Physician Staffing Patterns and Clinical Outcomes in Critically Ill Patients

Abstract

Approximately 1% of the US gross domestic product is consumed in the care of intensive care unit (ICU) patients.¹ Despite this considerable investment of resources, there is wide variation in ICU organization,^2,3 and studies have suggested that differences in ICU organization may affect patient outcome. For example, staffing ICUs with critical care physicians (intensivists) may improve clinical outcomes.⁴ A conceptual model that explains this finding is that physicians who have the skills to treat critically ill patients and who are immediately available to detect and treat problems may prevent or attenuate morbidity and mortality.² Staffing ICUs with intensivists may also decrease resource use because these physicians may be better at reducing inappropriate ICU admissions, preventing complications that prolong length of stay (LOS), and recognizing opportunities for prompt discharge.²