Rational distribution of resources in intensive medicine. Analysis of admission and discharge criteria at intensive care units.

Abstract

Cost-containment in health care has become a major issue in today's practice of medicine. With its needs in advanced technologies and skilled personnel, intensive care is among the most expensive of all hospital activities. This fact makes the analysis of indications for intensive care unit admission, as well as early discharge, of paramount importance: patients who are not likely to benefit from intensive care are at the extremes of disease severity, since low-risk patients are not ill enough to need ICU admission and high-risk patients have a very high mortality, irrespective of intensive care treatment. In this paper we discuss, based on published evidence, the formulation of recommendations for admission and early discharge from ICUs, and also present the Society of Critical Care Medicine guidelines, on this subject.