Need estimates of psychiatric beds: a systematic review and meta-analysis.

This study aimed to review and synthesize the need estimates for psychiatric beds, explore how they changed over time and compare them against the prevalence of actually existing beds. We searched PubMed, Embase classic and Embase, PsycINFO and PsycIndex, Open Grey, Google Scholar, Global Health EBSCO and Proquest Dissertations, from inception to September 13, 2022. Publications providing estimates for the required number of psychiatric inpatient beds were included. Need estimates, length of stay, and year of the estimate were extracted. Need estimates were synthesized using medians and interquartile ranges (IQRs). We also computed prevalence ratios of the need estimates and the existing bed capacities at the same time and place. Sixty-five publications with 98 estimates were identified. Estimates for bed needs were trending lower until 2000, after which they stabilized. The twenty-six most recent estimates after 2000 were submitted to data synthesis (n = 15 for beds with unspecified length of stay, n = 7 for short-stay, and n = 4 for long-stay beds). Median estimates per 100 000 population were 47 (IQR: 39 to 50) beds with unspecified length of stay, 28 (IQR: 23 to 31) beds for short-stay, and 10 (IQR: 8 to 11) for long-stay beds. The median prevalence ratio of need estimates and the actual bed prevalence was 1.8 (IQR: 1.3 to 2.3) from 2000 onwards. Historically, the need estimates for psychiatric beds have decreased until about 2000. In the past two decades, they were stable over time and consistently higher than the actual bed numbers provided.

Changes in maerl-associated macroalgal community dynamics as evidence of anthropogenic pressure.

BACKGROUND AND AIMS: Maerl-associated communities have received considerable attention due to their uniqueness, biodiversity and functional importance. Although the impacts of human activities are well documented for maerl-associated macrofauna, the spatio-temporal variations of macroalgae have comparatively been neglected, and the drivers that influence their dynamics are poorly known. We investigate the links between maerl-associated macroalgal communities, anthropogenic pressures and environmental conditions, and hypothesize that sites under human pressure would exhibit different dynamics when compared to reference sites. METHODS: To better understand community variation through space and time, four subtidal maerl beds under different pressures were consistently monitored over one year in the bay of Brest, Brittany, France. Both macroalgae community monitoring and environmental data were acquired through field sampling and available models. KEY RESULTS: Higher macroalgal biomass was observed within eutrophic sites, especially in summer (more than ten times higher than in the Unimpacted site), caused by free-living forms of opportunistic red macroalgae. The Dredged site also exhibited distinct macroalgal communities during summer from the Unimpacted site. Nutrient concentrations and seasonality proved to be key factors affecting the macroalgal community composition, although dredging and its effects on granulometry also had a strong influence. Over the long term, fewer than half of the species identified during historical surveys were found, indicating major temporal changes. CONCLUSIONS: Human pressures have strong impacts on maerl-associated macroalgal communities. Nutrient concentrations and dredging pressure appear as the main anthropogenic factors shaping maerl-associated macroalgal communities. Additionally, our results suggest historical changes in maerl-associated macroalgal communities over 25 years in response to changes in local human pressure management. This study suggests that maerl-associated macroalgal communities could be used as indicators of anthropogenically driven changes in this habitat.

Revealing spatiotemporal inequalities, hotspots, and determinants in healthcare resource distribution: insights from hospital beds panel data in 2308 Chinese counties.

