A Cross-Cultural Comparison

This accounts, in part, for the relatively higher proportion of patients transferred to Japanese ICUs in this study from outside facilities (12.4%) when compared to the United States (7.2%), and the relatively higher degree of regionalized ICU care found in Japan. Contributing further to this tendency toward concentrating ICU care in larger facilities is a 1993 national government policy requiring a formalized certification of the need for highly specialized care be undertaken prior to and as part of the transfer triage process. The primary intent of this policy is to ensure that large tertiary, university-based teaching facilities remain focused on specialized care and the advancement of biomedical science. The demonstrable contribution of this policy initiative on ICU care is yet unmeasured, but can serve as a model for programs designed to coordinate and regionalize ICU services in the United States, an issue of growing importance as large health systems continue to coalesce. canadian pharmacy