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Prior studies consistently have shown better patient outcomes when critical care specialists are substantially involved in care of patients in intensive care units (ICUs), but these studies all had methodological limitations. These authors reviewed data from a national ICU database to compare hospital mortality rates in more than 100,000 patients who were cared for either entirely by intensivists or entirely by nonintensivist physicians. Intensivists were defined as physicians who were board certified in critical care medicine, trained in a critical care fellowship, or recognized by the institution as critical care specialists (e.g., burn surgeons).
The standardized mortality ratio (ratio of actual mortality to expected mortality measured by…