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Center for Health System Sustainability

Ritesh Maharaj MD, Ph.D.

Visiting Assistant Professor of Health Services, Policy, and Practice
ritesh_maharaj@brown.edu
Research Profile

Biography

Ritesh Maharaj is a critical care physician at King’s College Hospital, London with previous teaching experience at the King’s College London School of Medicine. His research focuses on the organization of health services and its impact on health outcomes. He focuses on critical care services and the effects of centralization, specialization and organizational learning. He is currently researching the supply of critical care services and its impact on mortality.

Recent News

Journal of the Intensive Care Society

Geographical disparities in adult intensive care beds in the English National Health Service: A retrospective, observational panel data study

June 26, 2025
The English National Health Service (NHS) is a publicly funded system, however significant disparities in provision exist. Whereas the national picture of the distribution of Intensive Care Unit (ICU) beds has increased over time, less is understood about the regional variation in the rate of growth in ICU services and whether this is related to population growth. The aim of this study was to describe the national variation in the supply of ICU beds in England and evaluate whether there has been a narrowing of the regional disparities in providing ICU beds over time.
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CHEST Critical Care

The Relationship Between Neighborhood Deprivation and Mortality in a Sepsis Cohort in England

May 2, 2025
Worse health outcomes have been described for patients with sepsis from more deprived neighborhoods, but it is unclear if this disparity gap has narrowed. Moreover, the mechanisms by which neighborhood disadvantage influences sepsis outcomes are not fully understood. This study aims to understand the trajectory of mortality among patients with sepsis in England across varying levels of neighborhood deprivation, and to what extent do patterns of ICU admission and treatment explain the observed differences.
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Acta Anaesthesiologica Scandinavica

Fever management with or without a temperature control device after out-of-hospital cardiac arrest and resuscitation (TEMP-CARE): A study protocol for a randomized clinical trial

April 13, 2025
Fever is associated with brain injury after cardiac arrest. It is unknown whether fever management with a feedback-controlled device impacts patient-centered outcomes in cardiac arrest patients. This trial aims to investigate fever management with or without a temperature control device after out-of-hospital cardiac arrest. The TEMP-CARE trial will investigate if post-cardiac arrest management of fever with or without a temperature control device affects patient-important outcomes after cardiac arrest.
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PLOS One

Does experience matter? Understanding the mechanism of the volume-outcome relationship: Learning-by-doing or economies of scale

March 26, 2025
The volume-outcome relationship has been a commonly invoked policy initiative aimed at improving the quality of healthcare. This inverse relationship between the caseload volume of patients treated and patient mortality has been described across many health settings and in many countries. Despite the large body of literature demonstrating this favourable relationship, most studies have focused on differentiating the effects of selective referral and the true effects of volume. In comparison, there are few studies evaluating the underlying mechanism of the volume-outcome relationship, namely dynamic learning-by-doing or the static effect of economics of scale. Resolving this tension between policies that allow providers to accrue experience over time and policies that promote centralisation of services would make a more compelling argument for policies such as minimum volume standards to be firmly established.
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Ritesh Maharaj MD, PhD