BACKGROUND There is marked regional variation in the availability of neonatal intensive care in the United States. We conducted a study to determine whether a greater supply of neonatologists or neonatal intensive care beds is associated with lower neonatal mortality. METHODS We used the 1996 master files of the American Medical Association and the American Osteopathic Association and 1998 an...

Critical care services are atypical in the wide heterogeneity of their patients. This is in part a reflection of the way in which these services have evolved. The progress of intensive care in the UK has been described as ‘haphazard’, consisting of ‘largely unplanned and unevaluated’ developments that occurred in reaction to changes in surgical and medical practice. There has been debate about ...

The demand for intensive care has increased relentlessly over the past 30 years. It is now regarded as a necessity rather than a luxury. The provision of intensive care has lagged behind that demand. Thus, patients who are judged to need intensive care when a bed is unavailable are increasingly transferred to another hospital for such care. The present commentary discusses intensive care transf...

OBJECTIVES To determine the number of children from a defined population who use intensive care facilities, to analyse bed occupancy data for those children, and to estimate the number of intensive care beds required to satisfy this demand throughout the year. DESIGN Examination of admission data books from intensive care units within the four Birmingham health authorities and the neighbourin...

Int ensive care medicine aims t o of f er cr i t ical pat ient s qual it y medical care adj ust ed t o t heir needs, and in t he safest way possible. This specialized f ield of medical care const i t ut es one of t he main el ement s of al l modern heal t hcare syst ems, represent ing a resource t hat i s increasingly in demand, and which impl ies import ant sanitary costs. In the United States...

The concepts of medical futility and rationing are often misunderstood and lead to significant consternation when resources are stretched and pediatric intensive care unit (PICU) beds are unavailable. While the two concepts overlap, each has its own distinct application and moral justification. Most importantly, we should avoid using one to justify the other. Bioethics professionals should assi...

Methods In a polyvalent ICU of 30 beds, from October 7 to December 3