Key messages

• Effective resource management in the intensive care unit (ICU) is largely dependent on the clear definition of intensive care policies at regional and hospital level.

• Managerial tools such as cost accounting systems and budgets, if correctly implemented, enhance the quality of ICU management, particularly with respect to resource use.

• When comparing ICUs, only the direct costs should be considered as they reflect resource use under the responsibility of the ICU manager.

• When evaluating ICU management, the direct costs should be considered together with ICU output and patient characteristics.

• The costs and the cost structure in the ICU should reflect the number and the type of activities.

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