ArticleHealth services research2012
Hospital-level variation in the use of intensive care.
Article in Health services research, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 76 papers, 1 of them a synthesis that pooled it.
What it found
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
76 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Do-not-intubate orders in patients with acute respiratory failure: a systematic review and meta-analysis.Intensive care medicine · 2020Pooled it
- The influence of hospitalization or intensive care unit admission on declines in health-related quality of life.Annals of the American Thoracic Society · 2015Trial
- Intensive care under uncertainty: a qualitative study of how older patients and their relatives wish to contribute to decision-making.European geriatric medicine · 2026Observational
- The functional landscape of critical care: a nationwide study of volume, capability, and institutional variation in South Korea.Acute and critical care · 2026Article
- Applying journey mapping and human-centered design to improve critical care delivery for patients with acute respiratory failure.BMC health services research · 2025Article
- Contemporary reperfusion therapies in patients with intermediate- and high-risk pulmonary embolism.Thrombosis research · 2025Article
- Methicillin-resistantAntimicrobial stewardship & healthcare epidemiology : ASHE · 2025Article
- Long-term trends in intensive care unit hospitalizations in Poland: a study based on the National Hospital Registry, 2012-2021.Archives of medical science : AMS · 2025Article
- Intensive care unit admission criteria: a scoping review.Journal of the Intensive Care Society · 2024Article
- Article
- Hospital factors that influence ICU admission decision-making: a qualitative study of eight hospitals.Intensive care medicine · 2023Article
- More than patient benefit: taking a broader view of ICU admission decisions.Intensive care medicine · 2023Article
- Hospital-level variation in practices and outcomes for patients with severe acute exacerbations of idiopathic pulmonary fibrosis: a retrospective multicentre cohort study.BMJ open respiratory research · 2023Article
- Defining Physiological Decompensation: An Expert Consensus and Retrospective Outcome Validation.Critical care explorations · 2022Article
- Hospital Capacity Strain as a Window into the Value of ICU Admission: Some Answers, More Questions.American journal of respiratory and critical care medicine · 2022Article
- Intensive Care Unit Utilization Following Major Surgery and the Nurse Work Environment.AACN advanced critical care · 2021Article
- Emergency department admissions to the intensive care unit - a national retrospective study.BMC emergency medicine · 2021Article
- Dynamic data in the ED predict requirement for ICU transfer following acute care admission.Journal of clinical monitoring and computing · 2021Article
- Determinants of Medical Practice Variation Among Primary Care Physicians: Protocol for a Three Phase Study.JMIR research protocols · 2020Article
- Evaluation of Low-Value Diagnostic Testing for 4 Common Conditions in the Veterans Health Administration.JAMA network open · 2020Article
16 more citing papers are in PubMed but not listed here.
Corrections and comments
- Erratum issued
Authors and funding
5 authors.
Funding
Abstract
objectiveTo determine the extent to which hospitals vary in the use of intensive care, and the proportion of variation attributable to differences in hospital practice that is independent of known patient and hospital factors. DATA SOURCE: Hospital discharge data in the State Inpatient Database for Maryland and Washington States in 2006. STUDY
designCross-sectional analysis of 90 short-term, acute care hospitals with critical care capabilities. DATA COLLECTION/
methodsWe quantified the proportion of variation in intensive care use attributable to hospitals using intraclass correlation coefficients derived from mixed-effects logistic regression models after successive adjustment for known patient and hospital factors. PRINCIPAL
findingsThe proportion of hospitalized patients admitted to an intensive care unit (ICU) across hospitals ranged from 3 to 55 percent (median 12 percent; IQR: 9, 17 percent). After adjustment for patient factors, 19.7 percent (95 percent CI: 15.1, 24.4) of total variation in ICU use across hospitals was attributable to hospitals. When observed hospital characteristics were added, the proportion of total variation in intensive care use attributable to unmeasured hospital factors decreased by 26-14.6 percent (95 percent CI: 11, 18.3 percent).
conclusionsWide variability exists in the use of intensive care across hospitals, not attributable to known patient or hospital factors, and may be a target to improve efficiency and quality of critical care.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.