BACKGROUND\r\nStructures in intensive care medicine comprise human as well as material resources, organization, and management and may be related to processes thereby affecting patients' outcomes. Utilizing a unique data base we evaluated structures of German intensive care units (ICUs).\r\nMETHODS\r\nThe study was carried out by the German Competence Network Sepsis (SepNet). Data were prospectively collected on a cross-sectional basis in a representative random sample of German hospitals utilizing a questionnaire. Structures were related to ICU outcome of patients with severe sepsis or septic shock. The sample was subdivided in 5 strata according to hospital size.\r\nRESULTS\r\nA total of 454 ICUs cared for 3877 patients including 415 patients (11\%) with severe sepsis or septic shock. The mean number of beds per ICU was 10.4, the ratio of ICU to hospital beds 1:27, both with significant differences depending on hospital size. 81\% of the ICUs provided around the clock physician presence (range: 66-98\% across hospital strata, p < 0.001). Shift-wise, one nurse was responsible for a mean number of 2.7 patients (morning 1:2.3, afternoon 1:2.6, night 1:3.3 patients) with significant variation according to hospital size (smaller hospitals 1:2.9, university hospitals 1:2.1, p < 0.001). More than half of all German ICUs are lead by anesthesiologists. Neither physician nor nurse staffing was associated with mortality in the subset of patients with sepsis.\r\nCONCLUSIONS\r\nIn a representative, nationwide sample of German ICUs key elements of structures varied considerably with respect to hospital size. This has to be considered when proposing standards, reimbursement strategies, or quality assessment.
%0 Journal Article
%1 Graf.2010
%A Graf, Jürgen
%A Reinhold, Andrea
%A Brunkhorst, Frank M.
%A Ragaller, Max
%A Reinhart, Konrad
%A Loeffler, Markus
%A Engel, Christoph
%D 2010
%J Wiener klinische Wochenschrift
%K Delivery_of_Health_Care/statistics_&_numerical_data Female Germany/epidemiology Humans Intensive_Care/utilization Intensive_Care_Units/utilization Male Sepsis/epidemiology/therapy Workload/statistics_&_numerical_data
%N 19-20
%P 572–578
%T Variability of structures in German intensive care units--a representative, nationwide analysis
%V 122
%X BACKGROUND\r\nStructures in intensive care medicine comprise human as well as material resources, organization, and management and may be related to processes thereby affecting patients' outcomes. Utilizing a unique data base we evaluated structures of German intensive care units (ICUs).\r\nMETHODS\r\nThe study was carried out by the German Competence Network Sepsis (SepNet). Data were prospectively collected on a cross-sectional basis in a representative random sample of German hospitals utilizing a questionnaire. Structures were related to ICU outcome of patients with severe sepsis or septic shock. The sample was subdivided in 5 strata according to hospital size.\r\nRESULTS\r\nA total of 454 ICUs cared for 3877 patients including 415 patients (11\%) with severe sepsis or septic shock. The mean number of beds per ICU was 10.4, the ratio of ICU to hospital beds 1:27, both with significant differences depending on hospital size. 81\% of the ICUs provided around the clock physician presence (range: 66-98\% across hospital strata, p < 0.001). Shift-wise, one nurse was responsible for a mean number of 2.7 patients (morning 1:2.3, afternoon 1:2.6, night 1:3.3 patients) with significant variation according to hospital size (smaller hospitals 1:2.9, university hospitals 1:2.1, p < 0.001). More than half of all German ICUs are lead by anesthesiologists. Neither physician nor nurse staffing was associated with mortality in the subset of patients with sepsis.\r\nCONCLUSIONS\r\nIn a representative, nationwide sample of German ICUs key elements of structures varied considerably with respect to hospital size. This has to be considered when proposing standards, reimbursement strategies, or quality assessment.
@article{Graf.2010,
abstract = {BACKGROUND\r\nStructures in intensive care medicine comprise human as well as material resources, organization, and management and may be related to processes thereby affecting patients' outcomes. Utilizing a unique data base we evaluated structures of German intensive care units (ICUs).\r\nMETHODS\r\nThe study was carried out by the German Competence Network Sepsis (SepNet). Data were prospectively collected on a cross-sectional basis in a representative random sample of German hospitals utilizing a questionnaire. Structures were related to ICU outcome of patients with severe sepsis or septic shock. The sample was subdivided in 5 strata according to hospital size.\r\nRESULTS\r\nA total of 454 ICUs cared for 3877 patients including 415 patients (11\%) with severe sepsis or septic shock. The mean number of beds per ICU was 10.4, the ratio of ICU to hospital beds 1:27, both with significant differences depending on hospital size. 81\% of the ICUs provided around the clock physician presence (range: 66-98\% across hospital strata, p < 0.001). Shift-wise, one nurse was responsible for a mean number of 2.7 patients (morning 1:2.3, afternoon 1:2.6, night 1:3.3 patients) with significant variation according to hospital size (smaller hospitals 1:2.9, university hospitals 1:2.1, p < 0.001). More than half of all German ICUs are lead by anesthesiologists. Neither physician nor nurse staffing was associated with mortality in the subset of patients with sepsis.\r\nCONCLUSIONS\r\nIn a representative, nationwide sample of German ICUs key elements of structures varied considerably with respect to hospital size. This has to be considered when proposing standards, reimbursement strategies, or quality assessment.},
added-at = {2014-10-14T15:27:58.000+0200},
author = {Graf, Jürgen and Reinhold, Andrea and Brunkhorst, Frank M. and Ragaller, Max and Reinhart, Konrad and Loeffler, Markus and Engel, Christoph},
biburl = {https://www.bibsonomy.org/bibtex/212851f6d36e847284e346f760b159ffa/drtester},
interhash = {e15fb8ab6422eb5c0573647e200a2728},
intrahash = {12851f6d36e847284e346f760b159ffa},
journal = {Wiener klinische Wochenschrift},
keywords = {Delivery_of_Health_Care/statistics_&_numerical_data Female Germany/epidemiology Humans Intensive_Care/utilization Intensive_Care_Units/utilization Male Sepsis/epidemiology/therapy Workload/statistics_&_numerical_data},
number = {19-20},
pages = {572–578},
timestamp = {2014-10-14T15:27:58.000+0200},
title = {Variability of structures in German intensive care units--a representative, nationwide analysis},
volume = 122,
year = 2010
}