BACKGROUND: Ensuring universal health coverage and equitable access to health services requires a comprehensive understanding of spatiotemporal heterogeneity in healthcare resources, especially in small areas. The absence of a structured spatiotemporal evaluation framework in existing studies inspired us to propose a conceptual framework encompassing three perspectives: spatiotemporal inequalities, hotspots, and determinants. METHODS: To demonstrate our three-perspective conceptual framework, we employed three state-of-the-art methods and analyzed 10 years' worth of Chinese county-level hospital bed data. First, we depicted spatial inequalities of hospital beds within provinces and their temporal inequalities through the spatial Gini coefficient. Next, we identified different types of spatiotemporal hotspots and coldspots at the county level using the emerging hot spot analysis (Getis-Ord Gi* statistics). Finally, we explored the spatiotemporally heterogeneous impacts of socioeconomic and environmental factors on hospital beds using the Bayesian spatiotemporally varying coefficients (STVC) model and quantified factors' spatiotemporal explainable percentages with the spatiotemporal variance partitioning index (STVPI). RESULTS: Spatial inequalities map revealed significant disparities in hospital beds, with gradual improvements observed in 21 provinces over time. Seven types of hot and cold spots among 24.78% counties highlighted the persistent presence of the regional Matthew effect in both high- and low-level hospital bed counties. Socioeconomic factors contributed 36.85% (95% credible intervals [CIs]: 31.84-42.50%) of county-level hospital beds, while environmental factors accounted for 59.12% (53.80-63.83%). Factors' space-scale variation explained 75.71% (68.94-81.55%), whereas time-scale variation contributed 20.25% (14.14-27.36%). Additionally, six factors (GDP, first industrial output, local general budget revenue, road, river, and slope) were identified as the spatiotemporal determinants, collectively explaining over 84% of the variations. CONCLUSIONS: Three-perspective framework enables global policymakers and stakeholders to identify health services disparities at the micro-level, pinpoint regions needing targeted interventions, and create differentiated strategies aligned with their unique spatiotemporal determinants, significantly aiding in achieving sustainable healthcare development.

2022 insights on hospital bed distribution in Saudi Arabia: evaluating needs to achieve global standards.

BACKGROUND: Equitable geographical distribution of health resources, such as hospital beds, is fundamental in ensuring public accessibility to healthcare services. This study examines the distribution of hospital beds across Saudi Arabia's 20 health regions. METHODS: A secondary data analysis was conducted using the 2022 Saudi Ministry of Health Statistical Yearbook. The study focused on calculating the hospital beds-per-1,000-people ratio across Saudi Arabia's 20 health regions. The analysis involved comparing regional bed distributions using the Gini index and Lorenz curve to assess the distribution of hospital beds. RESULTS: The national average beds-per-1,000-people ratio was 2.43, serving a population of approximately 32.2 million. The calculated mean Gini index for bed distribution was 0.15, which indicates a relatively equitable distribution. Further analysis revealed some regional disparities, with health regions like Makkah and Jeddah displaying critically low bed-to-population ratios. In contrast, others like Al-Jouf and the Northern region reported higher ratios. The study also identified the need for an additional 17,062 beds to meet international standards of 2.9 beds per 1,000 people. CONCLUSIONS: The findings revealed a national average beds-per-1,000-people ratio of 2.43, with some regional disparities. The study highlights the critical need for targeted healthcare planning and policy interventions to address the uneven distribution of hospital beds across Saudi Arabia. TRIAL REGISTRATION: Not applicable.

Hematite reconstruction of Late Triassic hydroclimate over the Colorado Plateau.

Hematite is the most abundant surficial iron oxide on Earth resulting from near-surface processes that make it important for addressing numerous geologic problems. While red beds have proved to be excellent paleomagnetic recorders, the early diagenetic origin of hematite in these units is often questioned. Here, we validate pigmentary hematite ("pigmentite") as a proxy indicator for the Late Triassic environment and its penecontemporaneous origin by analyzing spectrophotometric measurements of a 14.5-My-long red bed sequence in scientific drill core CPCP-PFNP13-1A of the Chinle Formation, Arizona. Pigmentite concentrations in the red beds track the evolving pattern of the Late Triassic monsoon and indicate a long-term rise in aridity beginning at ∼215 Ma followed by increased oscillatory climate change at ∼213 Ma. These monsoonal changes are attributed to the northward drift of the Colorado Plateau as part of Laurentia into the arid subtropics during a time of fluctuating CO2 Our results refine the record of the Late Triassic monsoon and indicate significant changes in rainfall proximal to the Adamanian-Revueltian biotic transition that thus may have contributed to apparent faunal and floral events at 216 to 213 Ma.

