Critical care capacity in Haiti: A nationwide cross-sectional survey

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 thi...

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Veröffentlicht in:	PloS one Jg. 14; H. 6; S. e0218141
Hauptverfasser:	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
Format:	Journal Article
Sprache:	Englisch
Veröffentlicht:	United States Public Library of Science 13.06.2019 Public Library of Science (PLoS)
Schlagworte:	Adolescent Capacity Child Child, Preschool Consortia Critical care Critical Care - statistics & numerical data Critical care medicine Critical Illness Cross-Sectional Studies Education Emergency medical care Emergency medical services Emergency Service, Hospital - statistics & numerical data Engineering and Technology Equipment and Supplies, Hospital - statistics & numerical data Female Global Health - statistics & numerical data Haiti Health care Health care facilities Health facilities Health Facilities - statistics & numerical data Hospital facilities Hospitals Hospitals - statistics & numerical data Humans Infant Infant, Newborn Intensive care Intensive Care Units - statistics & numerical data Internal medicine Low income groups Male Medical personnel Medicine Medicine and Health Sciences Nurses Patients Pediatrics People and places Physicians Physicians - statistics & numerical data Polls & surveys Poverty - statistics & numerical data Research and Analysis Methods Sepsis Streamlining Supply and demand Surveys Surveys and Questionnaires Training Western Hemisphere Haiti North Carolina United States > US Port Au Prince Haiti Uganda Maryland Baltimore Maryland
ISSN:	1932-6203, 1932-6203
Online-Zugang:	Volltext
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Zusammenfassung:	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. Nationwide, cross-sectional survey of Haitian hospitals in 2017-2018. Haiti. All Haitian health facilities with at least six hospital beds. Electronic- and paper-based survey. 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. 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.
Bibliographie:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 Membership of the Research and Education consortium for Acute Care in Haiti (REACH) is provided in the acknowledgments. Competing Interests: The authors have declared that no competing interests exist. These authors are are co-senior authors on this work.
ISSN:	1932-6203 1932-6203
DOI:	10.1371/journal.pone.0218141