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Pro/con debate: Do the benefits of regionalized critical care delivery outweigh the risks of interfacility patient transport?

Jeffrey M Singh12* and Russell D MacDonald23

Author Affiliations

1 Interdepartmental Division of Critical Care and Department of Medicine, University of Toronto, Toronto Western Hospital, 399 Bathurst Street, 2 McLaughlin – 411K, Toronto, Ontario M5T 2S8, Canada

2 Research and Development, Ornge Transport Medicine,20 Carlson Court, Suite 400, Toronto, Ontario M9W 7K6, Canada

3 Division of Emergency Medicine, Department of Medicine, University of Toronto, 2075 Bayview Avenue, Room C-710, Toronto, Ontario M4N 3M5 Canada

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Critical Care 2009, 13:219  doi:10.1186/cc7883

Published: 10 August 2009


You are providing input in planning for critical care services to a large regional health authority. You are considering concentrating some critical care services into high-volume regional centres of excellence, as has been done in other fields of medicine. In your region, this would require several centres with differing levels of expertise that are geographically separated. Given there are inherent risks and time delays associated with interfacility patient transport, you debate whether these potential risks outweigh the benefits of regional centres of excellence.