© 2013

ICU Resource Allocation in the New Millennium

Will We Say "No"?

  • David W. Crippen
  • Written by leading international experts in critical care practice, biomedical ethics, and law and medicine

  • This is the first book since the advent of the global economic crisis and American health care reform to address resource allocation in critical care, the most expensive utilization in the hospital setting, and often the most demanded, especially in the context of the end of life.

  • Up-to-date information

  • Includes supplementary material:


Table of contents

  1. Front Matter
    Pages i-xxiv
  2. Contrasts in Global Health Care Resource Allocation

    1. Front Matter
      Pages 1-1
    2. Ian M. Seppelt
      Pages 3-10
    3. Frederico Bruzzi de Carvalho, Álvaro Réa Neto, Rodrigo Ferreira Simões, Monica Viegas Andrade
      Pages 11-16
    4. Christopher James Doig
      Pages 17-24
    5. Thomas Kerz
      Pages 25-31
    6. Farhad Kapadia, Atul P. Kulkarni, J. V. Divatia
      Pages 33-38
    7. Eran Segal
      Pages 39-45
    8. Marco Luchetti, Giuseppe A. Marraro
      Pages 47-57
    9. Frank H. Bosch
      Pages 59-64
    10. Stephen Streat
      Pages 65-73
    11. R. Eric Hodgson, Timothy C. Hardcastle
      Pages 75-87
    12. Anna M. Batchelor
      Pages 89-96
    13. Ian M. Seppelt
      Pages 107-112
    14. Rubens Costa-Filho
      Pages 113-121
    15. Randy S. Wax
      Pages 123-129
    16. Thomas Kerz
      Pages 131-138
    17. Farhad Kapadia, J. V. Divatia
      Pages 139-143

About this book


Intensive care medicine is one of the fastest growing services provided by hospitals and perhaps one of the most expensive.  Yet in response to the global financial crisis of the last few years, healthcare funding is slowing or decreasing throughout the world. 


How we manage health care resources in the intensive care unit (ICU) now and in a future that promises only greater cost constraints is the subject of this book, the third in an informal series of volumes providing a global perspective on difficult issues arising in the ICU. 


Leading healthcare experts, including critical care physicians, critical care nurses, ethicists, and attorneys, provide snapshots of current ICU resource allocation in 12 developed countries on which other experts then draw to analyze resource allocation and consumer demand at the level of the global medical village.  The process is repeated with an eye toward the future that takes into account initiatives and reforms now underway.


A fictional healthcare plan, the “Fair & Equitable Healthcare Plan,” is put forth to address weaknesses in existing approaches, and healthcare experts and ethicists are invited to respond to its often provocative provisions.  Structured as a dialogue, the book is a great starting point for serious discussion about the looming issue of ICU healthcare resource allocation.




Crippen Critical Care Health Care Reform ICU Intensive Care Resource Allocation

Editors and affiliations

  • David W. Crippen
    • 1
  1. 1.and Neurological Surgery, University of PittsburghDepartments of Critical Care MedicinePittsburghUSA

About the editors

David W. Crippen, MD, FCCM is Professor of Critical Care Medicine at the University of Pittsburgh School of Medicine and Co-Director, Neurovascular ICU at the University of Pittsburgh Medical Center. He also holds secondary appointments as Professor in the Department of Emergency Medicine and in the Department of Neurologic Surgery. 


Dr. Crippen trained in general surgery, emergency medicine, and critical care medicine. He is a member of the Society for Critical Care Medicine, the European Society for Intensive Care Medicine, and the American College of Emergency Physicians. He is a Fellow of the American College of Critical Care Medicine, has been a Diplomate of the American Board of Emergency Medicine for 20 years, and received the European Diploma in Intensive Care Medicine.


Dr. Crippen is a prolific writer in the medical and popular literature and a frequent speaker at international medical meetings. He moderates the Critical Care Medicine Internet Group (CCM-L) with more than 800 members around the world. Dr. Crippen plays lead and rhythm guitar for the rock group The CODES, has raced motorcycles on off-road and road racing circuits, and collects and tours the world on vintage motorcycles.

Bibliographic information

  • Book Title ICU Resource Allocation in the New Millennium
  • Book Subtitle Will We Say "No"?
  • Editors David Crippen
  • DOI
  • Copyright Information Springer Science+Business Media New York 2013
  • Publisher Name Springer, New York, NY
  • eBook Packages Medicine Medicine (R0)
  • Softcover ISBN 978-1-4614-3865-6
  • eBook ISBN 978-1-4614-3866-3
  • Edition Number 1
  • Number of Pages XXIV, 351
  • Number of Illustrations 2 b/w illustrations, 9 illustrations in colour
  • Topics Intensive / Critical Care Medicine
    Theory of Medicine/Bioethics
    Quality of Life Research
Industry Sectors
Health & Hospitals
Internal Medicine & Dermatology


From the reviews:

“This monograph challenges the critical care community to evaluate the technical, moral, and financial limits of critical care. … Trainees, policy makers, and medical practitioners are an appropriate audience for this book, which features international perspectives on critical care resource utilization. … This book effectively frames the question of resource limitation and offers a short list of strategies to address this concern in the future.” (David J. Dries, Doody's Book Reviews, April, 2013)

“Simply compelling! … dynamic, balanced, and stimulating … challenges readers to question 'how things are done' and 'how things should be done' in the ever changing financial and ethical world of the ICU. … not only a must read for ICU clinicians of all disciplines but also for health economists, health policy makers, ethicists and even the lay public.” (Richard J. Brilli, Critical Care Medicine, Vol. 41 (4), April, 2013)

“It would appeal to individuals with an interest in the different systems of health care delivery, particularly from a global perspective. This book would also serve as an excellent foundation for anyone researching various care models throughout the globe. … intensive care physicians who wrestle daily with questions on how to deliver care in a system with limited resources and ever expanding patient expectations will take great interest in this book.” (Donald Griesdale, Canadian Journal of Anesthesia/Journal canadien d'anesthésie, Vol. 60, 2013)