Do we have standardization of Intensive Care Units across the Globe
Wunsch and his colleague did the retrospective review of existing national administrative data. They identified sources of data in each country to provide information on acute care hospitals and beds, intensive care units and beds, intensive care admissions, and definitions of intensive care beds. Data were all referenced and from as close to 2005 as possible.
Setting: USA, France, UK, Canada, Belgium, Germany, Netherlands, and Spain.
Results: No standard definition existed for acute care hospital and ICU across countries.
Hospital bed varied in #: USA = 221/100,000, Germany = 593/100,000
Adults ICU bed: UK = 3.3/100,000, Germany = 24/100,000
ICU admissions: UK = 216/100,000, Germany = 2353/100,000
- Ratio of intensive care unit beds to hospital beds was highly correlated across all countries except the United States (r = .90)
- There was minimal correlation between the number of intensive care unit beds per capita and health care spending per capita (r = .45), but high inverse correlation between intensive care unit beds and hospital mortality for intensive care unit patients across countries (r = -.82)
Conclusion: Services vary drastically between countries with significant differences in both numbers of beds and volume of admissions. The number of intensive care unit beds per capita is not strongly correlated with overall health expenditure, but does correlate strongly with mortality.
Editor Comments: Need for standardization among ICU criteria would be a way to compare morbidity and mortality.
Reference: click to get abstract
Wunsch, H, Angus D, Harrison D, Collang O et al. Variation in critical care services across North America and Western Europe. Critical Care Medicine. 36(10):2787-e8, October 2008
