Admissions to ICU not always required, study finds
Scientists have published a study in Annals of the American Thoracic Society wherein they have mentioned that not all ICU admissions are necessary and that they may be preventable thereby saving cost and time.
Authors based their findings on analysis of more than 16 million ICU admissions and estimated that between one in six and one in seven such admissions might have been avoided. The data sources included Medicare Fee-for-Service, a Medicare Advantage plan and a large private national insurer. Altogether, the data sources represented nearly two-thirds of U.S. adults age 65 and older and about 13 percent of the entire U.S. population. During this time period, there were nearly 100 million hospital admissions, of which 16.7 percent included an ICU admission.
The authors acknowledge in the article that there is no “gold standard” definition of a preventable ICU admission. For their analysis, they identified two patient groups whose care could potentially be handled better outside the ICU: those with an “ambulatory care sensitive condition” and those with a “life-limiting malignancy” who are nearing the end of their life.
Those in the first group have a chronic or medical condition such as high blood pressure, urinary tract infection or uncontrolled diabetes that with timely outpatient care can prevent the patient from being hospitalized.
Those in the second group are patients with cancer who are likely to die within a year and for whom palliative care may be appropriate. Although the authors only looked at life-limiting malignancy, they noted that ICU admissions may be preventable for other serious illnesses, including chronic lung disease, heart failure and neurodegenerative disorders.