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Critical care capacity in Haiti: A nationwide cross-sectional survey
OBJECTIVE: Critical illness affects health systems globally, but low- and middle-income countries (LMICs) bear a disproportionate burden. Due to a paucity of data, the capacity to care for critically ill patients in LMICs is largely unknown. Haiti has the lowest health indices in the Western Hemisph...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6565360/ https://www.ncbi.nlm.nih.gov/pubmed/31194795 http://dx.doi.org/10.1371/journal.pone.0218141 |
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author | Losonczy, Lia I. Barnes, Sean L. Liu, Shiping Williams, Sarah R. McCurdy, Michael T. Lemos, Vivienne Chandler, Jerry Colas, L. Nathalie Augustin, Marc E. Papali, Alfred |
author_facet | Losonczy, Lia I. Barnes, Sean L. Liu, Shiping Williams, Sarah R. McCurdy, Michael T. Lemos, Vivienne Chandler, Jerry Colas, L. Nathalie Augustin, Marc E. Papali, Alfred |
author_sort | Losonczy, Lia I. |
collection | PubMed |
description | OBJECTIVE: Critical illness affects health systems globally, but low- and middle-income countries (LMICs) bear a disproportionate burden. Due to a paucity of data, the capacity to care for critically ill patients in LMICs is largely unknown. Haiti has the lowest health indices in the Western Hemisphere. In this study, we report results of the first known nationwide survey of critical care capacity in Haiti. DESIGN: Nationwide, cross-sectional survey of Haitian hospitals in 2017–2018. SETTING: Haiti. SUBJECTS: All Haitian health facilities with at least six hospital beds. INTERVENTIONS: Electronic- and paper-based survey. RESULTS: Of 51 health facilities identified, 39 (76.5%) from all ten Haitian administrative departments completed the survey, reporting 124 reported ICU beds nationally. Of facilities without an ICU, 20 (83.3%) care for critically ill patients in the emergency department. There is capacity to ventilate 62 patients nationally within ICUs and six patients outside of the ICU. One-third of facilities with ICUs report formal critical care training for their physicians. Only five facilities met criteria for a Level 1 ICU as defined by the World Federation of Societies of Intensive and Critical Care Medicine. Self-identified barriers to providing more effective critical care services include lack of physical space for critically ill patients, lack of equipment, and few formally trained physicians and nurses. CONCLUSIONS: Despite a high demand for critical care services in Haiti, current capacity remains insufficient to meet need. A significant amount of critical care in Haiti is provided outside of the ICU, highlighting the important overlap between emergency and critical care medicine in LMICs. Many ICUs in Haiti lack basic components for critical care delivery. Streamlining critical care services through protocol development, education, and training may improve important clinical outcomes. |
format | Online Article Text |
id | pubmed-6565360 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-65653602019-06-20 Critical care capacity in Haiti: A nationwide cross-sectional survey Losonczy, Lia I. Barnes, Sean L. Liu, Shiping Williams, Sarah R. McCurdy, Michael T. Lemos, Vivienne Chandler, Jerry Colas, L. Nathalie Augustin, Marc E. Papali, Alfred PLoS One Research Article OBJECTIVE: Critical illness affects health systems globally, but low- and middle-income countries (LMICs) bear a disproportionate burden. Due to a paucity of data, the capacity to care for critically ill patients in LMICs is largely unknown. Haiti has the lowest health indices in the Western Hemisphere. In this study, we report results of the first known nationwide survey of critical care capacity in Haiti. DESIGN: Nationwide, cross-sectional survey of Haitian hospitals in 2017–2018. SETTING: Haiti. SUBJECTS: All Haitian health facilities with at least six hospital beds. INTERVENTIONS: Electronic- and paper-based survey. RESULTS: Of 51 health facilities identified, 39 (76.5%) from all ten Haitian administrative departments completed the survey, reporting 124 reported ICU beds nationally. Of facilities without an ICU, 20 (83.3%) care for critically ill patients in the emergency department. There is capacity to ventilate 62 patients nationally within ICUs and six patients outside of the ICU. One-third of facilities with ICUs report formal critical care training for their physicians. Only five facilities met criteria for a Level 1 ICU as defined by the World Federation of Societies of Intensive and Critical Care Medicine. Self-identified barriers to providing more effective critical care services include lack of physical space for critically ill patients, lack of equipment, and few formally trained physicians and nurses. CONCLUSIONS: Despite a high demand for critical care services in Haiti, current capacity remains insufficient to meet need. A significant amount of critical care in Haiti is provided outside of the ICU, highlighting the important overlap between emergency and critical care medicine in LMICs. Many ICUs in Haiti lack basic components for critical care delivery. Streamlining critical care services through protocol development, education, and training may improve important clinical outcomes. Public Library of Science 2019-06-13 /pmc/articles/PMC6565360/ /pubmed/31194795 http://dx.doi.org/10.1371/journal.pone.0218141 Text en © 2019 Losonczy et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Losonczy, Lia I. Barnes, Sean L. Liu, Shiping Williams, Sarah R. McCurdy, Michael T. Lemos, Vivienne Chandler, Jerry Colas, L. Nathalie Augustin, Marc E. Papali, Alfred Critical care capacity in Haiti: A nationwide cross-sectional survey |
title | Critical care capacity in Haiti: A nationwide cross-sectional survey |
title_full | Critical care capacity in Haiti: A nationwide cross-sectional survey |
title_fullStr | Critical care capacity in Haiti: A nationwide cross-sectional survey |
title_full_unstemmed | Critical care capacity in Haiti: A nationwide cross-sectional survey |
title_short | Critical care capacity in Haiti: A nationwide cross-sectional survey |
title_sort | critical care capacity in haiti: a nationwide cross-sectional survey |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6565360/ https://www.ncbi.nlm.nih.gov/pubmed/31194795 http://dx.doi.org/10.1371/journal.pone.0218141 |
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