Care call requests and inpatient beds modernization: Is there any link? A prospective observational study in the oncological setting.

AIM: The study aims to analyse the principal causes of patients' care calls and compare differences before and after inpatient beds' technological modernization in a surgical breast oncological ward. DESIGN: A prospective observational study was conducted under the STROBE guidelines. Data were collected from June to September 2022. METHODS: Statistical analyses were performed to compare each reason for care calls, by shifts and pre and post-inpatient bed modernization. RESULTS: Two thousand five hundred and fifty-nine care request calls were analysed during the 202 observed shifts. The most frequent reason was related to the requests for positions. CONCLUSION: Technological modernization of the beds has not led to effective-positive-changes; on the contrary, it seems at first glance to show an upward trend in calls above all in the short period after the changes. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: What problem did the study address? By analysing the principal causes of care calls and comparing the differences before and after inpatient beds' technological modernization, this study evaluates if inpatient gear or device modernization can impact care call requests. What were the main findings? The results show that the most frequent reasons for care calls were position, possession and other. These findings seem not superimposable; the hypothesis supported by the international literature in which the causes relating to potty and pain were found among the main reasons. Where and on whom will the research have an impact? These results could impact the care organizational area in nursing care and could improve care quality, patient satisfaction and safety. REPORTING METHOD: This prospective observational study was conducted following STROBE guidelines. PATIENT OR PUBLIC CONTRIBUTION: After adequate information (presentation, design methods and objectives), all unit healthcare staff agreed to collaborate in the study.

Real-time dynamics of aculeate hymenopteran reed gall inquilines in oligotrophic reed beds of anthropogenic and natural origin.

This is the first study providing long-term data on the dynamics of bees and wasps and their parasitoids for the evidence-based management of reed beds. Ten years ago, we identified Lipara (Chloropidae) - induced galls on common reed (Phragmites australis, Poaceae) as a critically important resource for specialized bees and wasps (Hymenoptera: Aculeata). We found that they were surprisingly common in relatively newly formed anthropogenic habitats, which elicited questions about the dynamics of bees and wasps and their parasitoids in newly formed reed beds of anthropogenic origin. Therefore, in the winter and spring of 2022/23, we sampled reed galls from the same set of reed beds of anthropogenic and natural origin as those in 2012/13. At 10 sites, the number of sampled galls was similar in both time periods (80-122% of the value from 2012/13); 12 sites experienced a moderate decline (30-79% of the value from 2012/13), and the number of galls at six sampling sites was only 3-23% of their abundance in 2012/13. Spontaneous development was associated with increasing populations. After 10 years of spontaneous development, the populations of bees and wasps (including their parasitoids) bound to Lipara-induced reed galls increased in abundance and species richness or remained at their previous levels, which was dependent on the sampling site. The only identified threat consisted of reclamation efforts. The effects of habitat age were limited, and the assemblages in habitats of near-natural and anthropogenic origin largely overlapped. However, several species were consistently present at lower abundances in the anthropogenic habitats and vice versa. In conclusion, we provided evidence-based support for the establishment of oligotrophic reed beds of anthropogenic origin as management tools providing sustainable habitats for specialized reed gall-associated aculeate hymenopteran inquilines, including the threatened species.

Evaluating the performance of faecal sludge dewatering technologies in urban settings of developing African countries: a review.

