Quality improvement of Dutch ICUs from 2009 to 2021: A registry based observational study
Authors' conclusion
Quality of Dutch ICU care based on seven indicators significantly improved from 2009 to 2019 and between-ICU heterogeneity is medium to small, except for pressure ulcers. The COVID-19 pandemic disturbed the trend in quality improvement, but unaltered the between-ICU heterogeneity.
Study context
- Population
- All ICU admissions in the Netherlands from ICUs submitting complete data to the National Intensive Care Evaluation (NICE) registry, 2009–2021
- Participants
- 705,822 ICU admissions
- Exposure
- Change in ICU quality indicators over time, 2009–2019 vs including COVID-19 years 2020–2021
- Outcome
- Development over time of eight ICU quality indicators
- Follow-up
- 2009 to 2021
Methodological detailsnational registry, multilevel regression
- National registry
- Multilevel regression
Main finding
As reported in the abstract
ICU length of stay (LOS), duration of mechanical ventilation (MV), readmissions, in-hospital mortality, hypoglycemia and pressure ulcers decreased significantly between 2009 and 2019
OR <1
Observational data: associations, not effects.
Further findings
Quality indicators including COVID-19 years 2020–2021
- Significant change in MV duration, ICU LOS and pressure ulcers disappeared
Between-ICU heterogeneity (intraclass correlation coefficients (ICC))
- ICC on the quality indicators for all years
- ≤0.07
- ICC for pressure ulcers, 2009 to 2021
- 0.27
Original publication
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