Our Experience with Patient Stratification in Critically Ill Patients

Overview

The goal of patient stratification in critical care setting can be seen in effective resource allocation to patients in whom real improvement in medicalstatus or restoration of acceptable quality of life could be expected; this must be done with respect to basic ethical principles. On the other hand, theextent of health care could be restricted in patients not benefiting from it, i.e. in patients in whom the level of care would just prolong the irreversiblestate and could not even possibly change the unfavourable outcome. The paper summarizes the experience with patient stratification in the Departmentof Anesthesia and Intensive Care, Charles University Teaching Hospital Hradec Králové, Czech Republic. In the period between 1996 and 1998 weused the patient stratification system in 356 patients. The level of care was changed in 51 patients. The introduction of stratification system promotesmore effective use of available resources in closed system of health care funding, increasing the availability of the most expensive diagnostic andtherapeutical procedures for patients with better survival prognosis.

Key words:
intensive care – critically ill – ethical principles – legislation