Inadequate dewatering technologies are reported as the dominant challenge in handling faecal sludge (FS) within urban settings of most African countries. Studies have been carried out to evaluate the efficiencies of unplanted sand drying beds (USDBs), decentralized wastewater treatment systems (DEWATS), and geo-tubes. However, limited information is available on comparative capabilities in dewatering the FS. This work reviewed treatment efficiencies by assessing the reported actual waste removal capacities and ascertaining if they align with the design removal provisions. Peer-reviewed papers, books, and technical reports from trusted sources were examined. The results show that all the technologies perform best in dewatering the FS; however, USDBs are widely adopted for city-wide treatment, and the other two are suited for decentralized communities. The USDB is challenged by frequent clogging and poor quality of dewatered sludge when reused or recycled in the production of solid fuel and compost due to sticking sand after sludge harvesting. The DEWATS and geo-tubes increase operational costs when used to treat the FS at a large scale. More studies should be conducted to explore locally made, cost-effective filter media and technologies to enhance the dewatering quality and quantity of the FS and increase the quality of recycled by-products.

This paper reviewed the capabilities of sand drying beds, decentralized wastewater treatment systems (DEWATS) and geo-tubes in dewatering the faecal sludge (FS).All reviewed dewatering technologies significantly reduce the solid concentration of faecal sludge, so they perform best in dewatering the FS.Sand drying beds are considered a suitable technology for city-wide sanitation management, the other two are best suited for decentralized communities.Although sand drying beds are viewed as the most promoted and adopted city-wide dewatering technology, they face clogging and poor quality of harvested dry solids for reuse and recycling purposes.More studies on alternative filter media and/or technologies are urgently needed. If the filter media is in contact and or is removed together with dry sludge during harvesting, then the media should be organic so that it enhances the quality of reused or recycled byproducts.

Effects of a mattress cover with special airflow technology on the structure and function of the sacral and heel skin during loading: A two-arm exploratory crossover trial.

Prolonged mechanical loading of the skin and underlying soft tissue cause pressure ulceration. The use of special support surfaces are key interventions in pressure ulcer prevention. They modify the degree and duration of soft tissue deformation and have an impact on the skin microclimate. The objective of this randomized cross-over trial was to compare skin responses and comfort after lying for 2.5 h supine on a support surface with and without a coverlet that was intended to assist with heat and moisture removal at the patient/surface interface. In addition, physiological saline solution was administered to simulate an incontinence episode on the mattress next to the participants' skin surface. In total, 12 volunteers (mean age 69 years) with diabetes mellitus participated. After loading, skin surface temperature, stratum corneum hydration and skin surface pH increased, whereas erythema and structural stiffness decreased at the sacral area. At the heel skin area, temperature, erythema, and stratum corneum hydration increased. These results indicate occlusion and soft tissue deformation which was aggravated by the saline solution. The differences in skin response showed only minor differences between the support surface with or without the coverlet.

Prediction of pseudoprogression in post-treatment glioblastoma using dynamic susceptibility contrast-derived oxygenation and microvascular transit time heterogeneity measures.

