The current situation of intensive care units in Chinese mainland: A nationwide survey

Background: Previous studies have highlighted the importance of intensive care units (ICUs) in providing specialized care for critically ill patients. However, little is known about the current distribution of ICU resources, medical personnel, and available technologies across hospitals of different levels in Chinese mainland. In response, this study evaluated the distribution of ICU resources, personnel, major diseases, medical techniques, and the relationship between ICU bed availability and economic development to provide an overview of the current state of ICU services in Chinese mainland. Methods: A comprehensive questionnaire was distributed to intensivists at all levels of hospitals in Chinese mainland via the Questionnaire Starmini-program, a commonly used web-based survey platform in China. The questionnaire covered a wide range of items, including the demographic characteristics of intensivists, ICU type and capacity, composition of medical teams, disease classification, and available medical techniques. Results: Data were analyzed from 3637 intensivists working in 2005 hospitals throughout Chinese mainland, representing approximately half of all hospitals with ICU settings nationwide. The median number of hospital beds was 1000 (interquartile range [IQR], 547-1800), and the median number of ICU beds was 17 (IQR: 11-25). Overall, 600 (IQR: 300-1091) patients were admitted to the ICU annually at each hospital. The mean number of ICU beds per 100,000 people was 5.31 in 2022. The majority of the surveyed medical groups (ranging from 97.7% to 98.8%) led by chief physicians have experience in treating the eight most common conditions managed in the ICU, including severe pneumonia, cardiogenic shock, hypovolemic shock, sepsis, septic shock, cardiopulmonary resuscitation, acute respiratory distress syndrome, and acute renal injury. Regarding essential medical techniques in the ICU, 98.2%, 86.5%, 71.2%, and 24.1% of surveyed hospitals have implemented invasive mechanical ventilation, continuous blood purification, bedside ultrasound, and extracorporeal membrane oxygenation, respectively. Conclusions: This survey indicates that, although ICUs in Chinese mainland have advanced significantly to some extent, there are still challenges to address, such as regional disparities and hospital grade differences.