Indian Journal of Critical Care Medicine

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 21 , ISSUE 10 ( 2017 ) > List of Articles


Mapping the characteristics of critical care facilities: Assessment, distribution, and level of critical care facilities from central India

Sanjay Kumar, Santosh Bhaskar, Jai Sharma, Yogesh Sabde, Pradip Bhattacharya

Keywords : Critical care units, India, Intensive Care Unit scoring, levels of Intensive Care Unit, Madhya Pradesh

Citation Information : Kumar S, Bhaskar S, Sharma J, Sabde Y, Bhattacharya P. Mapping the characteristics of critical care facilities: Assessment, distribution, and level of critical care facilities from central India. Indian J Crit Care Med 2017; 21 (10):625-633.

DOI: 10.4103/ijccm.IJCCM_193_17

License: CC BY-ND 3.0

Published Online: 01-12-2016

Copyright Statement:  Copyright © 2017; The Author(s).


Background: In low- and middle-income countries such as India, where health systems are weak, the number of available Critical Care Unit (Intensive Care Unit [ICU]) beds is expected to be low. There is no study from the Indian subcontinent that has reported the characteristics and distribution of existing ICUs. We performed this study to understand the characteristics and distribution of ICUs in Madhya Pradesh (MP) state of Central India. We also aimed to develop a consensus scoring system and internally validate it to define levels of care and to improve health system planning and to strengthen referral networks in the state. Methods: We obtained a list of potential ICU facilities from various sources and then performed a cross-sectional survey by visiting each facility and determining characteristics for each facility. We collected variables with respect to infrastructure, human resources, equipment, support services, procedures performed, training courses conducted, and in-place policies or standard operating procedure documents. Results: We identified a total of 123 ICUs in MP. Of 123 ICUs, 35 were level 1 facilities, 74 were level 2 facilities, and only 14 were level 3 facilities. Overall, there were 0.17 facilities per 100,000 population (95% confidence interval [CI] 0.14–0.20 per 100,000 populations). There were a total of 1816 ICU beds in the state, with an average of 2.5 beds per 100,000 population (95% CI 2.4–2.6 per 100,000 population). Of the total number of ICU beds, 250 are in level 1, 1141 are in level 2, and 425 are in level 3 facilities. This amounts to 0.34, 1.57, and 0.59 ICU beds per 100,000 population for levels 1, 2, and 3, respectively. Conclusion: This study could just be an eye opener for our healthcare authorities at both state and national levels to estimate the proportion of ICU beds per lac population. Similar mapping of intensive care services from other States will generate national data that is hitherto unknown.

PDF Share
  1. Amoateng-Adjepong Y. Caring for the critically ill in developing countries – Our collective challenge. Crit Care Med 2006;34:1288-9.
  2. Dünser MW, Baelani I, Ganbold L. A review and analysis of intensive care medicine in the least developed countries. Crit Care Med 2006;34:1234-42.
  3. WHO Centre for Health Development Ageing and Health Technical Report. A Glossary of Terms for Community Health Care and Services for Older Persons. Vol. 5. Australia: World Health Organization; 2004. p. 35.
  4. Rhodes A, Ferdinande P, Flaatten H, Guidet B, Metnitz PG, Moreno RP, et al. The variability of critical care bed numbers in Europe. Intensive Care Med 2012;38:1647-53.
  5. Lipman J, Lichtman AR. Critical care in Africa. North to South and the future with special reference to Southern Africa. Crit Care Clin 1997;13:255-65.
  6. Bhagwanjee S. Critical care in Africa. Crit Care Clin 2006;22:433-8.
  7. Baker T. Critical care in low-income countries. Trop Med Int Health 2009;14:143-8.
  8. Mungekar BL. Madhya Pradesh Development Report. A Glossary of Terms for Community Health Care and Services for Older Persons. New Delhi: Academic Foundation; 2011. Available from: [Last accessed on 2016 Jan 30].
  9. Medical Council of India. List of Colleges Teaching MBBS; 2015. Available from: [Last accessed on 2015 Jan 20].
  10. Rao HR. Economic Survey of Madhya Pradesh; 2011. Available from: [Last accessed 2016 Jan 25].
  11. Wunsch H, Angus DC, Harrison DA, Collange O, Fowler R, Hoste EA, et al. Variation in critical care services across North America and Western Europe. Crit Care Med 2008;36:2787-93, e1-9.
  12. Rungta N, Govil D, Sheila N, Manish M, Divatia J, Jani CK. Guidelines Committee ISCCM. ICU Planning and Designing in India; 2010. Available from: [Last accessed on 2015 Feb 10].
  13. World Bank Data. Health EXPENDITURE on GDP; 2011-2015. Available from: [Last accessed on 2016 Jan 30].
  14. World Bank Data. Hospital Beds Per 1000 People; 2011-2015. Available from: [Last accessed on 2016 Jan 14].
  15. Depasse B, Pauwels D, Somers Y, Vincent JL. A profile of European ICU nursing. Intensive Care Med 1998;24:939-45.
  16. Kluge GH, Brinkman S, van Berkel G, van der Hoeven J, Jacobs C, Snel YE, et al. The association between ICU level of care and mortality in the Netherlands. Intensive Care Med 2015;41:304-11.
  17. Fernando J, Wickramaratne C, Dissanayake R, Kolambage Sh, Aminda M, Cooray N, et al. Studying current status of intensive care services in Sri Lanka. Int J Crit Illn Inj Sci 2012;2:11-6.
  18. IDCCM Accredited Institutions; 2017. Available from: [Last accessed on 2017 May 05].
  19. Kahn JM, Linde-Zwirble WT, Wunsch H, Barnato AE, Iwashyna TJ, Roberts MS, et al. Potential value of regionalized intensive care for mechanically ventilated medical patients. Am J Respir Crit Care Med 2008;177:285-91.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.