Economic stress and misaligned incentives in critical care medicine in the United States.

OBJECTIVES: This review will provide an overview of issues with economic ramifications intrinsic to the management of intensive care resources and identify some of the external pressures that ultimately influence the provision of intensive care services.
DESIGN: A review of the current literature was performed.
RESULTS: Economic stress is a reality of the management of intensive care resources. The nature of critical care medicine as a technologically heavy, labor intensive, high-cost, limited resource, combined with a projected increase in demand in an era of cost containment, presents an array of challenges.
CONCLUSIONS: It is in the best interest of the care of our patients that critical care providers increase awareness of the many factors influencing our practice economically. It is through such understanding that challenges can be met, solutions can be found, and the quality of intensive care can be improved in a financially sustainable environment.