title: ICU service in Taiwan.
abstract: BACKGROUND
  The aim of the study was to understand the current status of intensive care unit (ICU) in order to optimize the resources achieving the best possible care.
  
  
  METHODS
  The study analyzed the status of ICU settings based on the Taiwan National Health Insurance database between March 2004 and February 2009.
  
  
  RESULTS
  A total of 1,028,364 ICU patients were identified. The age was 65 ± 18 years, and 61% of the patients were male. The total ICU bed occupancy rate was 83.8% which went up to 87.3% during winter. The ICU bed occupancy was 94.4% in major medical centers. The ICU stay was 6.5 ± 0.5 days, and the overall ICU mortality rate was 20.2%. The hospital stay was 16.4 ± 16.8 days, and the average cost of total hospital stay was approximately US$5,186 per patient.
  
  
  CONCLUSIONS
  The rate of ICU bed occupancy was dependent on seasonal changes, and it reached near full capacity in major medical centers in Taiwan. The ICU beds were distributed based on the categories of hospitals in order to achieve a reasonable cost efficiency. ICU faces many challenges to maintain and improve quality care because of the increasing cost of state-of-the-art technologies and dealing with aging population.
authors.affiliation: Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan ; Department of Safety Health and Environmental Engineering, Chung Hwa University of Medical Technology, Tainan, Taiwan ; Department of Medicine, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Kuo-Chen
authors.initials: KC
authors.lastname: Cheng
authors.affiliation: Department of Medical Research, Chi Mei Medical Center, Tainan, Taiwan.
authors.forename: Chin-Li
authors.initials: CL
authors.lastname: Lu
authors.affiliation: Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.
authors.forename: Yueh-Chih
authors.initials: YC
authors.lastname: Chung
authors.affiliation: Bureau of National Health Insurance Kao-Ping Branch, Kaohsiung, Taiwan.
authors.forename: Mei-Chen
authors.initials: MC
authors.lastname: Huang
authors.affiliation: Department of Intensive Care Medicine, Chi Mei Medical Center, Tainan, Taiwan.
authors.forename: Hsiu-Nien
authors.initials: HN
authors.lastname: Shen
authors.affiliation: Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.
authors.forename: Hsing-Min
authors.initials: HM
authors.lastname: Chen
authors.affiliation: The Keenan Research Centre in Biomedical Science, St. Michael's Hospital, Toronto, University of Toronto, Room 619, 209 Victoria Street, Toronto, Ontario M5B 1T8 Canada.
authors.forename: Haibo
authors.initials: H
authors.lastname: Zhang
keywords: Bed occupancy; Critical illness; ICU structure; Medical expenditure