[Intensive care capacities in Germany: provision and usage between 1991 and 2009]

Abstract

Background: The development of provision and usage of intensive care capacity in Germany in the last two decades has not yet been sufficiently studied.

Methods: Based on the official statistical data provided by the Federal Statistical Office (Statistisches Bundesamt) with respect to hospitals, the hospitals were analyzed in four categories: small hospitals (≤199 beds), medium size hospitals (200-499 beds), large hospitals (500-999 beds) and very large hospitals (≥1,000 beds). For the period between 1991 and 2009 the development of hospitals, hospital beds, the number and occupancy of intensive care unit beds, the number of cases and the length of stay of intensive care patients were analyzed.

Results: While the total number of hospital beds decreased, the number of critical care beds increased. During the period between 1991 and 2009 the occupancy rate increased. Also the proportion of critical care beds from all hospital beds doubled and currently exceeds 8% for very large hospitals. An increase in the length of stay in the intensive care units was also observed.

Conclusions: The provision and usage of intensive care capacities have increased steadily and independently of the hospital size in Germany in the last two decades. Major effects of cost reduction measures, such as the introduction of diagnosis-related reimbursement on the provision and usage of intensive care medicine were not observed.