Intensive care unit availability indexed to patient complexity

Abstract

In this paper, a procedure to estimate a Clinical Unit availability is presented. Service availability depends on multiple resources, some of them redundant, to function properly. However, resource consumption varies according to patient's medical condition. The availability of an Intensive Care Unit (ICU) depends both on basic components (electricity, water) and on requirements set by patient complexity and quantity. We propose using Diagnosis Related Groups (DRG) as an estimator of patient complexity. Accumulated DRG (DRG(a)) represents the quantity/complexity combination that the ICU has to care for at any given moment. Our analysis allowed us to find the theoretical combination of patients that would collapse a clinical unit. This limit was deemed reasonable to expert advisors based on their experience at the ICU. The study was conducted for the adult ICU at the 'Clínica Universitaria de Concepción', a teaching hospital in Concepción, Chile. Data was collected during 4 months and analyzed using reliability theory. Overall reliability and availability results are consistent with incident reports at the Clinic. The procedure and recommendations for unit design and management are applicable to Clinical Units both at early planning stages or for currently working units.