著者

Hiroyuki Ohbe Yusuke Sasabuchi Ryosuke Kumazawa Hiroki Matsui Hideo Yasunaga

出版者

Japan Epidemiological Association

雑誌

Journal of Epidemiology (ISSN:09175040)

巻号頁・発行日

vol.32, no.12, pp.535-542, 2022-12-05 (Released:2022-12-05)

参考文献数

31

被引用文献数

14

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Background: Detailed data on intensive care unit (ICU) occupancy in Japan are lacking. Using a nationwide inpatient database in Japan, we aimed to assess ICU bed occupancy to guide critical care utilization planning.Methods: We identified all ICU patients admitted from January 1, 2015 to December 31, 2018 to ICU-equipped hospitals participating in the Japanese Diagnosis Procedure Combination inpatient database. We assessed the trends in daily occupancy by counting the total number of occupied ICU beds on a given day divided by the total number of licensed ICU beds in the participating hospitals. We also assessed ICU occupancy for patients with mechanical ventilation, patients with extracorporeal membrane oxygenation, and patients without life-supportive therapies.Results: Over the 4 study years, 1,379,618 ICU patients were admitted to 495 hospitals equipped with 5,341 ICU beds, accounting for 75% of all ICU beds in Japan. Mean ICU occupancy on any given day was 60%, with a range of 45.0% to 72.5%. Mean ICU occupancy did not change over the 4 years. Mean ICU occupancy was about 9% higher on weekdays than on weekends and about 5% higher in the coldest season than in the warmest season. For patients with mechanical ventilation, patients with extracorporeal membrane oxygenation, and patients without life-supportive therapies, mean ICU occupancy was 24%, 0.5%, and 30%, respectively.Conclusion: Only one-fourth of ICU beds were occupied by mechanically ventilated patients, suggesting that the critical care system in Japan has substantial surge capacity under normal temporal variation to care for critically ill patients.

著者

Yusuke Sasabuchi

出版者

Society for Clinical Epidemiology

雑誌

Annals of Clinical Epidemiology (ISSN:24344338)

巻号頁・発行日

vol.4, no.1, pp.1-5, 2022 (Released:2022-01-07)

参考文献数

9

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It is common clinical practice for physicians to refer to specific diagnostic criteria for day-to-day decision-making. In particular, whether or not to provide a particular treatment is often determined by the cutoff value of a relevant diagnostic marker. Regression discontinuity design (RDD) is a method for evaluating scenarios where intervention is determined by the certain cutoff value (e.g., threshold) of a continuous variable. RDD represents a powerful method for assessing intervention effects and outcomes. RDD is underutilized in clinical research and there are many opportunities to apply RDD in this setting. This article introduces the principles of RDD and provides examples of clinical studies that have used this design.