![]() If and how these differences should guide safe intensivist staffing strategies is incompletely understood. Studies indicate that care delivered in intensive care units (ICUs) by dedicated intensivists improves short-term outcomes for critically ill patients. The low cohort predicted mortality may limit external validity. We found no association of PIR with hospital mortality across ANZ ICUs. We found no association of PIR with mortality in either the narrow (PIR 1st spline term odds ratio : 1, Wald testing of spline terms p = 0.61) or the broad (1.02, p = 0.4) cohort. The broad cohort of 91,206 patients across 73 ICUs (predicted mortality: 1.9% 7.6% ) had a median PIR of 7.8 (IQR 5.8–10.2). The narrow cohort of 27,380 patients across 67 ICUs (predicted mortality: median 1.2% mean 5.9% ) had a median PIR of 10.1 (IQR 7–14). The broad cohort model included non-PIR physician and non-physician staffing covariables. In each, PIR was modeled using restricted cubic splines to allow for non-linear associations. We used summary statistics to describe both cohorts and multilevel multivariable logistic regression models to assess the association of PIR with mortality. The exposure was average daily PIR and the outcome was hospital mortality. We conducted a retrospective study of adult admissions to ANZ ICUs (August 2016–June 2018) using two cohorts: “narrow”, based on previously used criteria including restriction to ICUs with a single daytime intensivist and “broad”, refined by individual ICU daytime staffing information. We sought to examine the association of patient-to-intensivist ratio (PIR) with hospital mortality in Australia/New Zealand (ANZ) ICUs. ![]() The impact of intensivist workload on intensive care unit (ICU) outcomes is incompletely described and assessed across healthcare systems and countries.
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