Critical Care Bed Capacity in Asian Countries and Regions

Phua J 1 , Faruq MO 2 , Kulkarni AP 3 , Redjeki IS 4 , Detleuxay K 5 , Mendsaikhan N 6 Show all authors , Sann KK 7 , Shrestha BR 8 , Hashmi M 9 , Palo JEM 10 , Haniffa R 11 , Wang C 12 , Hashemian SMR 13 , Konkayev A 14 , Mat Nor MB 15 , Patjanasoontorn B 16 , Nafees KMK 17 , Ling L 18 , Nishimura M 19 , Al Bahrani MJ 20 , Arabi YM 21 , Lim CM 22 , Fang WF 23 , Asian Analysis of Bed Capacity in Critical Care (ABC) Study Investigators, and the Asian Critical Care Clinical Trials Group

Affiliations 

  • 1 Fast and Chronic Programmes, Alexandra Hospital, National University Health System, Singapore
  • 2 General Intensive Care Unit and Emergency Department, United Hospital Ltd, Dhaka, Bangladesh
  • 3 Division of Critical Care Medicine, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India
  • 4 Faculty of Medicine, Department of Anesthesiology and Intensive Care, Padjadjaran University, Dr. Hasan Sadikin National Referal Hospital Bandung, Bandung, Indonesia
  • 5 Adult Intensive Care Unit, Mahosot Hospital, Vientiane, Lao PDR
  • 6 Anaesthesia and Critical Care Department, Mongolian National University of Health Science, Ulaanbaatar, Mongolia
  • 7 Department of Anaesthesiology and ICU, Yangon General Hospital, University of Medicine 1, Yangon, Myanmar
  • 8 Department of Anesthesia and Intensive Care, Kathmandu Medical College Teaching Hospital, Kathmandu, Nepal
  • 9 Department of Anaesthesiology, Aga Khan University, Karachi, Pakistan
  • 10 Acute and Critical Care Institute, The Medical City, Pasig City, Philippines
  • 11 Network for Improving Critical Care Systems and Training, Colombo, Sri Lanka
  • 12 Department of Critical Care Medicine, Shandong Provincial Hospital, Jinan, China
  • 13 Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • 14 Anaesthesiology and Intensive Care Department, Astana Medical University, Nur-Sultan, Kazakhstan
  • 15 International Islamic University Malaysia Medical Centre, Kuantan, Malaysia
  • 16 Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
  • 17 RIPAS Hospital, Bandar Seri Begawan, Brunei Darussalam
  • 18 Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
  • 19 Tokushima Prefectural Central Hospital, Tokushima, Japan
  • 20 Department of Anesthesia and Critical Care, Royal Hospital, Muscat, Oman
  • 21 King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia
  • 22 Department of Pulmonary and Critical Care Medicine, Asan Medical Center, Seoul, South Korea
  • 23 Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
Crit Care Med, 2020 05;48(5):654-662.
PMID: 31923030 DOI: 10.1097/CCM.0000000000004222

Abstract

OBJECTIVE: To assess the number of adult critical care beds in Asian countries and regions in relation to population size.

DESIGN: Cross-sectional observational study.

SETTING: Twenty-three Asian countries and regions, covering 92.1% of the continent's population.

PARTICIPANTS: Ten low-income and lower-middle-income economies, five upper-middle-income economies, and eight high-income economies according to the World Bank classification.

INTERVENTIONS: Data closest to 2017 on critical care beds, including ICU and intermediate care unit beds, were obtained through multiple means, including government sources, national critical care societies, colleges, or registries, personal contacts, and extrapolation of data.

MEASUREMENTS AND MAIN RESULTS: Cumulatively, there were 3.6 critical care beds per 100,000 population. The median number of critical care beds per 100,000 population per country and region was significantly lower in low- and lower-middle-income economies (2.3; interquartile range, 1.4-2.7) than in upper-middle-income economies (4.6; interquartile range, 3.5-15.9) and high-income economies (12.3; interquartile range, 8.1-20.8) (p = 0.001), with a large variation even across countries and regions of the same World Bank income classification. This number was independently predicted by the World Bank income classification on multivariable analysis, and significantly correlated with the number of acute hospital beds per 100,000 population (r = 0.19; p = 0.047), the universal health coverage service coverage index (r = 0.35; p = 0.003), and the Human Development Index (r = 0.40; p = 0.001) on univariable analysis.

CONCLUSIONS: Critical care bed capacity varies widely across Asia and is significantly lower in low- and lower-middle-income than in upper-middle-income and high-income countries and regions.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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