The contribution of intensive coronary care

Coronary care units are expensive consumers of scarce resources, and it is unfortunate that there has been little attempt to evaluate their achievements: even simple data relating outcome to age, duration of stay, and severity are not available. Indirect evidence is presented from the Hospital In-patient Enquiry and the national mortality reports for England and Wales. Over the period in which intensive care facilities have become widespread the hospital admission rates have risen steeply but numbers of hospital deaths have been stable. A part of this decline in case fatality has probably resulted from therapeutic advance, but most is probably due to the admission of larger numbers of milder cases.