Oct. 7 -- Many people are unnecessarily admitted to hospital intensive care units, a large new study suggests.
Better procedures for selecting patients who need the ICU could save money and improve care, researchers said.
"This study was motivated by my experiences caring for patients in the medical ICU who required maximal life support because, a few weeks or months before, they couldn't afford basic preventive medical services," said study lead author Dr. Gary Weissman, a researcher at the University of Pennsylvania's Palliative and Advanced Illness Research Center.
For the study, his team looked at data from Medicare Fee-for-Service, a Medicare Advantage plan and a large private insurer; together, the data represented about 66 percent of U.S. seniors. Between 2006 and 2015, nearly 100 million were hospitalized, and about 16 million were admitted to the ICU.
As many as 1 in 6 of the ICU admissions could have been avoided, the researchers found.
No "gold standard" exists for who should or should not be admitted to an ICU. Weissman's group, however, argued that ICU admission is preventable in two patient groups:
- Timely outpatient care can prevent hospitalization for people with conditions such as high blood pressure, urinary tract infections or uncontrolled diabetes.
- Among patients nearing the end of life, palliative care, not an ICU, may be appropriate, the researchers said. They added that patients with chronic lung disease, heart failure and neurodegenerative disorders may also be better served outside the ICU.
The report was published online Oct. 4 in the Annals of the American Thoracic Society. "Investing in outpatient, preventive and palliative services should therefore be viewed as an important complementary, if not alternative, strategy to increasing the critical care workforce in seeking to provide the best care for the nation's sickest patients," Weissman and his team said in a journal news release. More information
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