ICUs are being used too often on patients who don’t need an intensive level of care, study finds

Hospitals send too many patients in intensive care units (ICUs), where care is a lot more expensive and invasive, even if they don’t need it, according to a study from the University of California (UC), Los Angeles. The study, published in JAMA Internal Medicine, identified the need for better and more efficient allocation of ICU resources after looking at data from 800 ICU-admitted patients from July 2015 through June 2016 at Harbor-UCLA Medical Center.

Researchers determined that about 52 percent of the patients should have received hospital treatment outside of the ICU because they were either too sick or not sick enough to justify invasive ICU care. Specifically, 23 percent required close monitoring but not ICU-level care, while about 21 percent were classified as critically ill but with little hope of recovery. In eight percent of the cases, patients were unfortunately likely to die regardless of whether care was being rendered in the ICU or on a non-ICU basis.

“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,” explained Dr. Dong Chang, a co-author of the study. “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.”

“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,” he added.

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While Chang and his team acknowledged that the research focused on only one medical facility, he suggested that ICU overuse could be going on at other hospitals. He also expressed concern about the number of patients with irreversible illnesses, such as advanced-stage cancer or dementia, who received aggressive care after ICU admissions.

The study also suggested that healthcare providers more closely follow Society of Critical Care Medicine (SCCM) guidelines which prioritize ICU admissions into categories starting with those patients who are critically ill.

Clinical restraint and discussing care options with patients and their loved ones is also appropriate in this context, Dr. Chang added. “I believe that for many physicians it is reflexive to admit patients who are very ill to the ICU. However, as a medical community, we have to recognize that for some patients this results in no substantial long-term clinical benefit at best, and invasive treatments that can be harmful at worst.” He also acknowledged the necessity to gather more data about the tendency for doctors to admit patients to ICUs for care that may not necessarily be needed.

As a practical mater, it would be expected in many instances for a layperson who falls seriously ill, or has an ill family member, to expect the most aggressive care available. No ordinary person really knows how he or she would react when faced with a potentially life-threatening scenario.

In general, a disinterested cynic on the outside might wonder, however, if the purported ICU overuse in a given hospital, if or when it occurs, is profit driven or motivated by concerns about lawsuits, or both.

Citing a study from the Health Affairs journal, Natural News previously reported that hospitals are allegedly marking up their medical services to the tune of over 1,000 percent above and beyond actual costs, running up the bills of the uninsured and out-of-network patients the most. Hospitals are also breeding grounds for drug-resistant superbugs, and about 75,000 people die in the U.S. ever year from infections acquired in medical facilities, according to the Centers for Disease Control and Prevention.

Sources include:

News-Medical.net

JAMANetwork.com

DailyBreeze.com