team needs to be replenished urgently, and the improvement of the soft power of critical care medicine needs to be gradual and gradual
"The key at present lies in the improvement of software strength, that is, to strengthen the construction of critical care medical professionals." In Peng Zhiyong's view, the current top priority is still in "talent" and "technology". Duan Meili also said that at present, there is still a large gap in the number of intensive care specialists in the country. At the same time, intensive care medical talents are mainly distributed in tertiary hospitals, and problems such as serious shortage of secondary hospitals still exist.
Peng Zhiyong introduced that the talent training cycle of critical care medicine is very long, and it takes at least 3~5 years to train doctors who can handle basic work independently. Next, it will take at least 8~10 years to do a more difficult job. "It has been four years since the first batch of standardized training for intensive care medicine residents was launched in mainland China in 2020, and it still needs time to test their level and ability."
"From the perspective of the hospital as a whole, the income of medical staff in the intensive care department is in the middle and lower reaches, and it is often considered to be a discipline that is not cost-effective." Duan Meili said that the latest "Opinions" also pay attention to the above issues, requiring to enhance the attractiveness of the critical care medicine profession, including the reasonable guarantee of the remuneration of medical personnel in the intensive care department, which is conducive to further relieving the pressure on medical staff and fully mobilizing their enthusiasm.
In Duan Meimei's view, homogenization is still one of the biggest difficulties in the development of critical care medicine. In recent years, the critical care capacity of primary medical and health institutions has improved, but there is still a large gap between them and tertiary hospitals. The homogeneous development of critical care medicine should start from two aspects: one is to improve the technical level through professional education, and the other is to strengthen the quality control and continuous improvement of critical care medicine. This is also the focus of the Opinions.
Peng Zhiyong said that to improve the emergency and critical rescue capacity of county hospitals, it is necessary to take advantage of the development opportunities of the "Thousand Counties Project" to strengthen resource sharing and technical exchanges between upper and lower level hospitals. Large hospitals should play a leading role in driving the common progress of hospitals at all levels, promoting new technologies, and ultimately building a seamless nationwide critical care medical service network to ensure that every patient can receive high-quality critical care services in the shortest possible time.
"There is still a long way to go in the development of critical care medicine, and the improvement of soft power is not an overnight effort, it needs to be gradual and gradual, it may be ten years or longer." Duan Meili said.
Bibliography:
(1) Tao Siyu ,Zhu Geliang ,Shen Jie. Reflections and countermeasures on the capacity building of critical care medicine and critical care in mainland China[J]. Chinese Journal of Hospital Management, 2023,39 (10):733-738