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William A. Knaus, MD

JAMA. 1986;255(9):1176-1177.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

There are two articles in this week's issue of THE JOURNAL that address the important question of what happens when demand for sophisticated medical services, in this case intensive care treatment, exceeds supply.

If you haven't already done so, read the article by Strauss et al¹ first. These investigators were able to cleverly relate the number of available intensive care unit (ICU) beds to physicians' admitting and discharge decisions by matching the number of open beds to the characteristics of patients admitted. What happened when there were few or no empty beds? Medical and surgical patients who were not very ill—for example, patients with chest pain but with a low probability of having a myocardial infarction—the "too healthy," were excluded.

This study is the first to directly link daily variations in ICU bed availability to physicians' decision making. Its theme, however, is one that I increasingly hear during conferences . . . [Full Text PDF of this Article]

Author Affiliations
The George Washington University Medical Center Washington, DC

Footnotes
Address editorial communications to the Editor, 535 N Dearborn St, Chicago, IL 60610.

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