OBJECTIVES: To evaluate the added value of MR dynamic susceptibility contrast (DSC)-perfusion-weighted imaging (PWI)-derived tumour microvascular and oxygenation information with cerebral blood volume (CBV) to distinguish pseudoprogression from true progression (TP) in post-treatment glioblastoma. METHODS: This retrospective single-institution study included patients with isocitrate dehydrogenase (IDH) wild-type glioblastoma and a newly developed or enlarging measurable contrast-enhancing mass within 12 weeks after concurrent chemoradiotherapy. CBV, capillary transit time heterogeneity (CTH), oxygen extraction fraction (OEF), and cerebral metabolic rate of oxygen (CMRO2) were obtained from DSC-PWI. Predictors were selected using univariable logistic regression, and performance was measured with adjusted diagnostic odds with tumour volume and area under the curve (AUC) of receiver operating characteristics analysis. RESULTS: A total of 103 patients were included (mean age, 59.6 years; 59 women), with 67 cases of TP and 36 cases of pseudoprogression. Pseudoprogression exhibited higher CTH (4.0 vs. 3.4, p = .019) and higher OEF (12.7 vs. 10.7, p = .014) than TP, but a similar CBV (1.48 vs. 1.53, p = .13) and CMRO2 (7.7 vs. 7.3s, p = .598). Independent of tumour volume, both high CTH (adjusted odds ratio [OR] 1.52; 95% confidence interval [CI]: 1.11-2.09, p = .009) and high OEF (adjusted OR 1.17; 95% CI:1.03-1.33, p = .016) were predictors of pseudoprogression. The combination of CTH, OEF, and CBV yielded higher diagnostic performance (AUC 0.71) than CBV alone (AUC 0.65). CONCLUSION: High intratumoural capillary transit heterogeneity and high oxygen extraction fraction derived from DSC-PWI have enhanced the diagnostic value of CBV in pseudoprogression of post-treatment IDH-wild type glioblastoma. CLINICAL RELEVANCE STATEMENT: In the early post-treatment stage of glioblastoma, pseudoprogression exhibited both high oxygen extraction fraction and high capillary transit heterogeneity and these dynamic susceptibility contrast-perfusion weighted imaging derived parameters have added value in cerebral blood volume-based noninvasive differentiation of pseudoprogression from true progression. KEY POINTS: • Capillary transit time heterogeneity and oxygen extraction fraction can be measured noninvasively through processing of dynamic susceptibility contrast imaging. • Pseudoprogression exhibited higher capillary transit time heterogeneity and higher oxygen extraction fraction than true progression. • A combination of cerebral blood volume, capillary transit time heterogeneity, and oxygen extraction fraction yielded the highest diagnostic performance (area under the curve 0.71).

Optimizing inpatient bed management in a rural community-based hospital: a quality improvement initiative.

BACKGROUND: Appropriate use of available inpatient beds is an ongoing challenge for US hospitals. Historical capacity goals of 80% to 85% may no longer serve the intended purpose of maximizing the resources of space, staff, and equipment. Numerous variables affect the input, throughput, and output of a hospital. Some of these variables include patient demand, regulatory requirements, coordination of patient flow between various systems, coordination of processes such as bed management and patient transfers, and the diversity of departments (both inpatient and outpatient) in an organization. METHODS: Mayo Clinic Health System in the Southwest Minnesota region of the US, a community-based hospital system primarily serving patients in rural southwestern Minnesota and part of Iowa, consists of 2 postacute care and 3 critical access hospitals. Our inpatient bed usage rates had exceeded 85%, and patient transfers from the region to other hospitals in the state (including Mayo Clinic in Rochester, Minnesota) had increased. To address these quality gaps, we used a blend of Agile project management methodology, rapid Plan-Do-Study-Act cycles, and a proactive approach to patient placement in the medical-surgical units as a quality improvement initiative. RESULTS: During 2 trial periods of the initiative, the main hub hospital (Mayo Clinic Health System hospital in Mankato) and other hospitals in the region increased inpatient bed usage while reducing total out-of-region transfers. CONCLUSION: Our novel approach to proactively managing bed capacity in the hospital allowed the region's only tertiary medical center to increase capacity for more complex and acute cases by optimizing the use of historically underused partner hospital beds.

Disparity in hospital beds' allocation at the county level in China: an analysis based on a Health Resource Density Index (HRDI) model.

