Critical Care Centre of Critical Care Centre of Excellence MeetingExcellence Meeting

Palm Springs - January 2002Palm Springs - January 2002

E Silva, MD, PhDE Silva, MD, PhDHospital Israelita Albert EinsteinHospital Israelita Albert Einstein

Sao Paulo - BrazilSao Paulo - Brazil

Critical Care in BrazilCritical Care in Brazil

Distribution of ICUsDistribution of ICUs

Inhabitants : Inhabitants : 169,799,170 people169,799,170 people

Life expectancy:Life expectancy:69 years69 years

Child mortality Child mortality (<1y):(<1y):35 / 1,00035 / 1,000

Brazilian Survey - 2000Brazilian Survey - 2000

2.8%2.8%(7.6%)(7.6%)

15.8%15.8%(28.1%)(28.1%)

57.7%57.7%(42.7%)(42.7%)

6.5%6.5%(6.8%)(6.8%)

17.2%17.2%(14.8%)(14.8%)

Source: Brazilian Critical Care Society - 2000 Brazilian Survey - 2000

ICU

POPULATION

Critical Care in BrazilCritical Care in BrazilHOSPITAL CHARACTERISTICSHOSPITAL CHARACTERISTICS

68.4%68.4%privateprivate

hospitalshospitals

31.6%31.6%publicpublic

hospitalshospitals

17.5%17.5%universityuniversityhospitalshospitals

82.5%82.5%non-universitynon-university

hospitalshospitals

0

20

40

60

80

100

< 5 5 to 9 10 to 14 15 to 19 20 to 29 > 29

Critical Care in BrazilCritical Care in BrazilICU DISTRIBUTION BY NUMBER OF BEDSICU DISTRIBUTION BY NUMBER OF BEDS

%%ICUsICUs

Number of BedsNumber of Beds

Critical Care in BrazilCritical Care in BrazilICU CHARACTERISTICSICU CHARACTERISTICS

72.4%72.4%General / AdultGeneral / Adult

5.1%5.1%CoronaryCoronary

4.4%4.4%BurnsBurns

11.6%11.6%PediatricPediatric

6.6%6.6%NeonatalNeonatal

Critical Care in BrazilCritical Care in BrazilICU DISTRIBUTION BY NUMBER OF ADMISSIONSICU DISTRIBUTION BY NUMBER OF ADMISSIONS

Not informedNot informed22.5%22.5%

0

5

10

15

20

25

30

<20 21 to30

31 to40

41 to50

51 to60

61 to70

71 to80

81 to90

>90

%%ICUICU

Mean of admissions (monthly)Mean of admissions (monthly)

Not informedNot informed28%28%

0

10

20

30

40

1 to 2 3 to 4 5 to 6 7 to 8 9 to 10 11 to12

>13

%%ICUICU

DaysDays

Critical Care in BrazilCritical Care in BrazilICU DISTRIBUTION BY LENGTH OF STAYICU DISTRIBUTION BY LENGTH OF STAY

Critical Care in BrazilCritical Care in BrazilPHYSICIAN CHARACTERISTICSPHYSICIAN CHARACTERISTICS

SpecialistSpecialist23.1%23.1%

Non-specialistNon-specialist76.9%76.9%

AMIB membersAMIB members31.8%31.8%

AMIB Non-membersAMIB Non-members68.2%68.2%

Trained by AccreditedTrained by AccreditedInstitutionInstitution

15.3%15.3%

Not trained by AccreditedNot trained by AccreditedInstitutionInstitution

84.7%84.7%

Critical Care in BrazilCritical Care in BrazilDISTRIBUTION OF ICU BY POLICIES IN COMPLIANCEDISTRIBUTION OF ICU BY POLICIES IN COMPLIANCE

0

10

20

30

40

50

24 to 32 33 to41 42 to 50 51 to 59 60 to 66

%%ICUICU

Number of Policies in ComplianceNumber of Policies in Compliance

Total NumberTotal Numberof Policies: of Policies: 7676

Educational resources for ICU Educational resources for ICU

providersproviders

1.1. FCCS/ACLS/ATLSFCCS/ACLS/ATLS

2.2. Meetings / Symposiums:Meetings / Symposiums:

RegionalRegional

NationalNational

PrivatePrivate

3.3. Brazilian JournalBrazilian Journal

4.4. Postgraduate Courses: Postgraduate Courses:

Residency/FellowshipResidency/Fellowship

PhDPhD

Major educational needsMajor educational needs

1.1. Knowledge homogenizationKnowledge homogenization

2.2. Continuous educational Continuous educational

program (specific subjects)program (specific subjects)

3.3. Essential GuidelinesEssential Guidelines

4.4. Adequate medical trainingAdequate medical training

5.5. Evaluation ToolsEvaluation Tools

6.6. Research programsResearch programs

Critical Care in BrazilCritical Care in BrazilSUMMARYSUMMARY