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Objectives: To compare intensive care admissions from a defined population of children in 1991 and 1999, during a period of organisational change and centralisation of paediatric intensive care. Design: Two 12-month population-based audits were compared. Data were collected from hospitals in Birmingham and the surrounding districts. Denominator data were obtained from the Office for National Statistics. The place and rate of intensive care admission, the use of mechanical ventilation at admission, mortality and length of stay were compared. Setting: Hospitals in the West Midlands. Participants: All children (<15 yrs) living in Birmingham who received intensive care during the study periods. Measurements and results: The number of Birmingham resident children admitted for intensive care increased from 277 to 510 (p<0.0001) i.e. from 1.3 to 2.3 admissions per 1,000 children per year. The …