Global analysis of critical care burden

Abstract

Care of critically ill patients is a specialised task that demands high human and financial resources. In the USA, each day of critical care costs about US$3500 and accounts for 13% of hospital costs, amounting to 1% of GDP. 1 Halpern NA Pastores SM Critical care medicine in the United States 2000–2005: an analysis of bed numbers, occupancy rates, payer mix, and costs. Crit Care Med. 2010; 38: 65-71 Crossref PubMed Scopus (610) Google Scholar Neill Adhikari and Gordon Rubenfeld 2 Adhikari NK Rubenfeld GD Worldwide demand for critical care. Curr Opin Crit Care. 2011; 17: 620-625 Crossref PubMed Scopus (46) Google Scholar estimated that worldwide in 2004 there were 13–20 million mechanically ventilated patients, 1·2–5·5 million patients with acute respiratory distress syndrome, and 15–19 million patients with sepsis. However, despite the rapid expansion of critical care medicine and rising costs associated with treatment of the critically ill worldwide, there is a dearth of information on the epidemiology of critical care, particularly in low-income and middle-income countries. 3 Adhikari NK Fowler RA Bhagwanjee S Rubenfeld GD Critical care and the global burden of critical illness in adults. Lancet. 2010; 376: 1339-1346 Summary Full Text Full Text PDF PubMed Scopus (718) Google Scholar Data on the organisational structure and staffing of intensive care units (ICUs) across different worldwide settings remain scarce, which makes it difficult to estimate current global critical care capacity. 3 Adhikari NK Fowler RA Bhagwanjee S Rubenfeld GD Critical care and the global burden of critical illness in adults. Lancet. 2010; 376: 1339-1346 Summary Full Text Full Text PDF PubMed Scopus (718) Google Scholar This is even more relevant in low-income and middle-income countries where the availability of critical care services is limited and resources have to be used judiciously. Assessment of the worldwide burden of critical illness: the Intensive Care Over Nations (ICON) auditThis large database highlights that sepsis remains a major health problem worldwide, associated with high mortality rates in all countries. Our findings also show a significant association between the risk of death and the global national income and suggest that ICU organisation has an important effect on risk of death. Full-Text PDF