Hospital ICUs May Be Overused

Many patients admitted to intensive care units probably don’t need treatment in that expensive setting, new research suggests.

“Our study found over 50 percent of patients admitted to the ICU were categorized into groups suggesting that they were potentially either too well or too sick to benefit from ICU care or could have received equivalent care in non-ICU settings,” said Dr. Dong Chang. He is a researcher at the Los Angeles Biomedical Research Institute and the study’s corresponding author.

“This research indicates that ICU care is inefficient because it is devoting substantial resources to patients who are less likely to benefit from this level of care,” he said in an institute news release.

“These findings are a concern for patients, providers and the health care system because ICU care is frequently invasive and comes at a substantial cost,” Chang added.

The researchers tracked just over 800 patients who were admitted to the intensive care unit (ICU) at Harbor-UCLA Medical Center from mid-2015 to mid-2016. Of those, about one-quarter needed to be monitored closely but didn’t need the level of care provided in the ICU.

Another 21 percent were so sick that they weren’t likely to recover; another 8 percent were near death or were expected to have the same outcome outside of the ICU, the researchers found.

“While this is a study of just one hospital and results may differ at other medical centers, we suspect that these characteristics of ICU utilization are commonplace and prevalent in many institutions,” Chang said.

“There is likely to be a subset of patients in which ICU care leads to unwanted, invasive care without significant clinical benefit,” he added.

Figuring out who will benefit most from the ICU will help assure the best care for patients, Chang said. And making sure patients in the ICU really need that level of care will help make the best use of the health care system’s limited resources, he said.

The study was published Dec. 27 in JAMA Internal Medicine.

More information

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Source: HealthDay