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Study finds over half of ICU visits are unnecessary at U.S. hospital
Patients are either too well or too sick to benefit
A new study from UCLA and LA BioMed revealed that the intensive care unit is overused by patients who don’t require that level of care. The research was published yesterday in the Journal of the American Medical Association Internal Medicine.
All acute care hospitals have at least one ICU, and about 55,000 critically ill patients are cared for each day, according to the Society of Critical Care Medicine. The number of critical care beds in the U.S. rose 15 percent from 2006 to 2010.
The researchers evaluated 808 ICU admissions from July 1, 2015 to June 15, 2016 at Harbor-UCLA Medical Center and revealed that over half of the patients could have been taken care of in less expensive and invasive settings.
Out of those patients, 23.4 percent needed to be closely monitored but it didn’t have to be in an ICU, and 20.9 percent weren’t likely to recover because of the severity of the illness or another underlying illness. For 8 percent of the patients, either death was imminent or the same outcomes were expected in a non-ICU setting.
The researchers also added the number of days each of the patients spent in the ICU. They found that almost 65 percent of the total number of days were spent providing care that had a low likelihood of benefit or would have been manageable in non-ICU settings.
"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,” Dr. Dong W. Chang, author of the study and LA BioMed researcher, said in a statement. “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."
This study only involved one hospital and the results may be different at other medical centers, but the researchers predict that the results will be the same in many institutions. They also noted that the ICU might be the most appropriate level of care in some institutions because they don’t have another option.
Chang stated that in order to solve this issue, hospitals need to improve their ability to identify patients who don’t require ICU-level care. He believes they also need to develop approaches to improve ICU utilization.
