Quality of Care in Medical Intensive Care Unit: A Study in an Apex Tertiary Care Teaching Hospital of Northern India

Introduction:The endpoint in quality healthcare is evaluating the outcome of care being rendered.In India, the outcome of healthcare provided in intensive care units (ICUs) has not been studied extensively.The study was aimed to observe the outcome of care provided in a medical intensive care unit (MICU) at a tertiary care teaching institution in North India. Materials and methods:The study was descriptive and cross sectional.Medical records of all patients, admitted from January to June 2011, were analyzed to study demographic, morbidity and mortality parameters.Simplified acute physiology score (SAPS II) scoring was calculated to assess the severity of the admitted patients.Results: In medical intensive care unit (MICU) from January to June 2011, 203 patients were admitted, and 51.7% of them were admitted from the emergency department.The mean age of admitted patients was 50.62 years, and 59.3% were males.The majority (83.1%) of the patients required mechanical ventilation with an average of 3.8 ventilator days.Reintubation rate was found to be 16.9%.Bedsore rate in MICU was 9.9% of the total, 63.4% of patients required oxygen administration.Average MICU length of stay was 6.5 days with a readmission rate of 2.9%.Mean and median predicted mortality using SAPS II was 31.21% and 27.30% (range 0.1 to 96.6%) respectively.MICU mortality and Hospital mortality of MICU admitted was calculated to be 45.9% and 52.3% respectively.Mean age of the patients who died was 54.23 (range 13 to 98 years).Bed occupancy of MICU was 93.47%.Conclusion: Sepsis with septic shock was the major cause of mortality.Standardised mortality was found to be 1.47.Clinical significance: This study focuses on the quality of care in an intensive care unit setting, which is not a priority in developing countries like India.There have been so to say negligible literature on the same especially in developing countries.This study will help us identify the various parameters to measure the quality of care.