Out-of-hours consultant cover and case-mix-adjusted mortality in intensive care.
UK national recommendations include 24 h non-resident availability of consultants with a sessional commitment to intensive care (intensivists). We tested whether continual availability of such specialists improved standardised mortality ratios compared with non-specialist cover by anaesthetists who also cover other hospital departments. The case-mix-adjusted hospital mortality of intensive-care patients improved significantly in the intensivist group compared with the non-specialist group (standardised mortality ratios 0.81 vs 1.11 ratio 0.73 [95% CI 0.55-0.97]). Introduction of 24 h intensivist cover, therefore, seems to improve outcomes in intensive-care units.
Blunt
M C
MC
Burchett
K R
KR
D018806:APACHE; D000704:Analysis of Variance; D003422:Critical Care; D003953:Diagnosis-Related Groups; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units / Q000592:standards; D008485:Medical Audit; D008511:Medicine; D008875:Middle Aged; D013038:Specialization; D006113:United Kingdom; D000078329:Workforce