The Dynamics of The Development of the Load on the Anesthesiology and Critical Care Services in a Large City

Abstract

Purpose of the study: To identify areas for improving the conditions of effective work of the anesthesiology and critical care service.Materials and methods: The authors performed a comprehensive analysis of data from 75 inpatient medical organizations in St. Petersburg (continuous observation) on the number and structure of critical care and anesthetic support and personnel resources of anesthesiologists and critical care physicians for the period between 2015 and 2019 (1,309,700 cases of anesthetic support and 759,696 cases of critical care). The obtained data were statistically processed, and the average values, extensive and intensive parameters, the significance of differences in parameters according to Student's t-criterion, parameters of the time series, and correlation analysis were calculated.Results: The study showed an increase in the load on the anesthesiology and critical care services in recent years. The number of patients had increased by 13.8%, the volume of critical care and anesthetic support provided had increased by 9.4% and 14.8%, respectively. At the same time, the increase in the volume of manipulations performed by anesthesiologists and critical care physicians was not accompanied by an influx of specialists to work in that field or by staffing of hospitals with medical personnel in sufficient volume, which is confirmed by parameters characterizing the workload per 1 specialist of that profile in a hospital (in 2015, 1 specialist on average performed 101.4 anesthetic support manipulations, and in 2019, that number rose to 109.1 (t = 3.7, p <0.05)). The critical care load ratio in 2015 was 61.43, and in 2019, it equaled 63, 06 (t = 4.5, p <0.05).Conclusion: The anesthesiology and critical care services, as the most vulnerable due to the increased psychological, emotional, and physical stress of doctors, require special approaches to human resources. The growing general "volumetric" workload of anesthesiologists and critical care physicians is accompanied by factors that significantly complicate the conditions of their work (the prevalence of interventions carried out in the context of emergency and urgent medical care). These circumstances must be taken into account when implementing measures to improve the organization of work of anesthesiologists and critical care physicians.