Intensive care in Germany: classification of units (ITS levels 1–3)
In the German healthcare system, the intensive care unit (Intensivstation, or ITS) is one of the most important hospital departments. It is dedicated to patients in critical, life-threatening conditions such as organ failure, major surgery or severe trauma.
Classification of intensive care in Germany (ITS levels)
Level 1 – Basic intensive care (Basisversorgung)
Usually found in smaller or regional hospitals. These units provide basic but close monitoring, yet they are not equipped to manage very complex cases and cover only a limited number of medical specialties.
Level 2 – Extended intensive care (Erweiterte Versorgung)
These units offer medium to high technical standards, have specialised physicians on staff and support additional disciplines such as cardiology and neurology. They can perform interventions and treatments of medium complexity.
Level 3 – Highly specialised intensive care (Maximalversorgung)
This is the highest level of intensive care, typically located in university hospitals or large tertiary-care centres. They are equipped with advanced technologies such as ECMO and acute dialysis, have isolation rooms and employ multidisciplinary expert teams from all relevant specialties.
Key factors determining the appropriate level of care
Complexity of the patient’s condition and the number of organ systems involved
Need for advanced respiratory or cardiovascular support
Relevant comorbidities and risk of further deterioration
Use of standardised scoring systems such as the SOFA score to assess severity
Quality monitoring in intensive care
All intensive care units in Germany are registered in the national intensive care registry (DIVI-Intensivregister).
Data such as number of beds, available ventilators and mortality rates are continuously recorded.
These data are used for regional emergency coordination and for planning and managing intensive care capacities.
Quick comparison of the ITS levels
| Item | Level 1 | Level 2 | Level 3 |
|---|---|---|---|
| Equipment | Basic | Medium – high | Comprehensive – fully equipped |
| Number of specialties | Limited | Partially extended | Broad and multidisciplinary |
| Ability to handle complex cases | Not possible | Partially possible | Fully prepared |
| When is a patient admitted or transferred? | For simpler, less complex cases | For serious, high-risk situations | For very severe, rare or highly complex conditions |
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