Technical efficiency of high technology medicine

Intensive care units (ICUs) are classic examples of high technology medicine. The ICU has become an essential step in the clinical management of patients passing through a phase of critical illness, However, the costs are extremely h9gh (1% of GNP in the USA), whereas it has not ben adeqyately demonstrated that routine admission to intensive care is associated with an increase in survival rate and a decrease in morbidity. Consequently, intensive care is a logical arena in which to encourage more efficient use. The paper focuses on determinates of the technical efficiency of the ICU. Technical efficiency can only be ensured when the ICU is conceived as a responsibility centre where inputs, throughputs and outputs are measured. The reaponsbility centre in characterized by management control, which is dependent on reliable information regarding incentives and constraints of ICU performance. On the basis of the medical and economic literature, conjectures are made on determinants of ICU performance. In additi...