BACKGROUND: As approximately 3/4 of the population lives in county-level divisions in China, the allocation of health resources at the county level will affect the realization of health equity. This study aims to evaluate the disparity in hospital beds at the county level in China, analyze its causes, and discuss measures to optimize the allocation. METHODS: Data were drawn from the Chinese County/City Statistical Yearbook (2001-2020). The health resource density index (HRDI) was applied to mediate between the influence of demographic and geographical factors on the allocation of hospital beds. The trends of HRDI allocation were evaluated through the growth incidence curve and the probability density function. The regional disparity in the HRDI was examined through the Lorenz curve, and Dagum Gini coefficient. The contribution of the Gini coefficient and its change were assessed by using the Dagum Gini decomposition method. RESULTS: From 2000 to 2019, the number of hospital beds per thousand people at the county level in China increased dramatically by 1.49 times. From the aspect of the HRDI, there were large regional disparities at the national level, with a Gini coefficient of 0.367 in 2019 and in the three subregions. In 2019, the Gini coefficient of the HRDI exhibited regional variations, with the highest value observed in the western region, followed by the central region and the eastern region. Decomposition reveals that the contribution of interregional disparity changed from the dominant factor to the least important factor, accounting for 29.79% of the overall disparity and the contribution of trans-variation intensity increased from 29.19% to 39.75%, whereas the intraregional disparity remained stable at approximately 31% and became the second most important factor. CONCLUSION: The regional disparity in hospital beds allocation at the county level in China was large and has not improved substantially. Trans-variation intensity was the main reason for the overall disparity and changes, and the intraregional disparity was more important than the interregional disparity for the overall disparity.

Prevention of pressure injuries using a non-motorised decompression air mattress: a non-interventional study.

OBJECTIVE: Prevention of pressure injuries (PI) is a public health issue. Among the preventive measures, the use of support surfaces adapted to the risk of PI occurrence is recommended. This study aimed to report the incidence of PIs in patients at medium-to-high risk of occurrence of PIs and using a new non-motorised automated decompression air mattress combined with other recommended PI prevention measures. METHOD: An observational, national, multicentre, prospective, non-comparative study, with a follow-up period of 35 days was conducted. Patients at medium-to-high risk of PIs and without PIs at baseline were included if they were lying on a specific non-powered automated decompression air mattress. The primary outcome was the percentage of patients who developed at least one category 2 or more severe PI of the sacrum, backbone or heel between day 0 and day 35. RESULTS: In total, 81 patients were included from four participating centres. There was one report of a patient with a PI that fitted within the definition of the primary outcome, meaning an incidence of 1.2% (95% confidence interval (CI) 0-6.7%). More than 80% of patients rated the overall comfort and the stability of the non-motorised automated decompression air mattress as satisfactory or very satisfactory. In more than 80% of cases, the healthcare teams found the use of the mattress to be easy or very easy. CONCLUSION: This study has shown that in combination with other preventive measures, the use of a specific non-motorised air mattress with automated decompression is associated with a low incidence of PIs in patients with medium-to-high risk of occurrence of PIs.

Australian older persons mental health inpatient and ambulatory services in 2015-2020 - A descriptive analysis and commentary.

OBJECTIVE: To provide a commentary on Australian state/territory older persons mental health service (OPMHS) expenditure, inpatient and outpatient services and key performance indicators (KPIs). METHOD: Descriptive analysis of data from the Australian Institute of Health and Welfare (AIHW), the Australian Bureau of Statistics and the World Health Organisation. RESULTS: Between 2015-16 and 2019-20, annual expenditure on OPMHS in Australia increased by an average of only 2.3%, compared to 2.9% for all population groups, despite an increase in the number of over 65 year olds. Per capita recurrent expenditure on OPMHS decreased by an average of 1% annually. Australia's total mental health beds increased, whereas OPMHS beds decreased, mainly due to a reduction in non-acute beds. Outcomes for OPMHS admissions were similar to other age groups, except for a longer length of stay and reduced readmission rate. Older Australians accessed ambulatory mental health care at a lower rate and had a lower rate of improvement after a completed episode. CONCLUSIONS: OPMHS expenditure has not increased at commensurate levels compared to other populations. The mental health of people aged over 65 appears to be a neglected policy priority in Australia. The Royal Commission into Aged Care Quality and Safety may herald service and expenditure changes.

Child and Adolescent Mental Health Services in Australia: A descriptive analysis between 2015-16 and 2019-20.

