The demand for ICU-services is increasing in all western countries and complaints about a lack of ICU-beds arise – independent of the actual density of ICU-services in the countries.
The demand for more ICU-beds triggered a debate on whether it is possible to define an "objective" need. It was the aim of the assessment to analyse conventional as well as innovative planning approaches and to define the determinants of the demand.
Systematic Review, multistep searches in Medline, EmBase, Cochrane, HTA-Database, Websearches, informal searches through planning and HTA-networks; micro-planning for an Austrian region.
The differences between the density of intensive care in Europe and other parts of the Western world is enormous. At a first superficial glance, Austria and Germany - in absolute figures - have many more ICU-beds than any other European country. In relative figures, taken into consideration that Austria has also many more acute care beds, the number of ICU-beds corresponds to the European average. It is therefore impossible to analyse the need for ICU-beds without taking into account the national context of delivered acute hospital services. Although ICU-services take up about 15-20% of the hospital budgets, many questions remain unanswered.
In countries with a high density of ICU-services such as Austria not expanding capacities, but rather making better use of existing resources is recommended. For a fair comparison participation in national databases, in registers as well as benchmarking and quality-assurance programmes should be enforced.
Applying an "appropriateness" approach, the ICU-data of an Austrian region (Tyrol) are analysed and we devise a plan for the region.
01/2002 - 12/2002