Basic investigation into the present burn care system in China: burn units, doctors, nurses, beds and special...

The aim of the study was to survey the current burn units in China to understand the burn care system in the country and supply basic data for the National Burn Repository of China (NBRC) and further research.

A questionnaire was developed and sent to burn unit directors in China via e-mail, which was followed up with reminder text messages to obtain information for the study.

Of the 405 hospitals from the 31 provinces in mainland China that responded to the questionnaire, 63.7% of the responses came from Grade 3A hospitals, and the most popular model of organisation was the Burns and Plastic Surgery arrangement (63.0%). An average of 9.43±0.351 doctors work in each burn unit with 70.4% of all units having 4-11 doctors. The ratio of chief surgeon to associate chief surgeon to attending surgeon to resident surgeon and surgeon assistant was 1:1.8:2.2:2.3. An average of 30% of all doctors in each burn unit held postgraduate degrees, and more than 90% of all surgeons held a bachelor's degree or higher. There were 16.48±0.637 nurses per burn unit, 56.5% of burn units had 8-15 nurses, and the ratio of chief nurse to associate chief nurse to supervisor nurse to nurse practitioner to junior nurse was 1:11.8:57.0:82.1:86.1. More than 80% of all nurses had received a college education or above. However, only 30% of nurses held bachelor's degrees or higher, while only 0.66% of nurses had received postgraduate degrees. A total of 39.91±1.50 beds were available in each burn unit and 45% of burn units had 20-39 beds. Up to 70% of the total beds were prepared for patients with burn, and more than 10% of the beds were specifically for patients with severe burn. The ratios of doctors to nurses, beds to doctors, beds to nurses, and beds to doctors and nurses were 0.64±0.01, 4.48±0.12, 2.67±0.09, and 1.66±0.06, respectively. The workload of each doctor and nurse was most heavy in units with 40-59 beds. In addition, we estimated that there were 0.05, 0.5, 0.8, and 1.9 burn units, burn doctors, nurses, and beds, respectively, per 100,000 members of the population in mainland China. Chinese burn units lack special burn treatments, nursing equipment, and operation apparatuses.

To the best of our knowledge, this is the first survey of the present burn care system in China. These results confirm that the burn care system is not equivalent to the national power of this country and the system lacks a great number of trained burn professionals. Burn doctors and nurses bear a heavy burden of work. This report supplies basic data to spur further research. We propose creating a burn unit registration system and a special database in China.