Journal of Intensive Medicine Reveals disparities in China’s intensive care units

Critical care medicine is a cornerstone of modern healthcare, providing specialized treatment for patients with life-threatening conditions such as severe infections, organ failure, and traumatic injuries. Intensive care units (ICUs) combine advanced medical technologies with highly trained multidisciplinary teams to stabilize critically ill patients. As populations age and complex diseases become more common, the demand for intensive care services continues to increase. In China, critical care medicine has expanded rapidly alongside improvements in hospital infrastructure and medical technology. However, comprehensive nationwide data describing ICU capacity, workforce characteristics, and available technologies have been limited.

To better understand the current state of ICU services, researchers conducted a nationwide survey examining critical care resources across mainland China. The study collected responses from 3,637 intensivists working in 2,005 hospitals across all 31 provincial regions, representing roughly half of hospitals with ICU facilities nationwide. The survey gathered information on hospital characteristics, ICU capacity, staffing patterns, disease spectrum, and the availability of key medical technologies. Results showed that the median number of ICU beds per hospital was 17, and hospitals admitted about 600 ICU patients annually on average. Nationwide, the mean number of ICU beds was 5.31 per 100,000 people in 2022, indicating that although ICU capacity has grown significantly, it remains relatively limited compared with many developed healthcare systems. Their findings were made available online on February 5, 2026, in the Journal of Intensive Medicine.

The research was led by Professor Dechang Chen from the Department of Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China, along with Professor Xiangdong Guan from the Department of Critical Care Medicine at The First Affiliated Hospital, Sun Yat-sen University, Guangdong, China, and Professor Kaijiang Yu from the Department of Critical Care Medicine, First Affiliated Hospital of Harbin Medical University, China.

The survey identified differences in ICU resources among hospital tiers and regions. Higher-level tertiary hospitals generally had larger ICU units, greater patient volumes, and better access to advanced medical technologies. These hospitals were also more likely to serve as teaching centers and employ physicians with higher academic qualifications. In contrast, hospitals in less developed regions often had smaller ICU facilities and more limited technological capacity.

Despite these differences, the study found that many essential life-support technologies are widely available. Invasive mechanical ventilation was implemented in 98.2% of surveyed hospitals, while continuous blood purification was available in 86.5% and bedside ultrasound monitoring in 71.2%. However, more advanced therapies remain less common. Extracorporeal membrane oxygenation (ECMO), a specialized treatment that temporarily replaces heart and lung function, was available in 24.1% of hospitals. Hospitals with larger bed capacity, higher patient volumes, and teaching hospital status were more likely to implement these advanced technologies.

The study also highlighted the conditions most frequently treated in ICUs. Severe pneumonia, sepsis, septic shock, cardiogenic shock, hypovolemic shock, acute respiratory distress syndrome, and acute kidney injury were among the most common causes of ICU admission. Most medical teams reported experience managing these conditions, reflecting the growing clinical capabilities of critical care professionals across the country.

“Over the past two decades, critical care medicine in China has progressed rapidly, and many hospitals now provide essential life-saving treatments,” said Prof. Chen. “At the same time, differences in infrastructure and access to advanced technologies remain important challenges.”

Researchers believe the findings can support future healthcare planning and policy development. By identifying variations in ICU capacity and technology availability, the survey provides evidence that may help guide improvements in infrastructure, training, and resource distribution.

“Understanding how ICU resources are distributed nationwide is essential for strengthening critical care systems,” said Prof. Yu. “These findings offer valuable insights that can support more equitable access to high-quality intensive care.”

In summary, this nationwide survey provides one of the most comprehensive overviews of ICU resources across mainland China. The findings highlight both the progress made in expanding critical care services and the disparities that remain, offering important guidance for improving ICU capacity, resource distribution, and access to advanced treatments in the future.

Reference
Titles of original paper: The current situation of intensive care units in Chinese mainland: A nationwide survey
Journal: Journal of Intensive Medicine
DOI: https://doi.org/10.1016/j.jointm.2025.08.011

About Professor Dechang Chen
Professor Dechang Chen is the Director of the Intensive Care Unit at Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, China. He serves as the president-elect of the Chinese Society of Critical Care Medicine. A nationally recognized leader, Prof. Chen has played a key role in advancing the standardization and development of critical care medicine in China. His academic work focuses on intensive care systems, emergency preparedness, and quality improvement. He has authored more than 30 articles and contributed extensively to the development of national guidelines and policies shaping critical care practice across hospitals nationwide.

Funding Information
This study was supported by grants from the National Natural Science Foundation of China (grant numbers 82102244, 82172152, 82241044, and 82172154) and the Fundamental Research Funds for the Central Universities (grant number YG2023LC01).