The demand for critical care services in the United States will soon outpace the supply of specialists trained in intensive care, a situation that, if not remedied, may prove fatal for critically ill patients.
The solution to this problem lies not in recruiting and training more personnel, but in reorganizing the critical care system nationwide, according to a report from a group of critical care stakeholders, led by University of Pittsburgh School of Medicine researchers and published in the April issue of the journal Critical Care Medicine.
"The number of Americans over the age of 65 is expected to double by 2030. In addition to non-elective medical admissions for critical illness among chronically ill elders, the growth rate in elective surgical procedures requiring intensive care unit admission, such as bypass surgery, is growing fastest among this age group," said Amber E. Barnato, M.D., M.P.H., M.Sc., assistant professor, department of medicine, University of Pittsburgh School of Medicine. "All of this means more and more people will demand already strained intensive care services. This anticipated mismatch between supply and demand is perhaps no different for critical care services than for other medical care disproportionately serving elders , ranging from emergency services to long-term care services , but the opportunities for improving the efficiency of the existing system to meet demand are probably greater."
The report, developed following a meeting of critical care stakeholders called the Prioritizing the Organization and Management of Intensive care Services (PrOMIS) Conference held in September 2005, calls for creation of a tiered, regionalized system for critical care services in an effort to centralize expertise, equipment and facilities. This would make the necessary critical care services readily available to the patients who are most in need.
"Prior conferences aimed at addressing this problem sought input only from critical care professionals, who are a fraction of all the stakeholders," said Dr. Barnato, lead author of the report. "These groups often stated the need for more trained providers. Surveying a wider group of interested parties, we found that this isn't necessarily the best or only solution."