International comparisons of intensive care

Prin, Meghan; Wunsch, Hannah

doi:10.1097/mcc.0b013e32835914d5

Cited by 179 publications

(69 citation statements)

References 57 publications

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“…[9] KZN is a resource-poor setting when compared with international standards such as those in the USA or Germany, where 5 000 and 4 065 individuals, respectively, are served by each ICU bed. [5] Compounding the issue of scarcity is a significantly higher burden of illness and critical illness in this LMIC. [3] Unfortunately, limited evidence currently exists to confirm that the number of ICU beds in KZN is inadequate to serve the population, and data are needed to quantify the extent of the pressure placed on these limited resources.…”

Section: Discussionmentioning

confidence: 99%

“…[3,4,15] The mean age, which is low when compared with HIC ICUs, is to be expected in SA where average life expectancy is 59.6 years. [3][4][5]15] However, the wide age range illustrates that we are not immune to the international trend of a growing aged population.…”

Section: Patient Demographics and Case-mix Of Total Referralsmentioning

confidence: 99%

“…These trends support the idea that the more limited the availability of ICU beds, the more this resource must be reserved for active physiological support of severely ill patients rather than for intensive monitoring purposes. [3][4][5]5] The ICU at Grey's Hospital is primarily a surgical unit, while that at Edendale Hospital caters for a mix of surgical and medical patients. It is therefore to be expected that these units will see a relatively high proportion of surgical patients.…”

Section: Accepted Patient Demographics and Case MIXmentioning

confidence: 99%

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Analysis of referrals and triage patterns in a South African metropolitan adult intensive care service

2015

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Section: Discussionmentioning

confidence: 99%

Section: Patient Demographics and Case-mix Of Total Referralsmentioning

confidence: 99%

Section: Accepted Patient Demographics and Case MIXmentioning

confidence: 99%

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Analysis of referrals and triage patterns in a South African metropolitan adult intensive care service

2015

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“…Comparative epidemiological data on ICU capacity is important for rational allocation of health care resources and to deliver life-saving, cost-efficient intensive care services, especially in settings where resources are scarce [36,37]. However, the burden of critical illness and its global variation are not well established, even by the Global Burden of Disease project [4,9,21,38].…”

Section: Challenges To Critical Care In Resource-limited Settings Gapmentioning

confidence: 99%

Global Critical Care: Moving Forward in Resource-Limited Settings

Dı́az

Riviello

Papali

et al. 2019

Annals of Global Health

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IntroductionCritical care is an important component of health care systems around the world (Figure 1). Caring for critically ill patients in resource-rich settings typically involves treatment in intensive care units (ICUs) staffed with highly specialized health care professionals, systematic monitoring and use of high-cost technology [1]. Unfortunately, these components are not always available in resource-limited settings [2, 3], where the burden of disease is greater [4], outcomes are poorer [5, 6], and local characteristics require context-specific approaches to the organization of critical care services.Critical care delivery, education, and research require a global perspective based on epidemiologic considerations. The burden of critical illness in resource-limited settings is not well described, but the best available estimates suggest that it may be greater than in resource-rich settings [7, 8] due to deficiencies in access to health care, emergency triage, and lack of early recognition [9][10][11]. Mortality for adults with sepsis [5, 12, 13] and acute respiratory distress syndrome (ARDS) [14][15][16] in resource-limited settings is higher than in resource-rich settings, and decedents are usually young (mean age 35 years vs. 61 years in United States) [12,17], which contributes to a greater negative downstream social and economic impact. Similarly, there is a higher burden of sepsis and respiratory infection mortality among children [18][19][20][21]. Recent epidemiological changes in global health have created a ' double burden of disease' to resource-limited settings [9,22] due to an increase in the prevalence of non-communicable diseases combined with lack of improvement in the long-recognized higher burden of communicable diseases, maternal and child mortality, malnutrition, and human immunodeficiency virus (HIV)-related complications.Health care professionals from resource-rich and resource-limited settings should take a global perspective on critical care for both ethical and practical reasons. Ethically, health care professionals, trainees, professional societies, non-governmental organizations (NGOs), and international organizations from resource-rich settings have the capacity of deploying resources to improve outcomes for critically ill patients in resource-limited settings [11,23,24]. Assistance can include financial help, knowledge exchange in the form of research and educational partnerships, and capacity building in operations and implementation science. From a practical point of view, supporting resource-limited settings is also important given that inter-related economies, Caring for critically ill patients is challenging in resource-limited settings, where the burden of disease and mortality from potentially treatable illnesses is higher than in resource-rich areas. Barriers to delivering quality critical care in these settings include lack of epidemiologic data and context-specific evidence for medical decision-making, deficiencies in health systems organization and resources, and in...

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“…This epidemic can be pushed back, but only with a collective, coordinated and comprehensive approach that engages the entire machinery of government' [5]. Considering the advanced biotechnology and ICU capacity per citizen (20.0-31.7 ICU beds per 100,000 inhabitant [6], higher than any other country in the world) in the US, the large case number (431, 437 as of April 8) and the high death rate (3.4% as of April 8) of COVID-19 in the US seem puzzling [7]. The fact that the United States and South Korea announced their first cases of COVID-19 on the same day [7] makes the comparison between the US and South Korea even more valuable.…”

mentioning

confidence: 99%

How many COVID-19 cases could have been prevented in the US if its interventions were as effective as those in China and South Korea?

Song

Li³

et al. 2020

Preprint

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The COVID-19 [1] pandemic has forced governments to take measures to contain the spread of the disease [2]; however, the effects have varied significantly from one country to another contingent on governments' responses. Countries that have flattened their coronavirus curves prove that interventions can bring COVID-19 under control. These achievements hold lessons, such as the strict social distancing and coordinated efforts of all government levels in China and massive testing in South Korea, for other countries battling the coronavirus around the world. In this work, we attempt to estimate how many COVID-19 cases could have been prevented in the United States (US) when compared with the US's actual number of cases assuming that on a certain date, the US took China-like or South Korea-like interventions and that these interventions would have been as effective in the US as in China and South Korea. We found that if that date was at the early stage of the outbreak (March 10), more than 99% (1.15 million) fewer infected cases could be expected by the end of the epidemic. This number decreases to 66.03% and 73.06% fewer infected cases with the China-like scenario and the South Korea-like scenario, respectively, if actions were taken on April 1, highlighting the need to respond quickly and effectively to fight the virus. Fur- * Corresponding author

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International comparisons of intensive care

Cited by 179 publications

References 57 publications

Analysis of referrals and triage patterns in a South African metropolitan adult intensive care service

Analysis of referrals and triage patterns in a South African metropolitan adult intensive care service

Global Critical Care: Moving Forward in Resource-Limited Settings

How many COVID-19 cases could have been prevented in the US if its interventions were as effective as those in China and South Korea?

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