REGIONALIZATION OF CRITICAL CARE MEDICINE - TASK-FORCE REPORT OF THE AMERICAN-COLLEGE-OF-CRITICAL-CARE-MEDICINE

Objectives: To review the existing literature and task force opinions on regionalization of critical care services, and to synthesize a judg ment on possible costs, benefits, disadvantages, and strategies. Data Sources: Pertinent literature in the English language. Study Selection : One hundred forty-six English language papers were studied to determ ine possible ramifications of regionalization of critical care or othe r similar services. Data Extraction: Information on possible influence on the care of the critically ill was sought and integrated with the opinions of task force members. Possible costs, benefits, as well as d isadvantages to the patient, transferring and receiving institutions, and region as a whole were sought. Data Synthesis: Regionalization of critical care services was thought to be advantageous to the patient. The larger academic institutions tend to have more resources, better s ubspecialty availability, and expertise in the care of the critically ill. Efficiency and safety during transport need to be in place. Disad vantages of overutilization, possible costliness to both the referring institution as well as to the receiving institution were outlined. It was agreed that pediatric critical care medicine was a separate issue . Conclusions: Regionalization of critical care medicine probably is b eneficial and the concept should be explored.