北京市流感大流行医疗救治能力评估：Flu Surge模型的应用及适用条件的初步探索

Assessment of current hospital capacity in Beijing in responding to potential influenza pandemic： an application on Flu Surge model

根据F1u Surge模型估算的北京市应对流感大流行医疗救治能力结果对该模型的适用条件进行讨论，为科学运用该模型提供依据。通过对北京市医疗机构资源的调查，以FluSurge模型估算流感大流行时各医疗机构的医疗救治能力，并结合北京市医疗机构实际情况对Flu Surge模型的适用条件进行初步探索。Flu Surge模型估算流感罹患率为35％时，北京市的流感患者将达到5383000人，就诊患者2691500例，住院治疗患者76450例，死亡14508例；需占用普通病床、ICU和呼吸机分别为8％、210％和128％。一、二、三级医疗机构每日每个门／急诊将分别达到1742、650和139例。现场调查医护人员流感防治知识技能正确率为63．4％，洗手方法正确率为73．5％，个人防护用品使用率为63．5％。以总床位数、内科床位数、呼吸科床位数估算床位使用率分别需要占用8％、35％和128％。结论根据模型估算结果，北京市医疗机构应对流感大流行ICU和呼吸机数量不足。模型估算结果可作为参考依据，但需要结合实际情况进行分析，全面、客观的看待模型估算结果。

Based on the estimate results of the capacity and preparedness of Beijing hospitals to respond to pandemic influenza, using flu surge model to evaluate its applicable hypothesis and to provide government with sentient strategy in planning pandemic influenza. Through collection of medical resources information, we calculated the possible impaction on hospitals by Flu Surge model and explored the applicable hypothesis in model operation through a questionnaire, direct observation and group discussion in 3 hospitals in Beijing. Based on flu surge model estimation during a 6-week epidemic from a pandemic virus with 35% attack rate, Beijing would have had an estimation of 5 383 000 influenza illnesses, 2 691 500 influenza outpatients, 76 450 influenza hospitalizations and 14 508 excess deaths. For a 6-week period with 35% attack rate, there would be a peak demand for 8% of beds, 210% of ICU beds, and 128% of ventilators estimated. Outpatients in different level hospital were quite disproportionated with 1742/ hospatail/day, 650/hospatail/day, and 139/hospatail/day respectively. The sampled health workers had a mastery of 63.4 % of the total knowledge and skills of diagnosing and treating of influenza, 73.5 % of them washed their hands and 63.5 % used PPE correctly. The total beds capacity, medical beds capacity and respiratory medical beds capacity would increase 8%, 35% and 128% respectively. Conclusion The estimation results could be referenced when planning the pandemic strategy, but the results should be treated objectively when considering the hypothesis and practical situation in this model being used.