Variation in critical care services across North America and Western Europe*
Top Cited Papers
- 1 October 2008
- journal article
- research article
- Published by Wolters Kluwer Health in Critical Care Medicine
- Vol. 36 (10) , 2787-e8
- https://doi.org/10.1097/ccm.0b013e318186aec8
Abstract
Critical care represents a large percentage of healthcare spending in developed countries. Yet, little is known regarding international variation in critical care services. We sought to understand differences in critical care delivery by comparing data on the distribution of services in eight countries. Retrospective review of existing national administrative data. We 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. United States, France, United Kingdom, Canada, Belgium, Germany, The Netherlands, and Spain. Not available. None. No standard definition existed for acute care hospital or intensive care unit beds across countries. Hospital beds varied three-fold from 221/100,000 population in the United States to 593/100,000 in Germany. Adult intensive care unit beds also ranged seven-fold from 3.3/100,000 population in the United Kingdom to 24.0/100,000 in Germany. Volume of intensive care unit admissions per year varied ten-fold from 216/100,000 population in the United Kingdom to 2353/100,000 in Germany. The 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). Absolute critical care services vary dramatically between countries with wide 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. These findings demonstrate the need for critical care data from all countries, as they are essential for interpretation of studies, and policy decisions regarding critical care services.Keywords
This publication has 22 references indexed in Scilit:
- Sepsis in European intensive care units: Results of the SOAP study*Critical Care Medicine, 2006
- International Comparisons of Intensive Care: Understanding the DifferencesPublished by Springer Nature ,2006
- Use of intensive care at the end of life in the United States: An epidemiologic study*Critical Care Medicine, 2004
- Multicenter clinical research in adult critical careCritical Care Medicine, 2002
- The hospital of the future: International trends in the provision and utilisation of hospital careBMJ, 1999
- Antibiotic Susceptibility Among Aerobic Gram-negative Bacilli in Intensive Care Units in 5 European CountriesJAMA, 1999
- INTERNATIONAL COMPARISONS OF CRITICAL CARE OUTCOME AND RESOURCE CONSUMPTIONCritical Care Clinics, 1997
- Survival after the Age of 80 in the United States, Sweden, France, England, and JapanNew England Journal of Medicine, 1995
- The economics and cost-effectiveness of critical care medicineIntensive Care Medicine, 1995
- The Prevalence of Nosocomial Infection in Intensive Care Units in EuropeJAMA, 1995