Comparing intensive care units by size or level

Excerpt

Practice makes perfect! The association between higher volumes and better outcomes is nowadays a generally accepted motivation for concentration of care. The strongest associations are found when the task or treatment is high risk or of high complexity. In trauma surgery, percutaneous coronary interventions in myocardial infarction, and many high-risk surgical procedures such a correlation between volume and outcome has been established [1]. It is very tempting to assume that such a volume–outcome relationship does exist for intensive care units (ICUs) as well, which combine both high risk and high complexity. Indeed, several studies have shown a better hospital outcome for high-volume ICUs in comparison to low-volume ICUs [2]. The question really is “is it merely volume or are other variables influencing outcome as well?” …