Abstract

Critical care, also known as intensive care, refers to medical treatment and monitoring provided to patients with severe, life-threatening illnesses or injuries in a specialized hospital unit, typically an intensive care unit (ICU). Emerging over half a century ago, the specialty has grown into a multidisciplinary discipline facing the challenges of increased demand driven by aging populations with increasingly complex profiles of comorbidities, workforce shortages, and rapid technological advances.

Although ICUs represent a compelling case study, many of these same pressures extend across the hospital environment as a whole. Hospitals remain sites of both extraordinary innovation and persistent defects in value. These defects are breakdowns in the design and delivery of care that compromise safety, quality, and efficiency.

Despite evidence from industrialized countries that critical care costs represent a significant proportion of acute hospital budgets, a recent systematic review of health economic evaluations conducted in the critical care context identified only 219 relevant studies published over the last 30 years, albeit with a notable spike in publications over the last decade. Furthermore, the number of health economic analyses of other types applied to critical care remains sparse. This scarcity is mirrored in hospital medicine more broadly, in which health economic evaluations of system-level safety and quality initiatives are rare relative to the scale of the problem.