Intensive Care Medicine

, Volume 22, Issue 7, pp 664–669 | Cite as

The importance of technology for achieving superior outcomes from intensive care

  • P. G. Bastos
  • W. A. Knaus
  • J. E. Zimmerman
  • A. MagalhãesJr
  • X. Sun
  • D. P. Wagner
  • The Brazil APACHE III Study Group
Original

Abstract

Objective

To test the hypothesis that technology availability, staffing, and diagnostic diversity in an intensive care unit (ICU) are associated with the ability to decrease hospital mortality.

Design

Prospective multicenter descriptive cohort study.

Setting

Ten Brazilian medical-surgical ICUs.

Patients

1734 consecutive adult ICU admissions.

Measurements and results

We recorded t the amount of technology, number of diagnoses, and availability of nurses at each ICU. We also used demographic, clinical and physiologic information for an average of 173 admissions to each ICU to calculate standardized mortality ratios (SMRs) for each ICU. The mean SMR for the ten ICUs was 1.67 (range 1.01–2.30). A greater availability of ICU equipment and services was significantly (p<0.001) associated with a lower SMR.

Conclusion

The ability of Brazilian ICUs to reduce hospital mortality is associated with the amount of technology available in these units.

Key Words

Intensive care Outcome and process assessment (health care) Probability models Quality of health care Resource allocation Organization and administration 

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Copyright information

© Springer-Verlag 1996

Authors and Affiliations

  • P. G. Bastos
    • 1
    • 2
  • W. A. Knaus
    • 1
    • 2
  • J. E. Zimmerman
    • 1
    • 2
  • A. MagalhãesJr
    • 1
    • 2
  • X. Sun
    • 1
    • 2
  • D. P. Wagner
    • 1
    • 2
  • The Brazil APACHE III Study Group
  1. 1.Hospital de IpanemaRio de JaneiroBrazil
  2. 2.ICU Research UnitThe George Washington University Medical CenterWashington, DCUSA

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