TY - JOUR
T1 - Intensivists in U.S. acute care hospitals
AU - Halpern, Neil A.
AU - Tan, Kay See
AU - Dewitt, Meghan
AU - Pastores, Stephen M.
N1 - Publisher Copyright:
© 2020 Cambridge University Press. All rights reserved.
PY - 2019
Y1 - 2019
N2 - Objectives: To determine the total numbers of privileged and full-time equivalent intensivists in acute care hospitals with intensivists and compare the characteristics of hospitals with and without intensivists. Design: Retrospective analysis of the American Hospital Association Annual Survey Database (Fiscal Year 2015). Setting: Two-thousand eight-hundred fourteen acute care hospitals with ICU beds. Patients: None. Interventions: None. Measurements and Main Results: Of the 2,814 acute care hospitals studied, 1,469 (52%) had intensivists and 1,345 (48%) had no intensivists. There were 28,808 privileged and 19,996 full-time equivalent intensivists in the 1,469 hospitals with intensivists. In these hospitals, the median (25-75th percentile) numbers of privileged and full-time equivalent intensivists were 11 (5-24) and 7 (2-17), respectively. Compared with hospitals without intensivists, hospitals with privileged intensivists were primarily located in metropolitan areas (91% vs 50%; p < 0.001) and at the aggregate level had nearly thrice the number of hospital beds (403,522 [75%] vs 137,146 [25%]), 3.6 times the number of ICU beds (74,222 [78%] vs 20,615 [22%]), and almost twice as many ICUs (3,383 [65%] vs 1,846 [35%]). At the hospital level, hospitals with privileged intensivists had significantly more hospital beds (median, 213 vs 68; p < 0.0001), ICU beds (median, 32 vs 8; p < 0.0001), a higher ratio of ICU to hospital beds (15.6% vs 12.6%; p < 0.0001), and a higher number of ICUs per hospital (2 vs 1; p < 0.0001) than hospitals without intensivists. Conclusions: Analyzing the intensivist section of the American Hospital Association Annual Survey database is a novel approach to estimating the numbers of privileged and full-time equivalent intensivists in acute care hospitals with ICU beds in the United States. This methodology opens the door to an enhanced understanding of the current supply and distribution of intensivists as well as future research into the intensivist workforce.
AB - Objectives: To determine the total numbers of privileged and full-time equivalent intensivists in acute care hospitals with intensivists and compare the characteristics of hospitals with and without intensivists. Design: Retrospective analysis of the American Hospital Association Annual Survey Database (Fiscal Year 2015). Setting: Two-thousand eight-hundred fourteen acute care hospitals with ICU beds. Patients: None. Interventions: None. Measurements and Main Results: Of the 2,814 acute care hospitals studied, 1,469 (52%) had intensivists and 1,345 (48%) had no intensivists. There were 28,808 privileged and 19,996 full-time equivalent intensivists in the 1,469 hospitals with intensivists. In these hospitals, the median (25-75th percentile) numbers of privileged and full-time equivalent intensivists were 11 (5-24) and 7 (2-17), respectively. Compared with hospitals without intensivists, hospitals with privileged intensivists were primarily located in metropolitan areas (91% vs 50%; p < 0.001) and at the aggregate level had nearly thrice the number of hospital beds (403,522 [75%] vs 137,146 [25%]), 3.6 times the number of ICU beds (74,222 [78%] vs 20,615 [22%]), and almost twice as many ICUs (3,383 [65%] vs 1,846 [35%]). At the hospital level, hospitals with privileged intensivists had significantly more hospital beds (median, 213 vs 68; p < 0.0001), ICU beds (median, 32 vs 8; p < 0.0001), a higher ratio of ICU to hospital beds (15.6% vs 12.6%; p < 0.0001), and a higher number of ICUs per hospital (2 vs 1; p < 0.0001) than hospitals without intensivists. Conclusions: Analyzing the intensivist section of the American Hospital Association Annual Survey database is a novel approach to estimating the numbers of privileged and full-time equivalent intensivists in acute care hospitals with ICU beds in the United States. This methodology opens the door to an enhanced understanding of the current supply and distribution of intensivists as well as future research into the intensivist workforce.
KW - beds
KW - critical care
KW - hospitals
KW - intensive care
KW - intensivists
KW - privileged
UR - http://www.scopus.com/inward/record.url?scp=85063250701&partnerID=8YFLogxK
U2 - 10.1097/CCM.0000000000003615
DO - 10.1097/CCM.0000000000003615
M3 - Article
C2 - 30694817
AN - SCOPUS:85063250701
SN - 0090-3493
VL - 47
SP - 517
EP - 525
JO - Critical Care Medicine
JF - Critical Care Medicine
IS - 4
ER -