Intensive care performance: How should we monitor performance in the future?
Intensive care faces economic challenges. Therefore, evidence proving both effectiveness and efficiency, i.e., cost-effectiveness, of delivered care is needed. Today, the quality of care is an important issue in the health care debate. How do we measure quality of care and how accurate and representative is this measurement? In the following report, several topics which are used for the evaluation of intensive care unit (ICU) performance are discussed: (1) The use of general outcome prediction models to determine the risk of patients who are admitted to ICUs in an increasing variety of case mix for the different intensive care units, together with three major limitations; (2) As critical care outcomes research becomes a more established entity, mortality is now only one of many endpoints that are relevant. Mortality is a limited outcome when assessing critical care performance, while patient interest in quality of life outcomes is relevant; and (3) The Quality Indicators Committee of the Society of Critical Care Medicine recommended that short-term readmission is a major performance indicator of the quality of intensive care medicine.
Tim K Timmers, Luke PH Leenen, Department of Surgery, University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands.
Tim K
TK
Timmers
Tim K Timmers, Luke PH Leenen, Department of Surgery, University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands.
Michiel Hj
MH
Verhofstad
Tim K Timmers, Luke PH Leenen, Department of Surgery, University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands.
Karl Gm
KG
Moons
Tim K Timmers, Luke PH Leenen, Department of Surgery, University Medical Center Utrecht, 3508 GA Utrecht, The Netherlands.
Luke Ph
LP
Leenen
Critical care; Intensive care medicine; Intensive care performance; Quality of care