Public Health Preparedness

Pandemic, disaster could overwhelm U.S. critical care capacity in certain regions

A new study finds that a pandemic or disaster that affects a small portion of the population could overwhelm critical care capacity in some parts of the United States while leaving capacity unused in other areas. Using the Dartmouth Atlas hospital referring regions (HRRs), Brendan G. Carr, M.D., M.S., and colleagues at the University of Pennsylvania determined there were 67,357 critical care beds in the United States in 2007. Available intensive care unit (ICU) beds ranged from 1.01 to 5.95 beds per 10,000 individuals in each of the 306 HRRs, with a median of just 2.77 available beds per 10,000.

A simultaneous episode of critical illness in a small percentage of the population would exceed regional resources in a substantial number of HRRs, with greater effect in the more urban areas in the Northeastern and Western United States, note the researchers. For example, they calculated that if a crisis affected .02 percent of the more than 2 million people living in Portland, Oregon, 400 critical care beds would be needed. The .02 percent of the population affected in Tampa, Florida, would require 200 critical care beds.

The authors caution that their findings do not signal a need for additional ICU beds. There is little consensus about the optimal number of ICU beds per capita. The findings do, however, highlight the need for comprehensive national health care planning to ensure critical care capacity is coordinated across HRRs so that hospitals are neither overwhelmed nor underutilized in a disaster. This study was funded in part by the Agency for Healthcare Research and Quality (HS17960).

See "Variation in critical care beds per capita in the United States: Implications for pandemic and disaster planning," by Dr. Carr, Daniel K. Addyson, B.S., and Jeremy M. Kahn, M.D., M.S., in the April 14, 2010, JAMA, 303(14), pp. 1371-1372.

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