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Table 3 Data extraction of existing guidelines on critical care resource allocation

From: Developing a Thai national critical care allocation guideline during the COVID-19 pandemic: a rapid review and stakeholder consultation

Country/setting

Guiding principles

Target patients

Prioritization criteria

Decision-making process

Implementation conditions

1. Austria [40]

Ethical principles of justice, beneficence, well-being, autonomy

All patients needing critical care

Comorbidities

Decision-maker: intensive care specialist

Process: consultation with designated experts and patients and relatives

Time of decision-making: –

Health resource demand exceeds supply

2. Belgium [11]

First come, first served

Randomization

All patients needing critical care

First-come, first served; medical urgency; cognitive impairment; patient age; comorbidities

Decision-maker: Team of healthcare professionals

Process: consultation with experts (technical, nursing, etc.)/patient’s general practitioner

Time of decision-making: upon admission with daily reassessment

Health resource demand exceeds supply

3. Germany [12]

Clinical success

All patients needing critical care

Comorbidities

Decision-maker: team of healthcare professionals

Process: consultation with experts (technical, nursing, etc.)/patient’s general practitioner

Time of decision-making: upon admission

Health resource demand exceeds supply

4. Italy [23]

Greatest life expectancy

All patients needing critical care

Patient age; Comorbidities

Decision-maker: healthcare staff with patients, proxies + others (ethics committees)

Process: consultation with designated experts and patients/relatives

Time of decision-making: upon admission with daily reassessment

Health resource demand exceeds supply

5. Switzerland [9]

Beneficence

Non-maleficence

Respect for autonomy

Equity

All patients needing critical care

Patient age; comorbidities

Decision-maker: team of healthcare professionals

Process: consultation with ethics committee/team

Time of decision-making: upon admission with reassessment every 2–3 days

 

6. United Kingdom (NHS) [10]

Clinical success

All patients needing critical care

Clinical frailty; comorbidities

Decision-maker: team of healthcare professionals

Process: consultation with experts (technical, nursing, etc.)/patient’s general practitioner

Time of decision-making: upon admission

 

7. United Kingdom (BMA) [41]

Promote safe and effective patient care as far as possible in the circumstances

All patients needing critical care

 

Decision-maker: team of healthcare professionals

Time of decision-making: upon admission

 

8. United States (Hastings Center) [42]

Promote equality and equity in distribution of the risks and benefits in society

All patients needing critical care

 

Decision-maker: healthcare staff with patients, proxies and others (ethics committees)

Process: consultation with designated experts and patients/relatives

Time of decision-making: upon admission

 

9. United States (New York) [24]

Save the most lives

All patients needing critical care

First come, first served; randomization; social usefulness; patient age; comorbidities; Sequential Organ Failure Assessment

Decision-maker: nominated triage officer or triage committees

Process: consultation with experts (technical, nursing, etc.)/patient’s general practitioner 

Time of decision-making: upon admission with reassessment after 48 and 120 h

Health resource demand exceeds supply

10. United States (Pittsburgh) [25]

Duty to care

Duty to steward resources to optimize population health

Distributive and procedural justice

Transparency

All patients needing critical care

Patient age; comorbidities

Decision-maker: nominated triage officer or triage committees

Process: consultation with designated experts

Time of decision-making: upon admission

Health resource demand exceeds supply

11. International (WHO) [43]

Utility and equity, on the basis of health-related considerations

All patients needing critical care

 

Decision-maker: intensive care specialist

Time of decision-making: upon admission

Health resource demand exceeds supply

  1. NHS National Health Service, BMA British Medical Association