title: Development of an intensive care unit resource assessment survey for the care of critically ill patients in resource-limited settings.
abstract: Capacity to provide critical care in resource-limited settings is poorly understood because of lack of data about resources available to manage critically ill patients. Our objective was to develop a survey to address this issue.
  
  
  
  We developed and piloted a cross-sectional self-administered survey in 9 resource-limited countries. The survey consisted of 8 domains; specific items within domains were modified from previously developed survey tools. We distributed the survey by e-mail to a convenience sample of health care providers responsible for providing care to critically ill patients. We assessed clinical sensibility and test-retest reliability.
  
  
  
  Nine of 15 health care providers responded to the survey on 2 separate occasions, separated by 2 to 4 weeks. Clinical sensibility was high (3.9-4.9/5 on assessment tool). Test-retest reliability for questions related to resource availability was acceptable (intraclass correlation coefficient, 0.94; 95% confidence interval, 0.75-0.99; mean (SD) of weighted κ values = 0.67 [0.19]). The mean (SD) time for survey completion survey was 21 (16) minutes.
  
  
  
  A reliable cross-sectional survey of available resources to manage critically ill patients can be feasibly administered to health care providers in resource-limited settings. The survey will inform future research focusing on access to critical care where it is poorly described but urgently needed.
authors.affiliation: Interdepartmental Division of Critical Care, University of Toronto, Toronto, Canada; Division of Critical Care Medicine, University Health Network, Toronto, Canada. Electronic address: aleksandra.leligdowicz@uhn.ca.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Leligdowicz
authors.affiliation: Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA. Electronic address: satsb@uw.edu.
authors.forename: Satish
authors.initials: S
authors.lastname: Bhagwanjee
authors.affiliation: Department of Medicine, California Pacific Medical Center, San Francisco, CA. Electronic address: dr.jvdiaz.criticalcare@gmail.com.
authors.forename: Janet V
authors.initials: JV
authors.lastname: Diaz
authors.affiliation: Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. Electronic address: wx.stats@gmail.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Xiong
authors.affiliation: Interdepartmental Division of Critical Care, University of Toronto, Toronto, Canada; Keenan Research Center at the Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Canada. Electronic address: marshallj@smh.ca.
authors.forename: John C
authors.initials: JC
authors.lastname: Marshall
authors.affiliation: Interdepartmental Division of Critical Care, University of Toronto, Toronto, Canada; Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. Electronic address: Rob.Fowler@sunnybrook.ca.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Fowler
authors.affiliation: Interdepartmental Division of Critical Care, University of Toronto, Toronto, Canada; Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. Electronic address: neill.adhikari@utoronto.ca.
authors.forename: Neill Kj
authors.initials: NK
authors.lastname: Adhikari
mesh_terms: D003422:Critical Care / Q000191:economics*; D016638:Critical Illness / Q000628:therapy*; D003430:Cross-Sectional Studies; D014943:Global Health; D006801:Humans; D007362:Intensive Care Units / Q000191:economics*; D020407:Internet; D008507:Medically Underserved Area; D017063:Outcome Assessment, Health Care; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires
keywords: Intensive care unit; Low-resource setting; Survey; resources