OBJECTIVE: To provide analysis and commentary on Australian state/territory child and adolescent mental health service (CAMHS) expenditure, inpatient and ambulatory structure and key performance indicators. METHOD: Data from the Australian Institute of Health and Welfare and the Australian Bureau of Statistics were descriptively analysed. RESULTS: Between 2015-16 and 2019-20, overall CAMHS expenditure increased by an average annual rate of 3.6%. Per capita expenditure increased at a higher rate than for other subspeciality services. CAMHS admissions had a higher cost per patient day, shorter length of stay, higher readmission rate and lower rates of significant improvement. Adolescents aged 12-17 had high community CAMHS utilisation, based on proportion of population coverage and number of service contacts. CAMHS outpatient outcomes were similar to other age-groups. There were high rates of 'Mental disorder not otherwise specified', depression and adjustment/stress-related disorders as principal diagnoses in community CAMHS episodes. CONCLUSIONS: CAMHS inpatient admissions had lower rates of significant improvement and higher 14-day readmission rates than other ages. Australia's young population had a high outpatient CAMHS contact rate. Evidence-based modelling of CAMHS providers and outcomes may inform future service improvement.

EFFECTIVENESS OF USING THE BED FUND AND HUMAN RESOURCES FOR PROVIDING MEDICAL CARE TO CHILDREN WITH RESPIRATORY DISEASES.

OBJECTIVE: The aim: Retrospectively evaluate the effectiveness of the use of beds and human resources for the treatment of children with respiratory diseases in hospitals in the period 2008-2021. PATIENTS AND METHODS: Materials and methods: We calculated indicators that characterize the efficiency of the use of bed and personnel resources: the density of beds per 10,000, the rate of hospitalized children per 10,000 (RH per 10,000), the bed occupancy rate per year (BOR), average length of stay (ALOS), full-time positions (FTP) per 100,000, number of beds per 1 FTP of doctors. RESULTS: Results: During 2008-2021, there was a significant decrease in the density of all types of beds. The percentage of hospitalized children for inpatient treatment decreased, BOR decreased, and ALOS decreased. The density of full-time positions of allergists increased by +23.78%, pediatricians by +4.86%, pulmonologists decreased by -13.15%. In 2021, there were 10.31 beds for 1 FTP of an allergist, 12.8 beds for 1 FTP of a pulmonologist, and 5.83 beds for 1 FTP of a pediatrician. According to the correlation matrix, it was established that the more beds there are for 1 full-time position of a pediatrician and 1 full-time position of an allergist, the longer the ALOS and the bed occupancy rate are. CONCLUSION: Conclusions: When planning staffing of health care institutions, it is necessary to mind the level of urbanization of the region, and ensure status of the general practitioner as a leading medical specialist responsible for medical care during the first meeting with the patient and his subsequent follow-up.

CHARACTERISTICS OF THE VOLUME AND OUTCOMES OF MEDICAL CARE FOR PATIENTS WITH SKIN CANCER IN UKRAINE IN 2010-2020.

OBJECTIVE: The aim: To investigate the dynamics of the volumes and outcomes of medical care for patients with skin cancer in Ukraine during 2010-2020. PATIENTS AND METHODS: Materials and methods: Official statistical data from the reports of the Center for Medical Statistics of the Center for public health of the Ministry of Health of Ukraine and the National Cancer Registry for 2010-2020. Statistical and bibliosemantic methods were used in the work. RESULTS: Results: A decrease in the capacity to provide medical care to patients with skin cancer was identified, as evidenced by a decrease in the number of oncological dispensaries, oncological and examination rooms in outpatient clinics, oncological and radiological beds, with a relatively unchanged level of staffing. An analysis of the main indicators of the organization and activities of medical care for patients with cancer skin revealed problems with early detection of tumors, in particular during preventive examinations, and incomplete coverage of patients with stages I-II of the disease with special treatment. The positive dynamics of melanoma treatment outcome indicators were revealed (increase in accumulation index, 5-year patient survival rate, decrease in lethality and mortality). CONCLUSION: Conclusions: the organization of medical care for patients with skin tumors, especially non-melanoma ones, needs further improvement in the context of preventive interventions, ensuring the coverage of patients with special treatment.

