There are 36 members of the special committee, among which 32 hospitals reported complete data within the prescribed time limit. The number of hospitals that met the investigation scope of oncology critical care medicine was 28, distributed in 20 provinces and 4 direct-controlled municipalities. Hospitals were divided into teaching hospitals affiliated with medical colleges, teaching hospitals affiliated with nonmedical colleges and hospitals affiliated with provinces, cities and counties. There were no private hospitals. The 28 units were all tertiary hospitals, including 3 comprehensive grade 3A hospitals, 1 comprehensive grade 3B hospitals, 23 specialist grade 3A hospitals and 1 specialist grade 3B hospitals.
From basic information on hospitals, the average number of ICU beds was 16.36 in terms of the basic profile of ICU and personnel allocation. At present, with the rapid development of critical care medicine in China, the ratio of comprehensive ICU beds in tertiary hospitals is considered to be a very important indicator in hospital evaluation. In this survey, the ratio of ICU beds to hospital beds was 1.06%, the ratio of ICU physicians to beds was approximately 0.62:1, and the ratio of nurses to beds was approximately 1.98:1, which fail to meet the national standards. In addition, the average numbers of single rooms, double rooms and triple as well as four-person and six-person rooms were 3.38, 0.75 and 0.83, respectively. Of the 28 hospitals, 15 were equipped with negative pressure beds, with an average number of 1.29.
According to the census of the population and GDP of different regions conducted by the State Statistics Bureau in 2017, the ratio of ICU beds for tumor patients to population was 4.55 beds per 10 million people. However, based on the national census data in 2015, the average number of ICU beds per 100 thousand people in China was 3.19. Furthermore, the ratio of ICU beds to GDP was 8.00 beds per RMB 100 billion, on average, according to the GDP of different regions in 2017. However, in 2015, the census data showed that the ratio of ICU beds to GDP in the six geographical regions of China averaged 7.36 beds per RMB 10 billion.
Regarding years of working in an ICU for the critical care medicine directors and head nurses, the average years of working for directors and head nurses in the ICU were 13.18 and 12.39, respectively, while the longest years of working for directors and head nurses in the ICU were 27 and 31, respectively. Regarding professional and technical titles, chief physicians, deputy chief physicians, attending physicians and resident physicians accounted for 9.89%, 13.43%, 37.10% and 39.58%, respectively. The highest degree compositions of physicians, doctorate, master’s degree, bachelor’s degree and college degree were 12.01%, 69.97%, 17.67% and 0.35%, respectively.
Regarding management, ICU management mode could be divided into closed management, semiclosed management and open management. Closed management mode was defined as ICU doctors and nurses with critical care medicine qualifications to manage patients. Semiclosed management mode was defined as the management of patients by ICU doctors, nurses and physicians. Open management mode was defined as patient management by ICU nurses and treatment by physicians. Among the respondents, 17 hospitals applied the closed management mode, 11 applied a semiclosed management mode, and none applied an open management mode. Regarding quality control of medical infection, all 28 hospitals had infection-control doctors and nurses, as well as corresponding isolation measures after the presentation of patients with drug-resistant bacteria, and were equipped with dry papers or hand dryers and automatic hand-washing switches.
Regarding technical skills and equipment configuration, the survey showed that the ICU could handle central venipuncture, tracheal intubation, tracheotomy, bronchoscopy treatment, hemodynamic monitoring, continuous blood purification, bedside ultrasound and other core technologies in critical care medicine, and continuous blood purification technology, bronchoscopy treatment, bedside ultrasound and other operations were gradually performed independently by ICU doctors. Among the 28 units included in the survey, only 1 hospital performed ECMO, but other hospitals had not performed ECMO, which may be due to the particularity of tumor patients’ diseases. The census collected the condition of patients admitted in 2016. From January 1, 2016 to December 31, 2016, a total of 44,023 patients were admitted in the 28 hospitals, mainly from thoracic surgery, general surgery, emergency department and postoperative observation room (the top four). The relevant ICU technologies for tumor treatment included intravenous infusion port implantation, radiotherapy and chemotherapy under monitoring, continuous blood purification technology for tumors with renal insufficiency, and individualized nutritional support for patients with various stages of malignant tumors and so on.