Resource utilization and outcome in Swedish intensive care. What conclusions can be drawn from more than 220.000 patient admissions in a Swedish national intensive care registry (SIR)?

Intensive care is an advanced type of healthcare and is offered to patients with severe failure of vital functions such as circulation, breathing or consciousness.

In the intensive care unit (ICU), patients are given life-sustaining treatment around the clock and have medical staff close by at all times. ICU care cost up to ten times as much as care in a general ward.

Sweden has the second lowest number of ICU beds per 100,000 inhabitants in Europe and a high occupancy rate, which may impact outcomes.

This is particularly the case for patients needing to be moved between ICUs for non-medical reasons which increases their mortality rate.

Lack of resources is also a problem for patients where early intervention could halt progression to critical illness, who instead risk becoming more ill while waiting for a bed in the ICU.International studies show an uneven distribution of resources with about 10% of patients consuming 50% of the resources, but the outcomes for these patients are not fully explored.

Using national longitudinal data from multiple registries, we will study resource utilization in Swedish intensive care and whether outcomes differ within and between groups. In a sub-study we will also investigate the effects of the current covid-19-pandemia on Swedish intensive care.

Our study population is retrieved from the Swedish ICU registry (icuregswe.org), a nationwide quality assessment and research registry, 2015-2019, with an extension of 2020 to incorporate covid-19.

We will analyze resource consumption (length of stay, use of advanced treatments, burden of care), background factors (demographic data, co-morbidities, socioeconomic factors), the nature of the acute illness and to patient outcome (survival, return to work, need for healthcare and social services after discharge).

Findings from this project support optimization and prioritization of resources in the ICU and may thus help every patient to the right treatment at the right time.