Macroeconomics of the ICU

Intensive care macroeconomics may be defined as the study of fiscal relatio nships between service organization and the processes and outcomes of care. There are substantial international variations in funding intensive care s ervices, which cannot be explained by differences in case mix or population health, Some of the variance may be attributed to the absence of explicit criteria for intensive care resource allocation and utilization at the leve l both of whole populations and within individual hospital services. This c an result in inefficiencies either from excessive funding of unnecessary ca re, or inadequate funding with too little being delivered too late. Managed care is seen as a method for driving cost-efficiency, but will fail if qua lity issues are ignored. Intensive care needs to become much more proactive in its relationships with other hospital services. It should promote resea rch into the processes and outcomes of care, with particular emphasis on fa ctors that may predispose to, and prevent, critical illness, The planning o f intensive care services would be facilitated by a common terminology and uniform methods of needs assessments.