Intensive care medicine in Singapore: challenges in a new era.

Introduction The specialty of intensive care medicine (ICM) is rapidly evolving as economic progress, ageing population, urbanisation, improved living standards, better education and rising patient expectations reshape medicine. A recent report by the Committee on Manpower for Pulmonary and Critical Care Societies (COMPACCS) identified care of the critically ill as one area in medicine that is likely to experience a major impact from an increase in the elderly population. A significant portion of health care resources is spent in the intensive care units (ICUs), with up to 2-fold variation in risk-adjusted mortality among units. Thus, it is important to identify ways of providing a service that is both scientific, appropriate and cost effective.