Volume, outcome, and the organization of intensive care.
Increasing evidence suggests that high case volume is associated with improved outcomes in the intensive care unit (ICU). Potential explanations for the volume-outcome relationship include selective referral, clinical experience and organizational factors common to high-volume ICUs. Distinguishing between these explanations has important health policy implications, because outcomes at low-volume ICUs could be improved either by exporting best practices found at high-volume centers or by regionalizing adult critical care - two very different care strategies. Future research efforts should be directed at better characterizing the process of care in high-volume ICUs and exploring the feasibility of creating a regionalized system of care.
Kahn
Jeremy M
JM
Division of Pulmonary, Allergy & Critical Care, University of Pennsylvania School of Medicine, 723 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104, USA. jmkahn@mail.med.upenn.edu
D001509:Bed Occupancy; D003422:Critical Care / Q000458:organization & administration; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration*; D017063:Outcome Assessment, Health Care