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Study of paediatric intensive care units in Spain. Spanish Society of Paediatric Intensive Care
J López-Herce1, L Sancho, J M Martinón
1Paediatric Intensive Care Unit, Gregorio Marañón University Hospital, Dr Castelo 49, E-28009 Madrid, Spain. pielvi@mx4.redestb.es
Insights
Spanish pediatric intensive care units (PICUs) are primarily run by specialized pediatricians. While 1996 outcomes align with European standards, further studies are needed for PICU reorganization.
Area of Science:
- Pediatric Intensive Care
- Healthcare Organization
- Public Health Systems
Background:
- Paediatric intensive care units (PICUs) are crucial for managing critically ill children.
- Understanding the structure and function of these units is vital for improving patient outcomes.
- The organization of PICUs in Spain in 1996 provides a benchmark for current healthcare practices.
Purpose of the Study:
- To delineate the organizational framework of pediatric intensive care units in Spain.
- To detail the medical assistance provided within these units during 1996.
- To establish a baseline for evaluating the efficiency and planning of Spanish PICUs.
Main Methods:
- A comprehensive written questionnaire was distributed to all pediatric ICUs affiliated with the Spanish public health system.
- Data collection focused on unit structure, staffing, training, patient demographics, and clinical outcomes.
- Thirty-one out of 34 targeted PICUs responded, providing a robust dataset for analysis.
Main Results:
- The study surveyed 31 medico-surgical pediatric ICUs, varying in patient focus (pediatric, neonatal, adult) and bed capacity (fewer than 7 to 13-18 beds).
- 83.8% of PICUs were staffed by pediatricians specializing in pediatric intensive care, with an average of 5.1 on-call duties per medical staff member monthly.
- In 1996, 9,585 patients were admitted (35.3 patients/bed), with a mean stay of 5.6 days and a 5.4% mortality rate, primarily due to multiple organ failure and brain death. Training for residents and medical students was common.
Conclusions:
- Paediatric intensive care in Spain is predominantly delivered by specialized paediatricians.
- Overall results from 1996 are comparable to those reported in other European countries.
- Further efficiency studies are recommended to guide the strategic planning and reorganization of pediatric intensive care units in Spain.
Objective:
To describe the organisation of paediatric intensive care units in Spain and the medical assistance provided during 1996.
Methods:
A written questionnaire was sent to all the paediatric ICUs linked to or within the Spanish public health system.
Results:
Thirty-one of the 34 paediatric ICUs replied. All are medico-surgical units. Eighteen treat only paediatric patients, 12 paediatric and neonatal patients, and one paediatric and adult patients. Fifteen units have fewer than seven beds, eight have between 7 and 12 beds, and eight between 13 and 18 beds. Of the paediatric ICUs, 83.8 % are staffed by paediatricians specialised in paediatric intensive care. The mean number of on-call on site periods of duty for each member of the medical staff was 5.1 +/- 1.7 per month. Thirty of the 31 units undertake paediatric resident training, 13 train residents specialising in paediatric intensive care and 12 participate in medical student training. In 1996 there were 9,585 admissions (309 +/- 182 patients per ICU) signifying 35.3 +/- 14 patients/bed. Of the patients, 65.9 % were medical and 34.1 % surgical. The mean duration of stay was 5.6 +/- 2.1 days. The mortality rate was 5.4 +/- 3.2 %. The main causes of death were multiple organ failure and brain death.
Conclusions:
In Spain, paediatric intensive care is principally performed by specialised paediatricians. Although the general results for 1996 are similar to those of other European countries, efficiency studies are necessary to plan and re-organise the paediatric intensive care units in Spain.
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