Need Analysis of Indian Critical Health Care Delivery in Government Sectors and Its Impact on the General Public: A Time to Revamp Public Health Care Infrastructure.

Background: Poverty is directly linked to public health care delivery in many ways and dimensions. Every aspect of the human sphere is preplanned, but a health crisis is the only emergency which pushes humanity into severe economic stress. Therefore, every nation aims to safeguard its citizens from a health crisis. In this aspect, India needs to improve its public health infrastructure in order to protect its citizens and save them from poverty. Objectives: (1) To assess the current pitfalls in public critical health care delivery, (2) to analyze whether the health care delivery matches the requirements of its population in every state, (3) to produce solutions and guidelines to overcome the stress in this priority area. Materials and methods: Data regarding the critical care workforce, which includes critical care doctors and nurses, were taken from official websites and other sources. Critical care infrastructure data were retrieved from the Internet sources. Data were validated by consulting state government sources and cross-checked for bias elimination. The data were analyzed using the "Statistical Package for Social Sciences" software version 20, and were presented using descriptive statistics. Results: There is a 1:10 percentage of deficit in the case of critical care workforce and infrastructure when compared with its need analysis. Critical care medicine specialists are in 1:75 when compared to other specialties. Conclusion: Overall, the public sector critical care needs a total boost through out of box solutions. According to the Stockholm International Peace Research Institute (SIPRI), India spent the third most on defense in the world in 2021. India spent 76.6 billion dollars on its military in 2021, up 33% from 2012 and 0.9% from 2020. However, since India is considered a fast-growing economy, there is still a huge disparity in critical care. Without resetting critical health care, India cannot grow in welfare indices even if it is among the top gross domestic product (GDP) countries. How to cite this article: Prabu D, Gousalya V, Rajmohan M, Dinesh MD, Bharathwaj VV, Sindhu R, et al. Need Analysis of Indian Critical Health Care Delivery in Government Sectors and its Impact on the General Public: A Time to Revamp Public Health Care Infrastructure. Indian J Crit Care Med 2023;27(4):237-245.

[The ways to resolve problems of forming reserve bed stock on purpose to decrease population mortality].

The article presents analysis of reduction of bed stock, including infectious hospitals, resulted from modernization, intensification and improvement efficiency of processes in health care of Russia. The pandemic of new coronavirus infectious COVID-19 led to increase of mortality not only because of this infection and its complications, but also to large extent from a number of other non-communicable diseases because of forced changes in system of medical care. The article analyzes mortality from the coronavirus infection COVID-19 and a number of non-communicable diseases. The ways of forming reserve bed stock to reduce population mortality are proposed.

Correlated geometric models of order k and its application to intensive care unit and leprosy data.

Geometric models are used to analyse the discrete time until the occurrence of an event of interest (success or consecutive successes). In two real data sets, named leprosy and intensive care unit (ICU), the events correspond, respectively, to abandoning the clinical treatment of leprosy, where abandonment corresponds to four consecutive patient absences from treatment, and the patient's discharge from the ICU. The distribution proposed in this article, called the correlated geometric distribution of order k (or correlated k-order geometric distribution), k≥1 , consists of including a correlation parameter in the geometric distribution of order k, thus considering the dependence between patient responses until the occurrence of the event. This model proves to be a better option for real data analysis where the effect of individual correlation is considered. The model is applied to real leprosy data to estimate the treatment abandonment probability. Bayesian methods are used to determine the parameter estimators of the models and to evaluate regression models. The covariates are related to the probability of the event by an appropriate link function chosen by Bayesian selection criteria. A diagnostic analysis evaluates the models fit by posterior randomized quantile residuals and influential observations by ψ -divergence measures. This methodology is illustrated by simulation studies and real ICU admission data analysis. Studies show a good fit of the proposed model. Real data analyses also find that the probabilities of the event of interest can be overestimated or underestimated when modeled without considering the effect of dependency on the model.