Intensive care--a medical audit.

A 4-year audit of one Intensive Care Unit, during which time 1718 patients were admitted, shows that allocating 1% of all acute beds for intensive care purposes is not adequate. This is reflected by the high mortality among the patients discharged from the unit. Sophisticated monitoring equipment led to a marked improvement in mortality rates in each group to which it was applied. Simple to use, automated, biochemical equipment was very cost effective for blood gas measurement but less so for electrolyte determinations. Intensive care is very labour intensive, but the cost benefit in terms of lives saved is large. It is suggested that audits of this type help to identify the consequences, including adverse consequences, of decisions by administrators.