[Efficiency of use of resources in intensive care units in an urban area]

2710 patients were admitted during 1988 in 14 ICU of a crowded urban area. We determined OMEGA score at the end of the ICU stay. OMEGA scores the intensity of the treatment and depicts the utilisation of resources giving rise to the variable costs. 2085 patients intensively treated resulted in a higher mean OMEGA score than 625 patients only monitored, the length of ICU stay over 8th day increases the allocation of resources. This was conditioned also by the diagnosis in both groups of patients being liver transplant (OLTX) and chronic obstructive lung diseases (COLD), the most resources-consuming intensive patients and cardiovascular (CARD), and drug intoxication (TS), the least ones. The efficiency of the use of resources (i.e. use in survivors) in ICU treatment was 100% in monitored patients and ranges from 47.3% to 90.9% in intensively treated ones: medical unspecified (Mm), COLD, strokes, surgical unscheduled, cardiac arrest, OLTX, pneumonia and ARDS, pulmonary embolism, surgical scheduled, trauma, neurological diseases, TS. Intensive patients could be divided in a group with a good utilization (26.5%) of employed resources: TS, PE, CARD, SS, TR, PNM, NRL, OLTX) in a group with a mean utilisation (50-65%: CCA, strokes, SU) and finally in a group with a weak utilisation of resources (Mm and COLD). We computed also the mean loss of resources for each diagnosis that ranges from COLD (76.1 OMEGA points) to OLTX, strokes, Mm, SU, PNM, CCA, NRL, TR, CARD, SS, PE, and TS (10.2 points). The implications of these results and the possibilities of improving the utilisation of resources in ICU are discussed.