Macroeconomics of the ICU

Intensive care macroeconomics may be defined as the study of fiscal relationships between service organization and the processes and outcomes of care. There are substantial international variations in funding intensive care services, 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 level both of whole populations and within individual hospital services. This can result in inefficiencies either from excessive funding of unnecessary care, 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 quality issues are ignored. Intensive care needs to become much more proactive in its relationships with other hospital services. It should promote research into the processes and outcomes of care, with particular emphasis on factors that may predispose to, and prevent, critical illness, The planning of intensive care services would be facilitated by a common terminology and uniform methods of needs assessments.