Demand for ever more ICU beds continues to grow in all western countries. The level of demand is independent of the actual density of ICU beds in a given country. Demand is the same in low density countries like Great Brittan, Australia and Canada, as it is in high density countries (US, Germany, Austria). The question here is that if demand were driven by an objective clinical need, demand would be higher in low density countries and lower in high density countries. The study found that demand is usually based on the existing style of practice within their countries, resulting in over utilization. Researchers also found that:

Innovative planners apply an “appropriateness of ICU-use” approach with analysing the actual utilisation by interpreting scores (especially TISS) and by identifying “low-risk” groups and propose a more flexible organisation of ICUs and a higher proportion of (intermediate care unit) IMCU-beds.

Reducing treatment variations plus better (and enforced) admission and discharge guidelines were found to more accurately gage need when evaluating and planning ICUs. This is consistent with recent studies that show ICUs have an inappropriate admissions rate of around a 20%,