The need for appropriate critical care service provision at non-tertiary hospitals in South Africa.

To the Editor: Critical care is an expensive and labour-intensive undertaking, and it is well recognised that there is a global shortage of intensive care unit (ICU) beds.1 Although there are no recent published data regarding the cost of ICU care, total costs were estimated to exceed R2 000 per patient per day in 1991.2 Despite the cost, it is widely accepted that patients refused ICU admission have a significantly worse outcome.3,4