The goal of patient stratification in critical care setting can be seen in effective resource allocation to patients in whom real improvement in medical status or restoration of acceptable quality of life could be expected; this must be done with respect to basic ethical principles. On the other hand, the extent of health care could be restricted in patients not benefiting from it, i.e. in patients in whom the level of care would just prolong the irreversible state and could not even possibly change the unfavourable outcome. The paper summarizes the experience with patient stratification in the Department of Anesthesia and Intensive Care, Charles University Teaching Hospital Hradec Králové, Czech Republic. In the period between 1996 and 1998 we used the patient stratification system in 356 patients. The level of care was changed in 51 patients. The introduction of stratification system promotes more effective use of available resources in closed system of health care funding, increasing the availability of the most expensive diagnostic and therapeutical procedures for patients with better survival prognosis.

        Key words: intensive care – critically ill – ethical principles – legislation