The first suggests that CCM uses too many hospital beds, and ineffectively at that, and a disproportionate quantity of healthcare resources ( 6).
Thought leaders have begun to address the ramifications of increasing or decreasing the national ICU bed supply ( 3– 5). However, there are many opinions about the utilization and costs of ICU beds and CCM resources. These data points are highly referenced as starting parameters for the critical care medicine (CCM) landscape in the US and are the basis for the Society of Critical Care Medicine (SCCM) critical care statistics sheet ( 2). In 2005, intensive care unit (ICU) beds in the United States (US) accounted for 15% of hospital beds occupancy rates were estimated at 68% and costs were roughly $82 billion, or 0.66% of the gross domestic product (GDP) ( 1). This review will also help the intensivist better understand published studies on administrative topics related to CCM and be better prepared to participate in their own local hospital organizations or regional CCM programs. At the national level, an understanding of US ICU beds, use and cost helps provide clarity to the width and scope of the critical care medicine (CCM) enterprise within the US healthcare system. Both methods are based on cost and use data from the national hospital datasets or from defined groups of hospitals or patients. Two costing methodologies can be used to calculate ICU costs: the Russell equation and national projections.
Data for total ICU beds, use and occupancy can be derived from two large national healthcare databases: the Healthcare Cost Report Information System (HCRIS) maintained by the federal Centers for Medicare and Medicaid Services (CMS) and the proprietary Hospital Statistics of the American Hospital Association (AHA). This article is a methodological review to help the intensivist gain insights into the classic and sometimes arcane maze of national databases and methodologies used to determine and analyze the intensive care unit (ICU) bed supply, occupancy rates, and costs in the United States (US).