ArticleRevista Brasileira de terapia intensiva
Planning and understanding the intensive care network in the State of Rio de Janeiro (RJ), Brazil: a complex societal problem.
Article in Revista Brasileira de terapia intensiva. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Transition experiences of patients and families upon discharge from intensive care: a scoping review.Revista latino-americana de enfermagem · 2025Article
- Improved performance of an intensive care unit after changing the admission triage model.Scientific reports · 2023Article
- Prioritization of ICU beds with renal replacement therapy support by court order and mortality in a Brazilian metropolitan area.Scientific reports · 2022Article
- Prioritization of ICU beds with renal replacement therapy support by court order and mortality in a Brazilian metropolitan area.Scientific reports · 2022Article
- Demand for Intensive Care beds and patient classification according to the priority criterion.Revista latino-americana de enfermagem · 2021Article
- Practices and challenges on coordinating the Brazilian Unified Health System.Revista de saude publica · 2020Article
- Access to public health services and integral care for women during the puerperal gravid period period in Ceará, Brazil.BMC health services research · 2019Article
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Authors and funding
6 authors.
Funding
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Abstract
objectivesTo determine the optimal number of adult intensive care unit beds to reduce patient's queue waiting time and to propose policy strategies.
methodsMultimethodological approach: (a) quantitative time series and queueing theory were used to predict the demand and estimate intensive care unit beds in different scenarios; (b) qualitative focus group and content analysis were used to explore physicians' attitudes and provide insights into their behaviors and belief-driven healthcare delivery changes.
resultsA total of 33,101 requests for 268 regulated intensive care unit beds in one year resulted in 25% admissions, 55% queue abandonment and 20% deaths. Maintaining current intensive care unit arrival and exit rates, there would need 628 beds to ensure a maximum wait time of six hours. A reduction of the current abandonment rates due to clinical improvement or the average intensive care unit length of stay would decrease the number of beds to 471 and 366, respectively. If both were reduced, the number would reach 275 beds. The interviews generated 3 main themes: (1) the doctor's conflict: fair, legal, ethical and shared priorities in the decision-making process; (2) a failure of access: invisible queues and a lack of infrastructure; and (3) societal drama: deterioration of public policies and health care networks.
conclusionThe queue should be treated as a complex societal problem with a multifactorial origin requiring integrated solutions. Improving intensive care unit protocols and reengineering the general wards may decrease the length of stay. It is essential to redefine and consolidate the regulatory centers to organize the queue and provide available resources in a timely manner, by using priority criteria, working with stakeholders to guarantee clinical governance and network organization.
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