• Kendiss Olafson, Clare Ramsey, Marina Yogendran, Randall Fransoo, Carla Chrusch, Evelyn Forget, and Allan Garland.
• Section of Critical Care, Department of Medicine, University of Manitoba, Winnipeg, MB.
• Health Serv Res. 2015 Feb 1;50(1):237-52.

ObjectiveTo compare methods of characterizing intensive care unit (ICU) bed use and estimate the number of beds needed.Study SettingThree geographic regions in the Canadian province of Manitoba.Study DesignRetrospective analysis of population-based data from April 1, 2000, to March 31, 2007.MethodsWe compared three methods to estimate ICU bed requirements. Method 1 analyzed yearly patient-days. Methods 2 and 3 analyzed day-to-day fluctuations in patient census; these differed by whether each hospital needed to independently fulfill its own demand or this resource was shared across hospitals.Principal FindingsThree main findings were as follows: (1) estimates based on yearly average usage generally underestimated the number of beds needed compared to analysis of fluctuations in census, especially in the smaller regions where underestimation ranged 25-58 percent; (2) 4-29 percent fewer beds were needed if it was acceptable for demand to exceed supply 18 days/year, versus 4 days/year; and (3) 13-36 percent fewer beds were needed if hospitals within a region could effectively share ICU beds.ConclusionsCompared to using yearly averages, analyzing day-to-day fluctuations in patient census gives a more accurate picture of ICU bed use. Failing to provide adequate "surge capacity" can lead to demand that frequently and severely exceeds supply.© Health Research and Educational Trust.

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