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Curr Opin Crit Care · Dec 2012
Review Comparative StudyInternational comparisons of intensive care: informing outcomes and improving standards.
- Meghan Prin and Hannah Wunsch.
- Department of Anesthesiology, Columbia University, New York, New York 10032, USA.
- Curr Opin Crit Care. 2012 Dec 1; 18 (6): 700706700-6.
Purpose Of ReviewInterest in international comparisons of critical illness is growing, but the utility of these studies is questionable. This review examines the challenges of international comparisons and highlights areas in which international data provide information relevant to clinical practice and resource allocation.Recent FindingsInternational comparisons of ICU resources demonstrate that definitions of critical illness and ICU beds vary due to differences in ability to provide organ support and variable staffing. Despite these limitations, recent international data provide key information to understand the pros and cons of different availability of ICU beds on patient flow and outcomes, and also highlight the need to ensure long-term follow-up due to heterogeneity in discharge practices for critically ill patients. With increasing emphasis on curbing costs of healthcare, systems that deliver lower cost care provide data on alternative options, such as regionalization, flexible allocation of beds, and bed rationing.SummaryDifferences in provision of critical care can be leveraged to inform decisions on allocation of ICU beds, improve interpretation of clinical outcomes, and assess ways to decrease costs of care. International definitions of key components of critical care are needed to facilitate research and ensure rigorous comparisons.
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