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.