Occupancy of the Departments of Intensive Care Medicine in Catalonia (Spain): A prospective, analytical cohort study.

BACKGROUND Before deciding increases in the number or capacitance of Intensive Care Units (ICUs), or the regionalization of Units, it is essential to know their present effectiveness. OBJECTIVE To analyze the daily occupancy rate of ICUs in Catalonia (Spain) and the frequency of denied admission due to lack of capacity. DESIGN A prospective, observational multicenter study was carried out. PARTICIPANTS A total of 35 out of 40 ICUs of Catalonia (87%). INTERVENTIONS Daily registry. VARIABLES OF INTEREST Open beds and free beds, patients not discharged due to unavailability of ward beds, critically ill patients not admitted due to a lack of ICU beds, and rate of transfer to other ICUs. STATISTICAL ANALYSIS A descriptive cohort analysis was made. RESULTS Daily averages were 383 open ICU beds, 58 available beds (15%), and 16 patients not discharged due to unavailability of ward beds. Each day 6 patients on average were not admitted due to a lack of ICU beds, and one of them (16%) was transferred to another ICU. The mean occupancy rate was 83±19%, and a 100% occupancy rate was reported in 35% of the registries. A subanalysis of the 24 public hospitals demonstrated slightly higher occupancy (87±16%), with a 100% occupancy rate reported in 38% of the registries. CONCLUSIONS The mean occupancy rate of Catalonian ICUs may appear correct, but in some Units over-occupancy very often precludes early ICU treatment and even ICU admission for a significant number of critically ill patients.